FIRST GRADUATE CONCESSION – JOINT DECLARATION FORM

24
CERTIFICATE No. VII
Name : …………………………………………. Application No.
First Graduate Certificate
It is certified that there is no Graduate in the family of Selvan / Selvi ……………………………………………………….
S/o / D/o Thiru. ………………………………………….…………………………………………………………….. presently residing at
……………………………………………………………………………………………………………………………………………………………………….
and who has applied for professional courses during the year 2010, is eligible for Tuition Fee exemption as per the
G.O. (Ms) No…………………………………………….. Higher Education (J2) Department, dated: ……………..04.2010.
Sl.
No. Name
Relationship
Father / Mother /
Brother / Sister / Grand
Father / Grand Mother
Age Educational
Qualification
Whether
Degree
holder
(1) (2) (3) (4) (5) (6)
Station:
Date:
Office Seal:
Head Quarters Deputy Tahsildar
Taluk:
District:
39
FIRST GRADUATE CONCESSION – JOINT DECLARATION FORM
I hereby declare the details of my family members and their education qualifications to avail the tuition fee
waiver for my studies in Professional Courses under the scheme of waiver of tuition fees to the students from the
family where there are no graduates.
Sl.
No. Name
Relationship
Father / Mother /
Brother / Sister / Grand
Father / Grand Mother
Age Educational
Qualification
Whether a
Degree
holder
(1) (2) (3) (4) (5) (6)
I hereby solemnly and sincerely affirm that I am the first person from my family to claim the waiver of
Tuition Fee for entire Professional Course of study and there is no graduate in my family so far. The particulars
furnished above are true. Should it, however, be found that any information furnished therein is false in material
particulars on verification at a later stage, I am liable for criminal prosecution and I also agree to return the amount
equal to three times the tuition fee waiver availed by me.
Date:
Place:
SIGNATURE OF THE CANDIDATE
I solemnly and sincerely affirm that I am fully aware of the above declaration and the particulars furnished
in the declaration are correct. I am liable for the criminal action / recovery of amount equal to three times of the fees
waived, for incorrect particulars furnished.
Date:
Place:
SIGNATURE OF THE PARENT / GUARDIAN

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About annaunivedu

Jeba Peace
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