Scribd
Upload
121 views2 pages

Caution Money Refund Application Form

This document is a request form from a student to the principal of a college for a refund of their caution money. It contains the student's personal details like name, degree, roll number, email, mobile number, address and bank account details where the refund should be deposited. It also has sections for signatures from the librarian, head of department, warden, exam incharge, registrar and accountant to confirm there are no dues pending against the student. At the end, the student signs declaring the information provided is true and they will be responsible for any loss due to incorrect details. It also states the college will not be responsible if the account details are wrong and all bank charges for the transfer will be borne by

Uploaded by

deep das
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
121 views2 pages

Caution Money Refund Application Form

This document is a request form from a student to the principal of a college for a refund of their caution money. It contains the student's personal details like name, degree, roll number, email, mobile number, address and bank account details where the refund should be deposited. It also has sections for signatures from the librarian, head of department, warden, exam incharge, registrar and accountant to confirm there are no dues pending against the student. At the end, the student signs declaring the information provided is true and they will be responsible for any loss due to incorrect details. It also states the college will not be responsible if the account details are wrong and all bank charges for the transfer will be borne by

Uploaded by

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

To,

The Principal,
<College Name >
<Address >
..

Date:
Sub : Refund of Caution Money

Name
:

Degree
:Stream :
..
Roll No.
:..Registration No.:

E-Mail Id
:Mobile No. :
..
Full Address
:

Bank A/c Details:


Name of the Account holder
:
..
Bank A/c No.
: .. Type of A/c
(SB/CD/OD) :..
Bank Name
:.Branch:

Bank Branch Full Address :

Bank Branch IFSC Code


:

NO DUES CERTIFICATE :
Library

Dues/No Dues

Signature of the Librarian

Department and Lab

Dues/ No Dues

Signature of the HOD

Hostel Clearance

Dues/ No Dues

Signature of the Warden

Exam Cell

Dues/ No Dues

Signature of the Exam Incharge

Registrars Office

Dues/ No Dues

Signature of the Registrar

Accounts section

Dues/ No Dues

Signature of the Accountant

I hereby declare and undertake that :


All the information provided above is true and complete in all respect
If the details mentioned by me above are incorrect due to any reason
(Including Typing/ Writing error, etc. ) I shall be completely responsible for
any loss such as non-receipt of caution money.
The college will not be responsible for wrong credit of caution money in
case where I have mentioned the Account No. and other details as above
wrongly and I also understand that in such cases I will not be getting any
Caution Money.
All charges related to transfer of Caution Money ( Applicable at the time of
transfer of Caution Money as levied by the Bank) in my Account will be
borne by me.
..

Signature of the Student


__________________________________________________________________________________
For Office Use Only
(Office to verify and check whether Form is complete in all respect before
accepting )
..
.
Signature of the
In-Charge Accounts Department
Seal of the college

Principal

You might also like