BONAFIED HOSTELLER/BOARDER STUDENT DECLARATION CERTIFICATE

For the purpose of availing Post-matric Scholarship for ST, SC, OBC/ SEBC and
Economically Backward Class (EBC) Students

This is to certify that student namely Shri/Kumari/Smt.

_______________________________________________________S/o/D/o/W/o/C/o

Shri/Smt. _________________________________________ having Admission/

Enrolment no._______________, pursuing ____________________________

course/branch in ____________(course year) during the Academic year ____________,

is a bonafied student of

______________________________________________________ (Name of the

college/institution). This is to further certify that, Shri/Kumari/Smt.

_______________________________________________________ is a bonafied

hosteller/boarder student of this College/Institute. He/ She is admitted/ continuing as a

hosteller/boarder w.e.f; _____________ (Date of Admission to Hostel) and residing

Inside/ Out Side campus of this College/Institute.

Principal

(Full Signature of student) (Signature & Seal)

The above-mentioned facts are true as per the College/Institute records and will be
produced on demand for verification by any authorized functionary. If any facts found
incorrect or false, Institution will be liable for stringent action under the law including
refund of the Scholarship Amount.

Principal

(Signature & Seal)