Indian Institute of Technology Guwahati Guwahati - 781 039 Form No.1
PASSPORT RELATED BONAFIDE, NO OBJECTION AND VERIFICATION CERTIFICATE
Name of student (in capital letters) Roll No. Programme:
E-mail ID:-
Name of Dept:B. Tech / B. Des/ M. Des/ M.A/ M.Sc/ M. Tech./ Ph.D Comment of hostel Sr. Asst/Jr. Asst. on current status of mess dues:Father’s Name: (in Mr. Capital letters)
Mother’s Name: (in capital letters) Home address
Semester:-
Date of Birth:-
Contact No.:
Mrs.
Place of birth
Mode of Passport Application Application (Tick)
Normal / Tatkal Scheme
If Tatkal, why? (attach relevant documents): Travel plans within 2 months with destination (Yes/No. If yes, enclose a proof):-
Purpose of Visit:-
From
Name of hostel: -
To
Room No:Signature of the applicant
Dealing Assistant
Received by Student on
Applied on Date:-
N.B. 1.
Enclose one copy of recent passport size photograph with clear white background , Xerox copy of ID card and duly filled in passport application form (1 st page only).
2.
Students are requested to keep for record xerox copy of these certificates certific ates (Bonafide, No Objection and Verification). Verification) .
3.
Students who want to do Summer Internship abroad should submit approved copy of the Summer Internship Form from Academic Affairs.
Indian Institute of Technology Guwahati Guwahati - 781 039 Phones: (0361) 2582161 Fax:(0361) 2690762 Email:
[email protected]
D. Sharma Assistant Registrar Students’ Affairs
Ref: SA/Bon/Certificate/10/ Date:
BONAFIDE CERTIFICATE
This is to certify that Mr./Ms ……………………………………..…(Roll No: ……………….), S/o/ D/o Mr. ………………………………………. , is a Bonafide student of Indian Institute of Technology Guwahati. He/she has been enrolled for the …………. years ………….. Programme in the Department of ………………………………….. Currently he/she is in the …… semester. His/her course is likely to be completed by May ………...
He/she is
currently residing in the ………….. Hostel, Room No.-………….. IIT Guwahati Campus, Guwahati. His/her date of birth is ………………………. is per record available. This Certificate is issued to enable him/her to apply for / for renewal of Indian Passport at his/her own request. Current Address:
Permanent Address:
Room NoHostel ………………….. Indian Institute of Technology Guwahati- 781039 (Assam), India Tel No...............................................
………………………………………
………………………………………..
Email: …………………………………
Pin…………………………………
Student’s Signature:
Tel No: ………………………………
………………………………………..
(D.Sharma) Assistant Registrar (SA)
Indian Institute of Technology Guwahati Guwahati - 781 039 Phones: (0361) 2582161 Fax:(0361) 2690762 Email:
[email protected]
D. Sharma Assistant Registrar Students’ Affairs
Ref: SA/Bon/Certificate/10/ Date:
NO OBJECTION CERTIFICATE This is to certify that Mr./Ms ………………………………………….. (Roll No:…………….), S/o/D/o Mr. …………………………………..,is a
Bonafide student of Indian Institute of
Technology, Guwahati. He/she has been enrolled for the ……….. years …………… Programme in the Department of ……………………………….. Currently he/she is in the …….. semester. His/her course is likely to be completed by May ……………. The Institute has no objection to recommend issuing of an Indian passport to him/her.
He/she is
currently residing in the …………………….Hostel, Room No.-…………., IIT Guwahati Campus, Guwahati. His/her date of birth is …………………is per record available. This Certificate is issued to enable him/her to apply for / for renewal of Indian Passport at his/her own request.
Current Address:
Permanent Address:
Room NoHostel ………………….. Indian Institute of Technology Guwahati- 781039 (Assam), India Tel No...............................................
………………………………………
………………………………………..
Email: …………………………………
Pin…………………………………
Student’s Signature:
Tel No: ………………………………
………………………………………..
(D. Sharma) Assistant Registrar (SA)
