Indian Institute of Technology Guwahati

Guwahati - 781 039

Form No.1
PASSPORT RELATED BONAFIDE, NO OBJECTION AND VERIFICATION CERTIFICATE

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:Fathers Name: (in Mr. Capital letters) Mothers Name: (in capital letters) Home address Mrs.

Name of student (in capital letters) Roll No. Programme:

E-mail ID:Semester:Contact No.: Date of Birth:-

Place of birth If Tatkal, why? (attach relevant documents):

Mode of Passport Application (Tick)

Normal / Tatkal Scheme

Travel plans within 2 months with destination (Yes/No. If yes, enclose a proof):Purpose of Visit:From To

Name of hostel: -

Room No:Signature of the applicant

Dealing Assistant Received by Student on N.B. Applied on Date:-

1. 2. 3.

Enclose one copy of recent passport size photograph with clear white background, Xerox copy of ID card and duly filled in passport application form (1st page only). Students are requested to keep for record xerox copy of these certificates (Bonafide, No Objection and Verification). 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
D. Sharma
Phones: (0361) 2582161 Fax:(0361) 2690762 Email: djs@iitg.ernet.in

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 ... 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: Room NoHostel .. Indian Institute of Technology Guwahati- 781039 (Assam), India Tel No............................................... Email: Students Signature: Permanent Address: .. .. Pin Tel No:

He/she is

currently residing in the .. Hostel, Room No.-.. IIT Guwahati Campus,

(D.Sharma) Assistant Registrar (SA)

Indian Institute of Technology Guwahati

Guwahati - 781 039
D. Sharma
Phones: (0361) 2582161 Fax:(0361) 2690762 Email: djs@iitg.ernet.in

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. 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: Room NoHostel .. Indian Institute of Technology Guwahati- 781039 (Assam), India Tel No............................................... Email: Students Signature: Permanent Address: .. .. Pin Tel No:

He/she is

currently residing in the .Hostel, Room No.-., IIT Guwahati

(D. Sharma) Assistant Registrar (SA)