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VISVESVARAYA TECHNOLOGICAL UNIVERSITY

“Jnana Sangama”, Belagavi- 590018


Application for Issue of Duplicate Marks Cards (DMC)
For Students of Non-Autonomous colleges only
POINTS TO NOTE


Pay online only by SBI Payment link http://vtu.ac.in/online-fee-payment and enclose Online Receipt of fees paid
DDs are not accepted
DMC
 Fees paid once cannot be refunded. (For office use only)
 Original police FIR regarding the lost of Original Documents.
 Original Affidavit on Stamp paper of ₹ 20, mentioning the details of USN, Name, Semester, Month and Year of Examination of the By Post Only
Marks cards/Degree Certificate lost and requesting the concerned authority for the issue of DUPLICATE of the same. If original is
found at later date after issue of duplicate, it should be returned to VTU.

Name of Student
(As on Grade/Marks Cards)
University Seat Number Old USN (if applicable):
Details of Fees Fees per Duplicate Grade card/Marks card: ₹ 300-00 + ₹ 100 × No. of years since issue of grade/marks card
Choose Category “F – Fees to be Year of completion: ________ Year of application: _________ No. of years since completion: ______
paid by student”– Examination
Fees paid: ₹ ________________ Payment ID: ______________________ Date: ______________
Marks Card Particulars : Applied for Duplicate Marks/Grade Card
Non CBCS Scheme CBCS Scheme
Semester First Attempt Second Attempt Third Attempt Fourth Attempt
Month Year Month Year Month Year Month Year Sem Month Year
1
2
3
4
5
6
7
8
9
10
CHECKLIST
 I declare that I have not studied in an Autonomous college  Original Police FIR with Affidavit on stamp paper
 Online receipt of fees paid

Name: _____________________________ Mobile: ____________________________ Date:_______________________


Address: _________________________________________________________________________________________________
_________________________________ PINCODE: _______________ Signature: ______________________

Application by Post Application by Hand (In person at VTU Belagavi)


Send the filled and signed application form and online receipt of  Applications are not recieved by hand due to Covid-19 Pandemic.
fees paid to the following addres:
Registrar (Evaluation)
Visvesvaraya Technological University, Jnana Sangama
Belagavi- 590018
For Office Use Only

Case Worker: _________________ Special Officer: __________________

To be filled in by applicant in BLOCK Letters


POSTAL ADDRESS TO WHICH DUPLICATE MARKS CARDS ARE TO BE SENT (This portion will be cut and pasted on envelope. Check for
correctness) Note: Postage fee of Rs. 1,500-00 to be added to the fees to be paid, for addresses outside India

Name USN:

Address

PIN: Mobile:

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