APPLICATION FOR DUPLICATE MARKSHEET/CERTIFICATE/TRANSCRIPT/VERIFICATION/BONAFIDE CERTIFICATE/ LANGUAGE
CERTIFICATE/CGPA CERTIFICATE/MODE OF STUDY CERTIFICATE/APPEARANCE CERTIFICATE/EQUIVALENCE CERTIFICATE
Director (EEA) For Office Use
The Institution of Engineers (India)
8, Gokhale Road
Kolkata 700020
Dear Sir,
I require the following as ticked (√) in appropriate box:
Tick Item (Per copy) Nepal/India Foreign Documents required
(√) (INR) INR-equivalent to be enclosed
Duplicate Grade Card (Current) 100 375 Copy of FIR/GD (for pass
marksheets only)
Duplicate Grade Card (Previous session) 300 750 Copy of FIR/GD (for pass
marksheets only)
Duplicate Marksheet (over 20 years old) 2000 7500 Copy of FIR/GD
Duplicate Combined Certificate 1000 3750 Copy of FIR/GD
Duplicate Combined Certificate (over 20 years old) 2000 7500 Copy of FIR/GD
No Objection Certificate 1000 3000
Appearance Certificate 500 1500
Transcript for Sections A and B* 1000 3750
Transcript for Sections A and B (over 20 years old)* 2000 7500
Equivalence/Bonafide Certificate 500 1500
CGPA Conversion to percentage of Marks/ Division Certificate 500 3000
Verification of Qualification ** 2000 3750
Language Certificate 500 1500
Certificate for Mode of Study 500 1500
Sec AB Exam Backlog Certificate upto 20 years Old 1000 3750
Sec AB Exam Backlog Certificate over 20 years Old 2000 7500
My particulars are given below:
Membership Grade and Number :
NAME (in capital letters):
ADDRESS (in capital letters):
PIN
ADDRESS where documents
are to delivered
PIN
Mobile No._____________________________ E-mail: ________________________________________________________________________________________
Passed Section A in Summer/Winter______________with Roll No. ______________________ or Exempted from Section A having passed __________
__________________________ Examination from ________________________________________ in the year ________________(Copy of the document enclosed).
Passed Section B in Summer/Winter __________________ with Roll No. __________________ and Membership No. _______________________ in _______________
_____________________________________________________________Branch
DETAILS OF PAYMENT (Please send duly filled hard copy of the form along with NEFT Payment Transaction Slip)
NEFT/RTGS/IMPS/Online Net Banking Transfer to IEI Account, please mention the following:-
Beneficiary Name : THE INSTITUTION OF ENGINEERS (INDIA)
Amount (`)
Account No. : 012104000094674 IFSC No. : IBKL0000012 Swift Code – IBKLINBB135
Bank Name & Branch : IDBI Bank, Siddha Point, Ground Floor, 101 Park Street, Kolkata 700 016
Transaction date : D D M M Y Y Y Y Name of Bank & Branch_______________________________________________________________
Transaction ID/UTR No./Payment Reference No. :- ___________________________________________________________________
After NEFT/Online Net Banking Transfer to IEI Account, please enclose the transaction slip generated.
Full Signature of Candidate with Date
The Official Transcript will be sent directly to the concerned university/institution/college.
* The name and address of the concerned university/institution/college along with photocopies of pass grade card of Sections A & B Examinations and For Office use combined
certificate of passing Sections A & B Examinations
** The Application should be received from the concerned authority enclosing photocopies pass grade card of Sections A & B Examinations and combined certificate of passing
Sections A & B Examinations..
IEI/EEA/01. Rev. 01/ 15.02.21 (Turn to page 2)
In case your application is not accepted, fee will be refunded through NEFT to the Bank Account mentioned by you below:
TO BE FILLED BY CANDIDATES (BLOCK LETTERS)
Name : _________________________________________________________________________________
Membership No. : _________________________________________________________________________________
Name as per Bank Account : _________________________________________________________________________________
Bank A/C No : _________________________________________________________________________________
Bank Name : _________________________________________________________________________________
Branch : _________________________________________________________________________________
IFSC Code : _________________________________________________________________________________
Mobile : _________________________________________________________________________________
Email : _________________________________________________________________________________
I am attaching the photocopy/original cancelled cheque with name printed in it.
