Student's Present Address:-1. KALINGA BOYS HOSTEL 2. Kalinga Girls Hostel
Student's Present Address:-1. KALINGA BOYS HOSTEL 2. Kalinga Girls Hostel
Student's Present Address:-1. KALINGA BOYS HOSTEL 2. Kalinga Girls Hostel
MOBILE NO:-…………….………………………………………………………………………………………………………………….
EMAIL ID:- …………..…….………………………………………………………………………………………………………………..
Adhar card no. / ID No:- …………………………………………………………….………………………………..................
D.O.B:-…….…./…………/…………………..
University Enrollment No:- …………………………………………………………….……………………………………………..
To,
UNDERTAKING/AFFIDAVIT
Respected Sir/Mam,
a) That I have passed my matriculation/10th /High School Examination in the session of……………………………… bearing roll
no………………………..from the School/Institute ……………
Affiliated to ……………………………..board.
c) That I will/have regularly attend(ed) the classes and will maintain /have maintained atleast 75% attendance in my
classes.
d) I appeared for my Bachelor /Masters (Please specify)………………………. Year/ Semester examination in the University
campus and passed the same, vide roll no …………….. ……….. in the year…………………………… .
e) That the eligibility documents submitted by me are true & genuine to the best of my knowledge and belief.
f) That during the course of study I will not / was not in any kind of regular job either in any Govt, Semi govt or private
authority/Company.
g) That during the course of the study I will not / was not doing any other regular course from any other university.
h) That I will not / was not indulged in any sort of legal cases, Whether Criminal/Civil during the course of study.
i) That I will not get / was not involved in any malpractice, misconduct, fraud in any manner during my tenure of study in
the University.
j) That my above statement is true & correct and in case any document ,information & statement given by me in this
affidavit are found false, fake, duplicate ,wrong and forged , the University will have every right to cancel /withdraw my
Mark Card/Degree issued by the University and University may take appropriate legal action in this regard against me.
Deponent
Verification :-
I above named deponent ,do hereby solemnly verify that the contents of my above affidavit are true &
correct within my knowledge & belief and nothing has been concealed .
Deponent
\