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Birla Institute of Technology Mesra, Ranchi: Form A

This document is an application form for verification of a degree certificate or education from Birla Institute of Technology in Mesra, Ranchi. It requests verification for a specific candidate by providing their name, gender, degree name, roll number, campus/location studied, years of study, year of passing, CGPA obtained, and purpose and destination for the verification report. It notes that a fee must be paid online via a provided link and receipt emailed for verification to take place, and includes instructions that a copy of the candidate's degree certificate must be provided.

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291 views2 pages

Birla Institute of Technology Mesra, Ranchi: Form A

This document is an application form for verification of a degree certificate or education from Birla Institute of Technology in Mesra, Ranchi. It requests verification for a specific candidate by providing their name, gender, degree name, roll number, campus/location studied, years of study, year of passing, CGPA obtained, and purpose and destination for the verification report. It notes that a fee must be paid online via a provided link and receipt emailed for verification to take place, and includes instructions that a copy of the candidate's degree certificate must be provided.

Uploaded by

shubhampms
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

BIRLA INSTITUTE OF TECHNOLOGY FORM A

MESRA, RANCHI

APPLICATION FOR
VERIFICATION OF DEGREE CERTIFICATE / EDUCATION

Fee Details
Amount : ………………………………………………..
SB Collect reference number:………………………………………….
Date:……………………………………….
_____________________________________________________________________________

To Date:
The Registrar,
Birla Institute of Technology, Mesra,
Ranchi, PIN- 835215 (Jharkhand)

Sir/Madam,
We need the verification of the following passed out student / existing student of Birla Institute
of Technology, Mesra. The details are as follows:

Name of the Candidate: ……………………………………………………………………………


(In BLOCK LETTERS - as per the Certificate)
Gender: ……………………………………………………………………………………………..
Name of the Degree: ……….……………………………………………………………………...
Roll No. ……….……………………………………………………………………………………
Mesra Campus / Off-Campus where studied: …………….………………………………………..
Period of study: …………………………………………………………………………………….
Year of Passing: ……………………………………………………………………………………
CGPA obtained: ……………………………………………………………………………………
Purpose of verification:…………………………………………………………………….............
Name & Location of the agency / company:……………………………………………………...
Any other remarks:…………………………………………………………………………………
Address for Communication where the verification report has to be sent:

……...……………………………………………………………………………………………….
……………………………………………………………………………………………………

Signature
Name & Designation
Name and address of the agency / company
(Including Email address and Phone)

Note: Fee has to be paid online using the given link


https://www.onlinesbi.com/sbicollect/icollecthome.htm

Select “Students Section Fee” in “Payment Category” option.


The receipt has to be emailed to [email protected]

NOTE:

1. This request form should be sent along with a photocopy/scanned copy of the Degree
Certificate of the candidate.
2. Without receiving verification fee, verification process shall not be carried out.
3. Central Govt. / State Govt. / Autonomous organizations / PSUs etc. claiming for waiver
of payment of verification fee are requested to submit documents/self-declaration where
it should be mentioned that their organization is empowered through certain O.M. for fee
waiver.

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