Print Back UTET-I -2011 PROVISIONAL ADMIT CARD CUM UNDERTAKING UTTARAKHAND VIDHYALEYE SIKSHA PARISHAD RAMNAGAR (NANITAL)

Application No. : duly attested by centre supdt. Roll No. : 6501071 CHANDRAKALA 100298 Affix photograph

Candidate's Name :

Date of Birth : 27/06/1987 Category : Address : GENERAL MAYA BAZAR G 9 C, ROAD NAG MANDIR, MARG BERINAG PITHORAGH Date of Exam: 27/08/2011 Time: 10:00am to 11:30am

CENTRE NAME & ADDRESS :

GOVERNMENT INTER COLLEGE, BERINAG

-----------------------------------------------------------------------------------------------------UNDERTAKING I CHANDRAKALA Son/ Daughter of shri JAGDISH CHANDRA JOSHI hereby solemnly declare as under : 1. My admit card bearing Roll no. 6501071for UTET-1-2011 has been lost/spoiled/ destroyed on account of conditions beyond my control. 2. No admit card for UTET-1-2011 was received by me, though I has applied vide application no 100298 I therefore may be allowed to appear in the examiantion, subject to verification of my documents already submitted to board office. If anything is found wrong, my candidature/result may be cancelled. Date : Signature of Candidate ---> ---------------------------------------------------------------------------------------------------------

Certificate by Centre Supt. It is certified that the name &roll no of the above candiate exist in the list of candidate supplied by the board office at centre against Roll no.Photograph of the candiate attested by me has been taken which is attached to this undertaking and tallies with the photograph and signature in the attandance Sheet for verification in the board office. Affix photograph duly attested by centre supdt. Date : Stamp : Signature of Centre Supt.

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