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Form 1A

This document is an affidavit for obtaining duplicate marks memos or certificates, stating that the individual has not received their original certificate from JNTUH and has lost it beyond recovery. The affiant declares the need for a duplicate certificate and commits to returning the original if found in the future. The affidavit is printed on Rs.20/- notary bond paper and requires a signature before a notary.

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Sana Sultana
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152 views1 page

Form 1A

This document is an affidavit for obtaining duplicate marks memos or certificates, stating that the individual has not received their original certificate from JNTUH and has lost it beyond recovery. The affiant declares the need for a duplicate certificate and commits to returning the original if found in the future. The affidavit is printed on Rs.20/- notary bond paper and requires a signature before a notary.

Uploaded by

Sana Sultana
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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FORM-IA

AFFIDAVIT
(For Duplicate Marks Memos / CMM)
(Printed on Rs.20/- Notary bond paper)
I,______________________________S/o/D/o _____________________________ aged_____ years
( Student’s Name) (Father’s Name)
Resident of ____________________________________________________________ ___________
(Residential Address)
____________________________________________________________________ do hereby solemnly
affirm and status follows:

I have passed _________________ Degree from_______________________________________________


(College Name)
_______________________in the year of ___________with Hall Ticket No.________________________

That the Original _______________ certificate was sent to me by JNTUH, but I did not receive the
certificate(s). I am unable to track the said certificate(s) and it is lost beyond recovery.

I am in need of a duplicate ________________ certificate(s) for which purpose I am hereby making this
declaration as required by the concerned authorities.

I solemnly that, in case my original certificates(s) is / are traced out in future, I shall submit the same to
JNTUH, Hyderabad authorities for cancellation

The facts stated above are true and correct to the best of my knowledge and belief.

Solemnly affirm and signed before me.

DEPONENT

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