Self-Affidavit

(Please note: this page must be typed on 100 Rupees Stamp Paper with notary stamp, notarized and
registered from the court.)
AFFIDAVIT, DECLARATION AND UNDERTAKING
I, (Student’s name) Mr. /Ms._____ __________________________________________________________________, age____________
Last Exam Passed ___________________________________________________________________________________________________
Address: ______________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
Ph. No. ________________________________________________________________________________________________________________
Do hereby take oath and state on solemn affirmation as under: -
1. I declare and undertake that I agree to abide by the rules of eligibility, conduct and discipline, laid
down by Symbiosis College of Arts and Commerce (SCAC). I agree and declare that I am solely
responsible for any discrepancies or incorrect information supplied by me in the application form
for admission, failing which my admission will stand automatically cancelled and Symbiosis
College of Arts and Commerce (SCAC) is not responsible for the same.
2. I further state that there is no Proxy / Agent admission. I have not paid any extra amount other
than eligibility fee and application form fee to any person at the SCIE or otherwise.
3. I state that I will remain present at the time of Firm admission personally with student visa. I do
hereby undertake that I will pay the fees of USD equivalent to INR 52,725. (USD equivalent to INR
52,725 includes USD equivalent to INR 40,000 towards Entrance fee, USD equivalent to INR 5,500
towards Medical Insurance Charges, USD Equivalent to INR 5,500 towards Medical Check-Up
Charges and USD equivalent to INR 1725 towards Letter of Provisional Eligibility and Admission).
4. I state that, I will abide by the condition that, fees once paid to the SCIE will not be refunded
under any circumstances.
5. I state that I will submit the same documents for both stages. There will be no discrepancy in
Marksheet of first and second stage. In case any discrepancy is found an FIR maybe filed and I will
be deported to my country.
6. I state that I will bring all the attested original documents at the time of my Firm Admission.
In case I am foreign national, marksheet needs to be attested from Ministry of Education or
Indian Embassy in my country or my Country Mission in India.
7. I state that during the course period I will not work with any institute/ firm.
8. In case any Institute/Firm/Organization approaches me for employment I will inform FRO.
9. I understand SCIE is not responsible for any late admission leading to non-filling of late
examination form. It is wholly my responsibility.
10. I accept I will report to FRO as and when required.
11. SCIE and SCAC is not responsible for the lectures’, internal assessments etc that the student
misses due to late admission, or for any other reason.

Whatever stated above is true and correct to the best of my knowledge, belief and information in witness
where of I have signed hereunder at Pune on date…..….………….…. Academic year 2020-21.

Before Me
( ) (Affiant Signature)