Form of Application For Issue Of A Duplicate Copy Of University Diploma/Degree/Certificate

Company Name(s): 

Payment is to be made between 9.30 A.M. to 12.30 P.M.
1. Fee for issuing a duplicate of :
(a) Diploma }
(b) Degree } Rs.600/- (after 10 years Rs.1,000/-)
(c) Certificate }
UNIVERSITY OF DELHI
FORM OF APPLICATION FOR ISSUE OF A DUPLICATE COPY OF
UNIVERSITY DIPLOMA / DEGREE / CERTIFICATE
NOTE : - For Instructions. Please see reverse.
To
The Registrar,
University of Delhi
Delhi-110007
Sir,
I wish to have a duplicate copy of my Diploma/Degree/certificate for the ____________________
Examination for the following reasons.
The prescribed fee is submitted herewith.
The required particulars are given below :
Name of Candidate (in block letters in English) _______________________________________________
Father’s Name (in block letters) ____________________________________________________________
Enrolment No. ______________________ Examination passed ________________Annual/supplementary
Held in the month of ________________ Subject ___________________
Roll No. __________________________ Division __________________
Name of College, Hall, Institution and other particulars _________________________________________
Full Permanent Address __________________________________________________________________
__________________________________________________________________
I solemnly declare that the particulars given above are correct to the best of my knowledge.
I certify that the above entries made by the applicant are correct
Yours faithfully
Signature and the present address of the candidate
Signature of the Principal
(with College Stamp)

INSTRUCTION TO CANDIDATES FOR ISSUE OF DUPLICATE COPY OF UNIVERSITY
DIPLOMA/DEGREE/CERTIFICATE
1. The forms should be filled in legibly and signed by the candidate.
2. The form should be submitted through the Head of the College, Hall or Institution through which the
candidate appeared at the said examination and the duplicate copy will be sent through the institution
concerned.
3. A duplicate copy of the diploma degree or certificate will be issued on submission of and affidavit
signed by a First Class Magistrate together with an attested copy of the F.I.R. lodged with the nearest
Police Station to this effect by the candidate on the grounds that cither the original diploma, degree or
certificate has been irrecoverably lost destroyed or defaced and on payment of the fee prescribed.
4. In very special case subsequent copies of the diploma, degree or certificate may be issued for not more that four times, on submission of an affidavit signed and certified by a First Class Magistrate to the effect that the diploma, degree or certificate issued previously by the University has been lost or
destroyed, and on payment of the same fee as are prescribed for the issued of duplicate copy.

FORM FOR AFFIDAVIT TO BE EXECUTED ON A NON-JUDICIAL STAMP PAPER OF THE
VALUE OF RS. 2/- BEFORE A FIRST CLASS MAGISTRATE.
I ___________________________________ Son/Daughter of Shri ___________________________
Resident of _______________________________________________________________________
______________________________________________________________________________________ do hereby solemnly declare that the original Degree Certificate dated _________________________ issued to me by the Registrar, University of Delhi, Delhi – 110007 on my passed the _______________________ Examination _______________________ under University Roll No._______________________________Enrolment No.______________________ has been lost/destroyed.
I have filled an F.I.R. with ______________________ Police Station _____________________ and a copy of the same duly attested by a Gazetted Officer/First Class Magistrate is appended hereto.
I also undertake that if my original Diploma/Degree/Certificate which has been lost, if put to any
unfair use by the person who may lay hands on it, I shall stand for the damages which may accrue from
such use.
Deponent
Signature ___________________
Address ____________________
___________________________
___________________________
Verification :
Verified at Delhi this ______________ day of ________________ , 20___ that the contents of my
affidavit are true to the best of my knowledge.
Deponent
SWORN BEFORE ME
Signature ____________________________
Designation __________________________
Office Seal _________________________