ANNA UNIVERSITY :: CHENNAI - 600 025

KNOWLEDGE DATA CENTRE

UNDERTAKING FORM TO BE GIVEN BY THE CANDIDATE & PARENT

NAME : CHARAN JAGAN COMMUNITY : Others - CIA

B.E.-ELECTRONICS AND
COURSE : COMMUNICATION CAMPUS : CEG CAMPUS
ENGINEERING[FULL TIME]

We hereby undertake to produce the following certificates in original for physical verification on the date
announced in the respective institution website, failing which I shall forgo my provisional admission.

Kindly tick the applicable boxes.

S.No. DOCUMENTS CHECKLISTS

1 10th MARK SHEET

2 12th MARK SHEET

3 TRANSFER CERTIFICATE

4 ALLOTMENT ORDER

5 AADHAAR CARD

6 PHOTO

7 SIGNATURE

8 ANTI RAGGING FORM

9 UNDERTAKING FORM

10 JOINT DECLARATION FORM

11 MEDICAL FITNESS CERTIFICATE

12 PASSPORT OF THE CANDIDATE

13 VALID STUDENT VISA / PIO / OCI CARD (IN CASE OF CITIZEN OF INDIAN ORIGIN)
PROOF OF FINANCIAL SUPPORT FOR THE LAST SIX MONTHS OR
14 SCHOLARSHIP OFFER LETTER FROM THE GOVERNMENT / OTHER AGENCIES

SIGNATURE OF STUDENT WITH DATE SIGNATURE OF PARENTS WITH DATE

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19/09/2022 19:36:24
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