Form M.
01
DIRECTORATE OF TECHNICAL EDUCATION, CHENNAI – 600 025
APPLICATION FOR DUPLICATE CERTIFICATE(S)
Institution Code Name of the Institution
Register Number Name of the Student
Course Code Name of the Course
Reason to apply for Duplicate
Complete Communication Address with Taluk/District/Pincode
Contact Mobile Number
E-mail ID
DETAILS OF IDENTITY PROOF ATTACHED (Self-attested xerox copy to be attached)
Tick Unique Number of the Document
Document Type
() (i.e. Driving License Number/Aadhaar Number/Voter ID Number)
Driving License
Aadhaar Card
Voter ID
Type of Duplicate Certificate(s)
Tick () Particulars Required Amount
Required
Diploma Certificate Month & Year of Passing
Consolidated Mark Statement Month & Year of Passing
Combined Mark Statement Month & Year of Exam
Semester Month & Year Semester Month & Year
Mark Statement
Details of Payment Made thro’ Indian Bank Multi-Utility Chalan
Reference Number Journal Number Date of Payment Total Amount
DECLARATION
I, ____________________________________________________________________________________________________ son/daughter of
___________________________________________________________________________________________________________ residing at
the above mentioned address do hereby solemnly and sincerely affirm that the Diploma Certificate/Consolidated
Mark Statement/Combined Mark Statement/Mark Statement issued to me has irrevocably been lost/destroyed.
I file this declaration for the purpose of receiving duplicate certificate(s).
I will return immediately the duplicate certificate(s) to the Chairman, Board of Examinations, Chennai – 600 025
only my original certificate(s) is/are recovered later.
The facts stated are true and correct to the best of my knowledge and if found false by the Chairman, Board of
Examinations, I shall abide by the decisions of the competent authorities.
Countersigned by the Principal with Designation Seal Signature of the Candidate
FOR OFFICCE USE ONLY
File no : Verified by :
Remarks (if any) : Regional Officer-III
INSTRUCTIONS
o Duplicate Certificate will be issued only when it is lost or destroyed irrevocably.
o Application should be made only by the Candidate in the prescribed format and should be
sent to The Chairman, Board of Examination, Directorate of Technical Education,
Chennai – 600 025, through the institution in which the candidate is studying / studied.
o Application received on behalf of the Candidate will not be entertained.
o The following enclosures are necessary:
o Xerox of the Certificate(s) for which duplicate certificate(s) are required (if available)
o Original Indian Bank Multi-Utility Challan
o Self-attested Photocopy of Aadhaar Card / Driving License / Voter ID Card
o Duplicate Certificate(s) are to be surrendered immediately to the Chairman, Board of
Examinations, if the Original Certificate(s) are recovered later.
o Request for issue for Duplicate Provisional Certificate will not be entertained, since its
validity is until the receipt of Diploma Certificate.
o Fees as per existing rates are to be paid through Indian Bank Multi-utility Challan only.
No other mode of payment will be accepted.
o For generation of Multi-Utility Challan, visit Indian Bank’s Website:
http://www.indianbank.in > Useful Links>Online services >other Links >Department
of Technical Education (DOTE) Multi-utility Payment–Students. Enter the Student
name, Reg No and Duplicate fees details and confirm to generate the Challan. After
generation of Multi-Utility Challan, payment can be made either through online or
through any branch of Indian Bank.
o Fees once paid will not be refunded or adjusted for any other certificate under any
circumstances.
o Duplicate certificates shall be dispatched to respective colleges in 15 working days
excluding day of submission in person or receipt of hardcopy at DOTE.
FEES TO BE REMITTED THROUGH INDIAN BANK MULTI-UTILITY CHALLAN
Amount per Certificate
Type of Certificate
(in Rupees)
Duplicate Diploma Certificate 450
Duplicate Mark sheet (issued within 5 years) 90
Duplicate Mark sheet (issued before 5 years and upto 10 years) 135
Duplicate Mark sheet (issued before 10 years) 180
*Amount mentioned above is exclusive of Bank Charges.
***
