Visvesvaraya Technological University
Examination Section,Belagavi 590 018.
Application for issue of DUPLICATE MARKS CARD (DMC) / DUPLICATE DEGREE CERTIFICATE (DDC)
Name of the
Candidate
(in CAPITAL LETTERS)
USN
2
Old USN (if any)
DMC Fees: Rs.150/-(For each Marks Card ) + Rs.50/-Per academic year (Single DD in Favour of Finance Officer, VTU, Belagavi)
DDC Fees: Rs. 1500/- +Penalty amount of Rs. 100/- per year
DD
Fees Paid
Details
No.: Bank:. Date:. .Amount:...
Attach Payment Receipt along
Payment Ref.No.: . Date:..Amount:
with this Application
ONLINE
Marks Cards/Degree Certificate Particulars:
Semester
II
Applied for DMC:
III
IV
VI
DDC:
VII
VIII
Month
Year of Exam
Passed
Documents to be attached with application:
1. Original Police FIR regarding the lost of ORIGINAL DOCUMENTS.
2. Original Affidavit ON STAMP PAPER OF RS.20/-, mentioning the details of USN, NAME, SEMESTER, MONTH and YEAR of
Examination of the MARKS CARDS/DEGREE CERTIFICATE lost and requesting the concerned authority for the issue of
DUPLICATE of the same.
indicate
Name: ..
the postal Address to which
DMC/DDC to be sent
Candidate
shall
(in CAPITAL LETTERS)
PIN:...
Country:Mobile: ..... e-mail id:...
FOR OFFICE USE ONLY
Date: _ _ _ _ _ _ _ _ _ _
Signature of the Candidate
PAYMENT DETAILS
B/H
POST
DD No.:.... ONLINE Payment Ref.No.:........................................
Date:..Bank: Rs.:....
Sign Signature and Date:.
DMC No:/DDC No....
Case Worker:___________ Special Officer:__________________Registrar(Evaluation):______________________
Application will be rejected if address is not same in Block 5 and 6
......................................................................................................................................................................................................................................................................................
Candidate
shall
indicate
the postal Address to which
Name: ...
DMC/DDC to be sent
...
(in CAPITAL LETTERS)
...
USN
..PIN:..
Country: Mobile: e-mail id:.