Undertaking

Date: ________________

I, Mr./Ms. ____________________________________ Regn. No. __________________

do hereby, undertake that I shall vacate the Room No. _____________________ of Hostel
_________________________ within _____________ days from the date of obtaining my Final
No Dues / Hostel Clearance Certificate, failing which the said room shall be sealed by the Office
of the Warden forthwith. If permitted, I shall pay the guest charge in advance for the duration. I
do not have any objections, if the Office of the Warden finds and disposes of anything belonging
to me lying in the said room at the time of or subsequent to sealing the room. I shall also sign the
Vacating Register/Ledger thereupon.
______________________
Signature of the Candidate
Permitted / Not permitted.

Warden / DyCW / Chief Warden

Official Seal

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Undertaking
Date: ________________

I, Mr./Ms. ____________________________________ Regn. No. __________________

do hereby, undertake that I shall vacate the Room No. _____________________ of Hostel
_________________________ within _____________ days from the date of obtaining my Final
No Dues / Hostel Clearance Certificate, failing which the said room shall be sealed by the Office
of the Warden forthwith. If permitted, I shall pay the guest charge in advance for the duration. I
do not have any objections, if the Office of the Warden finds and disposes of anything belonging
to me lying in the said room at the time of or subsequent to sealing the room. I shall also sign the
Vacating Register/Ledger thereupon.
______________________
Signature of the Candidate
Permitted / Not permitted.

Warden / DyCW / Chief Warden

Official Seal