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Visvesvaraya Technological University Application For The Extract Marks Cards Issued by VTU (UG/PG)

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VISVESVARAYA TECHNOLOGICAL UNIVERSITY

“Jnana Sangama”, Belagavi- 590018


Application for the Extract Marks Cards issued by VTU(UG/PG)
POINTS TO NOTE
 Pay online only by SBI Payment link http://vtu.ac.in/online-fee-payment and enclose Online Receipt of fees paid
 DDs are not accepted
 Fees paid once cannot be refunded. By Post Only

Name of Student
MOHAN KUMAR G L
(In Capital letters)
University Seat Number 1KI16EC040
Old USN (if USN changed)

C Choose one of the below options:


 Extract Marks Cards Fees ₹250 per semester marks card ₹250/for each semester
Details of Fees Marks card

Choose Category “F – Fees to be Fees paid: ₹ 250


paid by student” – Examination
DUE8667048
Payment ID: ______________________ 26-05-2021
Date: ______________________

Marks card particulars:-


Month / Year Semester
JANUARY 2020 7th
SEPTEMBER 2020 8th

CHECKLIST
 I declare that I have not studied in an Autonomous college
 Online receipt of fees paid
MOHAN KUMAR G L
Name: _____________________________ 6362308912
Mobile: ____________________________ 26-05-2021
Date:_______________________
S/O LOKESHAIAH G C ,GOVINDAGHATTA ,THANDAGA(P), TURUVEKERE(TQ), TUMKUR(DIST),
Address: ___________________________________________________________________________________________________________________________
KARNATAKA
___________________________________________________________ 572227
PINCODE: _______________ Signature: ______________________

Application by Post Application by Hand (In person at VTU Belagavi)


Send the filled and signed application form and online receipt of fees Applications are not recieved by hand due to Covid-19 Pandemic.
paid to the following address:
Registrar (Evaluation)
Visvesvaraya Technological University
Jnana Sangama
Belagavi - 590018
For Office Use Only

Case Worker: _________________ Special Officer: __________________


To be filled in by applicant in BLOCK Letters (POSTAL ADDRESS TO WHICH EXTRACT MARKS CARD ARE TO BE SENT)
(This portion will be cut and pasted on envelope. Check for correctness) Note: Postage fee of Rs. 1,500-00 to be added to the fees to be paid, for addresses outside India

USN: 1KI16EC040
Name MOHAN KUMAR G L
________________________
Address S/O LOKESHAIAH G C ,GOVINDAGHATTA ,THANDAGA(P), TURUVEKERE(TQ), TUMKUR(DIST),
KARNATAKA

PIN 572227 Mobile: 6362308912

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