SELF DECLARATION CERTIFICATE

This is to certify that I, _______________________, CAT Reg. No. __________,

have completed all my examinations (including all practical examinations and
supplementary examinations), required for obtaining bachelor’s degree/equivalent
qualification, as on the date of issue of this certificate.

I also certify that all the results (original/provisional) of these examinations are
being submitted to IIM Lucknow at the time of registration.

I undertake that I shall not join any post-graduation programme at IIM Lucknow (I
understand that IIM Lucknow shall not allow me to join (or continue with) their
programme) in case I am unable to complete all requirements including all
examinations, practical examinations and supplementary examinations for a
bachelor’s degree on or before July 31, 2020.

The deadline for submission of the original marksheets and the original certificates
of these examinations is December 31, 2020. NON FULFILLMENT OF THIS
CONDITION WILL AUTOMATICALLY RESULT IN THE
CANCELLATION OF THE PROVISIONAL ADMISSION.

Date: _________________

Signature of candidate