Format No.: QSP/7.5.1/01.
F12
Issue No.02 Dated: April 16, 2014
AUTHORIZATION LETTER
To : Controller of Examination
University of Petroleum & Energy Studies
Dehradun
Authority Letter to Collect the __________________________________________
for Program__________________ Batch _____________ in respect of Enroll.
No._____________ SAP ID_____________ Name _______________________
I authorize Mr./Ms./Mrs.____________________________________________,
Resident of _____________________________________________________________
Telephone No._____________________ whose three specimen signature are appended
below, is hereby authorized to collect the Degree Certificate on my behalf due to my
inability to come personally to collect the same.
_______________ _______________ _______________
Specimen Signature Specimen Signature Specimen Signature
Signature of the Student : _________________________
Name of the Student : _________________________
SAP ID of the Student : _________________________
Enrolment of the Student : _________________________
Program & Batch : _________________________
Telephone No. : _________________________
Date : _________________________