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Federal Board of Intermediate and Secondary Education

Islamabad.

Subject: APPLICATION FORM FOR DUPLICATE CERTIFICATE.


(SSC /HSSC)
Sir,
Kindly issue me a duplicate certificate. My relevant particulars are given hereunder.
a.
Name (In Capital Letters): ____________________________________________________________________
b
.
Father’s Name (in Capital Letters): _____________________________________________________________
c.
(SSC/HSSC) Registration # __________________ d. Roll No. ______________ e. Year ______
f.
Examination Passed (SSC /HSSC) g. Annual/Supplementary _________________
h
.
Name of institution for regular candidates ________________________________________________________
i.
Marks Obtained: ___________________ j. Grade: _______

I enclose herewith following requisite documents in original: -

1) An affidavit on judicial stamp paper of the value of Rs.100/- (or above) vetted by notary public or Oath Commissioner or 1 st
class Magistrate as per specimen is provided (Overleaf) by the Board.
2) Photocopy of Result Card or Certificate
3) Bank draft/ Challan bearing No. _____________ dated ___________ amount: _________
4) Bank draft/ Challan bearing No. _____________ dated ___________ amount: _________

Yours Obediently

Signature _________________________________
Name and Address _________________________
___________________________________________
Dated: __________________ Contact No. _______________________________
----------------------------------------------------------------------------------------------------------------------------------
REQUISITE FEE
Fee within Country Fee for Overseas Students
Rs.3000/- US$60/-
(Certificate will be issued on the same day) OR (equivalent in Pak Rupees)

Note:
1. Application shall not be entertained if any of the above document(s) is missing
2. Application shall be filled in properly. Incomplete application shall not be entertained.
3. In case by hand delivery of the certificate, only Father/Mother/Brother or Sister of the candidate can
receive/collect the certificate.
4.
(INSTRUCTIONS)

1. Overseas student on proof of permanent settlement in Pakistan i.e. photocopy of CNIC, copy of
appointment
letter, proof of admission in any college or university within Pakistan will be charged fee at par with the Inland
Candidates.
2. The following documents in original should be attached with this application form.
o An affidavit on judicial stamp paper of the value of Rs.100/- (or above) vetted by notary public or Oath

the Original Certificate as per specimen given below.


o A copy of Result Card or Certificate.
o Original Bank Draft/Challan

SPECIMEN OF AFFIDAVIT OF RS.100/-


I _________________________________________ Son/Daughter of ________________________________________
resident of ____________________________________________ do hereby solemnly affirm and declare as under: -

1. That I have lost my certificate of SSC/HSSC, Annual/Supplementary Examination bearing Roll


No._________________ passing year _____________ issued by the Federal Board of Intermediate and
Secondary Education Islamabad during transit shifting etc.
OR
That my certificate of SSC/HSSC, Annual/Supplementary Examination bearing Roll
No._________________ passing year _____________ issued by the Federal Board of Intermediate and
Secondary Education Islamabad has been damaged/blotted/torn/burnt/Stolen etc.
2. That in spite of my best efforts I could not trace the same.
3. That I did not use it for any other purpose.
4. That I further declare, if the original certificate is found, it shall not be used and will be returned to the
Board.
5. That my above statement is true to the best of my knowledge and nothing is concealed.

Signature _____________________________ Date _________________________


Address ______________________________ C.N.I.C. ______________________
_____________________________________ Contact #: ____________________

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