FORM IHA-10, JAWAHARLAL NEHRU UNIVERSITY Inter - Hall Administration Hostel SI.No., APPLICATION FOR TION THE HOSTEL (to be filled in triplicate) ‘The Sr. Warden Hostel Jawaherial Nehru University Sir/Madam, Kindly permit me to leave the Haste! with my personal belongings on. ge andtelura my scanty deport str ausinent des, any. My fre in the Centre, is wens scaumuss enum hace reesei sete AMM leaving the University, rane ‘Signature of Resid eM. enenneone neces Name of the Resident. Binlehiaan tries : ‘Address for future correspondence. i ‘SchoovCentre.. Raoom No. Mess Supervisor Part-I His!Her room has been checked and all furniture and fixtures allotted to him Mher space have been found intact. Damaged , any , have been recovered from him/her vide Receipt No, dt, ‘The possessionikey of the room has been taken end nothing is due from himiher Caretaker's Signature Date No dues are outstanding against him/her, HeyShe has been billed for the Whole Perio’ UP 10 annem and the bill sent to the Cashier. Gaahletacisisinaat hetieconaal cseOMhon InChpEL nin tincscin Ta Mess Supervisor Partai ShrlSmt KM... .allotied of Room No. Sictnol Hostel s permited ieave the hostel along with histher personel belongings « . t vveen MOfUNdEM by Cheque NOW reonnenninn ‘SrWarden Note: 4. Caretaker (to keep copy in the student's fle) 2. Security Guard to keep the Original with him 3.Third copy far stucient's use.