From:

Dated ..................
Students Name : ......................................................
Fathers Name : .......................................................
Mothers Name : ......................................................
Students Permanent Address : ......................................................
Students Present address : Raipur [c.g.]
D.O.B- ..... ...................
Adhar card no. / ID no. ..............................
University Enrollment no. .......................
To,

The Vice Chancellor,

Kalinga University,
Village- Kotni,
Near Mantralya,
Naya Raipur-492101,
Chhattisgarh

UNDERTAKING/AFFIDAVIT

Respected Sir/Mam,

I .................................... aged about .year , S/o . ............................................... R/

Address . ....................... is a regular student of Kalinga University vide Enrollment
No...................... /Roll No .................... under the course ...................... Yearly hereby tender the
following undertaking with regard to my eligibility document/conduct as a statutory requirement for
admission/award of Mark Cards/Degree,in the aforesaid course.

a) That I have passed my matriculation/10 th /High School Examination in the session

of. .................... bearing roll no...................... from the School/Institute ........................................

Affiliated to ..................... .board.

b) That I have passed my 12th /Sr. Secondary Examination in the session

of........ bearing roll no..............from the School/Institute ....................................... Affiliated

to ............... board.

c) That I have regularly attended the classes and maintained atleast 75% attendance in my
classes.
d) I appeared for my Bachelor /Masters (Please specify). Ist year examination in the
University campus and passed the same, vide roll no .. .. in the year .
From:
Dated ..................
Students Name : ......................................................
Fathers Name : .......................................................
Mothers Name : ......................................................
Students Permanent Address : ......................................................
Students Present address : Raipur [c.g.]
D.O.B- ..... ...................
Adhar card no. / ID no. ..............................
University Enrollment no. .......................
To,

The Vice Chancellor,

Kalinga University,
Village- Kotni,
Near Mantralya,
Naya Raipur-492101,
Chhattisgarh

UNDERTAKING/AFFIDAVIT

Respected Sir/Mam,

I .................................... aged about .year , S/o . ............................................... R/

Address . ....................... is a regular student of Kalinga University vide Enrollment
No...................... /Roll No .................... under the course ...................... Yearly hereby tender the
following undertaking with regard to my eligibility document/conduct as a statutory requirement for
admission/award of Mark Cards/Degree,in the aforesaid course.

a) That I have passed my matriculation/10 th /High School Examination in the session

of. .................... bearing roll no...................... from the School/Institute ........................................

Affiliated to ..................... .board.

b) That I have passed my 12th /Sr. Secondary Examination in the session

of........ bearing roll no..............from the School/Institute ....................................... Affiliated

to ............... board.

c) That I have regularly attended the classes and maintained atleast 75% attendance in my
classes.
d) I appeared for my Bachelor /Masters (Please specify). Ist year examination in the
University campus and passed the same, vide roll no .. .. in the year .
e) That the eligibility documents submitted by me are true & genuine to the best of my
knowledge and belief.
f) That during the course of study I was not in any kind of regular job either in any Govt,
Semi govt or private authority/Company.
g) That during the course of the study I was not doing any other regular course from any
other university.
h) That I was not indulged in any sort of legal cases, Whether Criminal/Civil during the
course of study.
i) That I was not involved in any malpractice, misconduct, fraud in any manner during my
tenure of study in the University.
j) That my above statement is true & correct and in case any document ,information &