Application for getting academic documents/certificates lost/damaged in the flood/landslide occurred in July/August 2018
Personal Details
Name of the applicant
Aadhar Number*
Gender Male       Female
Date of Birth
Mobile Number*
Email ID*
Name of the Parent/Guardian
Relationship with the applicant
Academic Details
Details of certificate lost(Please note that Separate Application Is required for each course of study) DEGREE CERTIFICATE   
PROVISIONAL CERTIFICATE   
MARKLIST/GRADE CARD
OFFICIAL TRANSCRIPT OF MARKS
OFFICIAL TRANSCRIPT OF SYLLABUS
OTHER CERTIFICATE: Please Mention
Register Number/PRN
Name of the Program/Course
Main/Core/Optional Subject(Economics/Physics etc)
Additional Language/Common Course II(for UG only - Hindi/Malayalam etc)
Subsidiary/Complementary Subjects(for UG only)
Centre of examination
Month & year of pass    
Marks/Grade obtained
Mode of study REGULAR – COLLEGE GOING   
PRIVATE STUDY   
OFF CAMPUS – DISTANCE EDUCATION
Period of study    
Any other relevant details helpful in preparing the lost certificate
Details of Residence
Permanent Address
Address to which the Certificate is to be sent Same as Permanent Address
Name of Taluk
Name of Village
Ward No.
House No.
Security Code