Rayat Shikshan Sanstha's

R. B. NARAYANRAO BORAWAKE COLLEGE, SIRIRAMPUR

(AUTONOMOUS)
Affiliated to Savitribai Phule Pune University, Pune
Examination Section

APPLICATION FORM FOR PHOTOCOPY/XEROX COPY OF ANSWER BOOKS

To,
The Principal,
R. B. Narayanran Borawake College (Autonomous),
Shrirampur-413709

Sir,
I, the undersigned, request you to verify and issue Xerox copy of my answer book(s) as per
details given below:

Full Name of the Candidate :

Exam Month and Year :
Class :
Semester :
No. of Subjects appeared :
Seat No. :
Eligibility No. :
PRN No. :

Subject (s) Xerox Copy of Answer Book(s) Theory Subjects Only

Subject code Subject Name Marks Obt. Photocopy
Photocopy/Scancopy
Photocopy/Scancopy
Photocopy/Scancopy

Declaration of the Candidate

I hereby declare that, I have gone through the rules for providing a xerox copy of
the answer book(s) and it shall be binding on me.

Date : Yours faithfully.

(Signature of the Candidate)