College

H.T.No. 1 3 KK1 A 0 4 4 3 Code KK

APPLICATION FOR PROVISIONAL CERTIFICATE
JAWAHARLAL NEHRU TECHNOLOGICAL UNIVERSITY
KAKINADA – 533003, A.P.

NAM1E OF THE CANDIDATE

*(IN BLOCK LETTERS AS PER v
S.S.C.)
S

s A N G E E T H A
FATHER’S NAME (IN BLOCK
LETTERS)

COURSE AND BRANCH Degree / P.G. B.Tech

Branch Electronics and Communication Engineering
MONTH & YEAR OF PASSING
EXAM
(To be filled by the candidate, December 2021
who Completed the Course)

PERMANENT ADDRESS

Aadhaar Card Number

Phone Number

e- Mail Id

FEE PARTICULARS: (200/-) (3000/-)

Click on amount (√)
Bank: __________________________E Receipt. No._____________________ Date: _____________

NOTE:
1. The consolidated Demand Draft should be drawn in favour of the REGISTRAR, JNT
UNIVERSITY, KAKINADA, Payable at Kakinada.
2. For TATKAL Provisional Certificate Rs. 3,000/- E-Receipt should be drawn in
favour of the REGISTRAR, JNT UNIVERSITY, KAKINADA, Payable at Kakinada.
3. Xerox Copy of SSC Certificate should be enclosed.
4. The filled in application along with E-Receipt. should be sent to the Director of
Evaluation, JNT University, Kakinada – 533 003.
5. Corrections in the individual Marks memos will not be entertained after issuing
PC&CMM.
Undertaking:-
I verified and agree with the marks of all memos and will not claim for any/further
changes in future.

Date: SIGNATURE OF THE CANDIDATE

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For College Office Use
Certificate of Identification

I certify that Mr. / Mrs. / Miss. __________________________________________________

S/o / D/o of _________________________________is a Bonafied Student of this College
_________________________________________________________________________________.
College Code: ___________during___________to ___________with H.T.No._______________
and he/she secured __________eligible credits out of credits and obtained
_______Percentage of marks. He/She is elegible to obtain Provisional Certificate as per the
regulation under which he/she is admitted.

Date: Head of Department PRINCIPAL

(Verified) With Office Seal
 JAWAHARLAL NEHRU TECHNOLOGICAL UNIVERSITY KAKINADA
University College of Engineering, Vizianagaram – 535 003, A.P.
CONSOLIDATED MARKS MEMO / CREDIT SHEET
Name : Year of Admission: College: Branch:

Month & Year of Final Exam: College Code: Hall Ticket No:
I YEAR I SEMESTER I YEAR II SEMESTER
S.N Course IM EM TM C S.N Course IM EM TM C
o
1 o
1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
Total Total
II YEAR I SEMESTER II YEAR II SEMESTER
S.N S.N
Course IM EM TM C Course IM EM TM C
o o
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
Total Total
III YEAR I SEMESTER III YEAR II SEMESTER
S.N S.N
Course IM EM TM C Course IM EM TM C
o o
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
Total Total
IV YEAR I SEMESTER IV YEAR II SEMESTER
S.N S.N
Course IM EM TM C Course IM EM TM C
o o
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
Total Total
Number of Credits Registered: Number of Credits Obtained: % of Marks:

Signature of the Candidate Head of Department PRINCIPAL

(Verified) With Office Seal