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Caution Money Refund Request Form

This document is a request form for a student to receive a refund of their caution money from Dr. Sudhir Chandra Sur Degree Engineering College. It requests the student's personal details like name, degree, roll number, email, address, and bank account information. It also requires signatures from the library, department head, warden, exam incharge, and registrar to confirm the student has no outstanding dues. The student must declare the information provided is true and they will be responsible for any losses due to incorrect details. The college is not liable if money is credited incorrectly due to invalid account information from the student. All bank charges for transferring the refund will also be borne by the student.

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akash dhar
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70 views2 pages

Caution Money Refund Request Form

This document is a request form for a student to receive a refund of their caution money from Dr. Sudhir Chandra Sur Degree Engineering College. It requests the student's personal details like name, degree, roll number, email, address, and bank account information. It also requires signatures from the library, department head, warden, exam incharge, and registrar to confirm the student has no outstanding dues. The student must declare the information provided is true and they will be responsible for any losses due to incorrect details. The college is not liable if money is credited incorrectly due to invalid account information from the student. All bank charges for transferring the refund will also be borne by the student.

Uploaded by

akash dhar
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

The Principal, Date: ..

Dr. Sudhir Chandra Sur Degree Engineering College,


540 Dum Dum Road, Surermath,
Kolkata-700 074
West Bengal

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 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 Principal
In-Charge Accounts Department Seal of the College
The Principal, Date: ..

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