HIMACHAL PRADESH TECHNICAL UNIVERSITY HAMIRPUR-177001

(Established under State Legislative Act-16 of 2010)

APPLICATION FOR OBTAINING VARIOUS ACADEMIC CERTIFICATES
STUDENT DETAILS
NAME OF THE APPLICANT : Male
(IN CAPITAL LETTERS) SEX: Female
FATHER’S NAME :
(IN CAPITAL LETTERS)
UNIVERSITY ROLL NO.
REGISTRATION NO.

PERMANENT ADDRESS:
(IN CAPITAL LETTERS with Pin Code)

CONTACT DETAILS : (M). (R).

E-MAIL ID:
NAME OF THE COLLEGE :
PROGRAMME OF STUDY : NAME OF BRANCH:
DEMAND DRAFT NUMBER AND NAME OF AMOUNT PAID :
THE BANK: DATE :
Month and Year of Passing Out:

Sr. Name of Service Procedure *Fees(applicable, if Time Limit

No. any)
1 Provisional Certificate 1. Attested copies of all DMC’s. 5 (Working
Rs. 300/-
days.)
1. Application Form through concerned Principal -
Rs. 1500/-
2 Registration Card (all documents 10th, 12th & any other relevant)
3 (a) Intra University
(For those who seek 1. Migration Form duly signed (NOC) by both the
migration from one Principals with the seal of college. Rs. 10,000/-
college to another during 2. Original registration card.
Migration course within HPTU)
Certificate (b) Inter University
(For those who seek 1. Migration Form duly signed (NOC) by the
migration at the equivalent concerned Principal with the seal of college. Rs. 20,000/-
level during tenure of the 2. Original registration card.
5 (Working
course) days.)
(c) Inter University
(For those who want to leave or 1. Migration Form duly signed (NOC) by the
concerned Principal with the seal of college.
Rs. 10,000/-
quit the programme/course
permanently) 2. Original registration card.
1. Migration Form duly signed (NOC) by the
(d) Inter University
concerned Principal with the seal of college. Rs. 400/-
(Passed out students)
2. Original registration card.
4 Duplicate DMC’s. 1. Original Copy of First Information Report (FIR) and Rs. 300/- for each 5 (Working
self-attested Affidavit. document. days.)
5 Duplicate Registration Card. 1. Undertaking for issue of Duplicate Registration Card. 5 (Working
Rs. 200/-
days.)
Rs. 300/- (No fee is
6 Correction of required if correction
DMC/Registration Card/Provisional 1. Photocopy of 10th Certificate is sought within three
month of the 5 (Working
Degree Certificate/Academic Transcript 2. Photocopy of Registration Card (if applicable)
declaration of the days.)
etc.
result.)
7 Academic Transcript 1. Photocopy of all DMCs. Rs. 2500/- for each 15(Working
2. Photocopy of Registration Card. docu ment. days.)
8 Re-checking 1. Apply within 21 days after the declaration of the Rs 400/- per answer -
result of concerned course. sheet.
9 Confidential Result Rs. 500/- per result -
each time.
 Rs 400/- per
Verification Within India examination each time.
10 Of Academic Outside India 7 (Working
Qualification Rs. 5000/- per days.)
examination each time.

11 Change of the Examination Centre 3 (Working

from one station to another within days.)
the jurisdiction of University. Rs. 1000/- each time
12 Change/Correction in Examination
form/Change of subject/option. Rs. 500/- for each
(not late than one month
before the commencement of examination) correction.
Postal Charges Extra (if required to send by registered post.)
(i) Rs. 100/- in India.
(ii) Rs. 200/- Outside India.
Note: Postal charges of Transcript should be on per set basis.
*Applicable w.e.f. Jan, 2016onward and subject to change as approved by Hon’ble Vice Chancellor/BOG.
Applicant must tick in given box for particular desired documents.

Signature of Applicant

Instructions for the Students:

1. If student is not available for receiving the document(s) applied for, he/she needs to send the following documents
along with receiving person.
 Authority letter of student.
 Receiving Person’s Photo Id Proof.
 Student Photo Id Proof.
 Original application receipt.
2. It is compulsory to pay fee in t he form o f Demand Draft in the favour of Finance Officer, Himachal
Pradesh Technical University Hamirpur, payable at Hamirpur (H.P.) or student can deposit the fee
there and then in the University.
3. Student needs to verify document while receiving from University.
4. Application without above details/documents will not be processed.
5. Students can submit the filled application form by hand/post in/at following addresses:
Sr. No. Name of the Document Address
Registration Card, Migration Certificate (Intra University & Inter Assistant Registrar (Acad.) H.P.
1. University), Duplicate Registration Card and correction in registration Technical University Daruhi Distt.
card Hamirpur (H.P.) 177001.
Provisional Certificate, Migration Certificate(Passed out Students and to Assistant Registrar (Exam.) H.P.
2. quit programme), Duplicate DMCs, Academic Transcript, Correction of Technical University Gandhi Chowk
DMCs, Rechecking, Confidential Result, Verification of Academic Distt. Hamirpur (H.P.) 177001.
Qualification, Change of Exam Centre, Correction in Exam. Form

DECLARATION
I hereby declare that I have read all the instructions and the entries made by me in the Application Form are correct
and true to the best of my knowledge.
(Any information given by the candidate if found incorrect at any stage, may lead to the cancellation of all the
academic certificates and debarring the candidate to appear in any examination of HPTU.)

Signature of Applicant
Date : Name …………………..

FOR OFFICE USE ONLY

Application receiver’s name
Fee receipt no. :

Document receiver’s name and sign. : -

Contact no : -