INSTRUCTIONS/GUIDELINES REGARDING COMPETENT AUTHORITY TO ISSUE CERTIFICATES

1. SCHEDULED CASTE CATEGORY

The format for SC Certificate is given as Annexure-II and the competent authorities to issue the
certificate are as under.
i. District Magistrate/Additional District Magistrate/Collector/Deputy Commissioner/Additional
Deputy Commissioner/Deputy Collector/Ist Class stipendary Magistrate/City
Magistrate/Sub-Divisional Magistrate/Talika Magistrate/Executive Magistrate/Extra
Assistant Commissioner (not below the rank of Ist Class stipendary Magistrate).
ii. Chief Presidency Magistrate/Additional Chief Presidency Magistrate/Presidency Magistrate.
iii. Revenue Officer not below the rank of Tehsildar.
iv. Sub-Divisional Officer of the area where the candidate and/or his family normally resides.
v. Administrator/Secretary to Administrator/Development officer Lakshadweep Islands
(Circulated vide No. 2/223/79-SWT/4387 dated 8.6.96).
vi. MLAs of the concerned constituency (Circulated vide No. 1/19/94-RCI/6045 dated 15.7.94)

2. SCHEDULED TRIBE CATEGORY

The competent authority to issue Scheduled Tribe certificate is same as given for Scheduled
Caste category.

3. BACKWARD CLASS CATEGORY

Competent authority to issue Backward Class Certificate:
i. Sub-Divisional Magistrate
ii. Executive Magistrate
iii. Tehsildar
iv. Naib Tehsildar
v. Block Officer
vi. District Revenue Officer

4. PHYSICALLY HANDICAPPED
The admission of candidates in this category will be made on the Submission of certificate to be
issued by Chief Medical Officer of the District concerned, which should indicate the extent of
disability. Minimum 40% disability is required to be eligible under this category.
However, this provision will be subject to the decision of the Admission Committee of
the Institute whether such a candidate would be able to pursue the studies at the Institute
with his specific disability. The decision of the Admission Committee in this regard shall
be final.
 TIET/ADMN/ACA/FT/07 (0)
Annexure-I

FORMAT OF CERTIFICATE OF SCHEDULED CASTE

Despatch No...................... Date.........................

1. It is certified that Mr./Ms. ............................................................……………………………… son/daughter of

Sh.……..................................................................................………………………………………..……….. of
village/town ...............………….................. district/division …….............................…. State of Punjab
belongs to ........................................................................Caste which has been recognised as Scheduled
Caste as per “The Constitution (Scheduled Castes) Order, 1950”.

2. Mr./Ms. ………………………...................................................................... and his/her family lives in

village/town ................................................................………………. district/division of Punjab State.

Place …………………………. Signature ………………………………..

Date …………………………... Designation .…………………………….

(with official seal of the officer concerned)
State …………………………..

SCHEDULED TRIBE CERTIFICATE

Same as for Scheduled Castes Candidates.
 TIET/ADMN/ACA/FT/08(0)
ANNEXURE-II

FORM OF CERTIFICATE OF BACKWARD CLASS

1. This is to certify that Shri/Shrimati/Kumari _____________

son/daughter of Shri of village/town in

District/Division of the State of Punjab belongs to the

Caste, which is recognised as a Backward Class in terms of Punjab Government Letter No.

____________________________________ dated __ .

2. This is also certified that he/she does not belong to any category of persons/sections mentioned

in column 3 of the schedule to the Punjab Government, Department of Welfare Letter No.1/41/93-

RCI/459 dated 17-01-1994, No. 1/41/93-RC1/159 Dated 17-08-2005 & No. 1/41/93-RCI/209 dated

24-02-2009 and No.1/41/93 RCI/609 dated 24.10.2013.

3. Shri/Shrimati/Kumari ________________________________ and or his/her family ordinarily

reside(s) in village/town_______________________ of _____________________ District/Division

of the State of Punjab.

Signature __________________________

Designation ________________________

(Seal of the officer concerned)

Place: _____________________

State: _____________________

Date: ______________________

*This Certificate must not be dated one year before the first day of counselling for admission. A
certificate issued more than one year before counselling date shall not be valid.
 TIET/ADMN/ACA/FT/08(0)
ANNEXURE-III

FORMAT OF MEDICAL CERTIFICATE

I certify that I have carefully examined Mr./Ms. ……………….………………………………… son/daughter

of Sh. ………………………………………………………………………………. His/her age is about

………………………..

His/her Chest Measurement is Unexpanded …………………. Cm

Expanded ……………………. Cm

His/her eyesight is upto the prescribed standards.

Details of glasses, if worn …………………………………………………………………

He/she has no disease or mental or bodily infirmity unfitting or likely to unfit him/her in the future for active

outdoor service.

Blood Group ____________________

Marks of identification

Thumb impression

HEPATITIS “B” IMMUNISATION? Yes No

Dated ………………………

Signature of Gazetted Medical Officer

(with official Seal)

Signature of Candidate
 TIET/ADMN/ACA/FT/10 (1)
Annexure-IV
FORMAT OF SPONSORSHIP AFFIDAVIT FOR ADMISSION TO
BE/BTech/MCA/MSc/ME/MTech/MPhil/PhD PROGRAMME
(To be submitted by NRI, FN Candidates)

I ............................................……............ son/daughter of Sh. ............…............................................ resident

of ................................................................................, am NRI being Permanent Immigrant*/ on H-1 Visa*

/Citizen* (Other than Indian Citizenship) in……………………………….............(Country)

since…………………………….. and I, hereby sponsor my ward

Mr./Ms .................................................................................. who is seeking admission to

BE/BTech/MCA/MSc/ME/MTech/MPhil Programme under Non-Resident Indian/ Foreign National Category at

Thapar Institute of Engineering & Technology, Patiala. My ward has passed his/her 10+2 /equivalent

examination from ………………………………………….. (Name of the Country).

I further declare and affirm that I shall be responsible for timely payment of prescribed tuition fee in US$ and

all other dues and charges to the Thapar Institute of Engineering & Technology, Patiala, immediately after the

admission is granted to the above candidate and also during subsequent years of studies.

Tuition fee shall be paid by me in the form of bank draft in US$ payable to the Registrar, Thapar Institute of

Engineering & Technology, Patiala, along with a bank certificate for encashment of foreign currency of the

like amount.

In addition to tuition fee, I shall pay all other dues and charges to the Thapar Institute of Engineering &

Technology, Patiala, as payable by other students of the same class belonging to same category in foreign

currency or in Indian Rupees, as per Institute Rules and Regulations.

Date.........................
DEPONENT

VERIFICATION
I solemnly state and affirm that the contents of my above affidavit are true to the best of my knowledge and

belief.

DEPONENT

Note: The above affidavit should be attested by a Notary Public or First Class Magistrate.
* Strike out whichever is not applicable.
 TIET/ADMN/ACA/FT/40(0)

Annexure-V

FORMAT OF CERTIFICATE FOR SPONSORED CANDIDATES

(for candidates applying for ME/MTech Programmes)

I certify that Mr./Ms. ………………………………………………………………………………… son/daughter of

Sh. ……………………………………………………………………… is currently employed in our organisation as

…………………………………….. from ………………………. He/She will be granted study leave for pursuing

the programme …………………………………… at Thapar Institute of Engineering & Technology, Patiala. All

the expenses till the completion of the programme will be borne by us. Further certified that the candidate will

not be withdrawn before the completion of the programme.

Place ………………….. Signature

Date ………………….. (with official seal)
 TIET/ADMN/ACA/FT/41(0)

Annexure-VI

FORMAT OF

CERTIFICATE BY PRINCIPAL OF THE INSTITUTION LAST ATTENDED

Certified that Mr./Ms. ……………………………………………………………….. son/daughter of Sh.

………………………………….……………………………….. bears a good moral character and according to

the School/College record, his/her date of birth is (in words)

……………………………………………………………………………………………………. and his/her

Institute/Board Registration No. is ………………….

Place ………………….. Signature

Date ………………….. (with official seal)
 Annexure-VII

TIET/ADMN/ACA/FT/42(0)

Format of Income Certificate

(Not required for Candidates applying for PhD Programme)

CERTIFICATE FROM THE HEAD OF THE OFFICE WHERE

FATHER/GUARDIAN OF THE STUDENT IS EMPLOYED

Certified that Sh. …………………………………….. S/o Sh. .…………………………………….. and father of Mr./Ms.
………………………………………………………… is employed in this office as …………………………………… and the
details of his monthly salary are given below:
Basic Pay (Rs.) Grade pay DA CCA Any other Allowance Total

Place ………………….. Signature of Head of Office

Date ………………….. (with official seal)

OR

Declaration (duly attested by Notary Public) to be deposed by father/guardian

who is not employed but is running his own business

I …………………………………….. S/o Shri ……………………………………….. and Father/Guardian of Mr./Ms.

……….………………………………………… and resident of ……………………………………………………………………… do
hereby solemnly declare that I am not employed anywhere and I am carrying on my own business
(name of business) ……….…………………………..………………… at …………………………………… (Place). My
average gross monthly income is Rs. ……………………

Place: …………………….. Signature of Father/Guardian

Date: ……………………..

Note: Candidates whose father/guardian has retired from Govt. service should produce pension
certificate in support of their income at the time of counselling.
 Annexure-VIII

FORMAT OF CERTIFICATE FOR CHILDREN OF EMPLOYEES OF PUNJAB GOVT. POSTED/DEPUTED OUTSIDE PUNJAB

CERTIFICATE FROM THE HEAD OF THE OFFICE WHERE

FATHER/MOTHER OF THE CANDIDATE IS EMPLOYED

Certified that Sh./Smt ……………………………………….…….. S/D/o Sh. .………………...……………………….. and

father/mother of Mr./Ms. …………………………………………………………………….… is a Punjab Government
employee and is posted/deputed in this office as ……………………………………………… and the details of
his/her services are given below:
Place of working (present): __________________________
___________________________(State)
Date of joining the Present Job ____________________________

Place: ………………….. Signature of Head of Office

Date: ………………….. (with official seal)

Annexure-IX
FORMAT OF GAP PERIOD AFFIDAVIT
(Notarized Affidavit on any amount stamp paper)

I______________________________(Name) S/D/o Shri__________________________________ and

resident of _____________________________________________________(address) do hereby declare

that I was not involved in any kind of illegal or unlawful activity during the

period____________________________________ (mention the period of GAP).

(Signature)
 Annexure-X

FORMAT OF UNDERTAKING TO BE GIVEN BY CANDIDATES OF

BE (LATERAL ENTRY)/MCA/MSc/ME/MTech/MA/MBA/PhD PROGRAMS IF THEIR FINAL RESULT OF
QUALIFYING EXAM IS NOT DECLARED

Such candidates have to furnish following undertaking at the time of document checking/’In Person’
counselling.

“I________________________________________________________________s/d/o Sh

___________________________________am applying on my own risk and responsibility as my final

result of the Qualifying exam has not been declared.

I do hereby declare that I do not have any backlog paper in any of the previous semesters

(Years) of study of the qualifying exam and also I do not expect any backlog in my final exam.

I assure you that I will produce the proof of passing of my Qualifying examination with the

minimum percentage of marks required on or before December 31, 2025, failing which my admission

shall stand cancelled and I shall not claim any right on any count whatsoever.”

Dated: ________________ Signature of Candidate

Signature of Father/Mother
 ANNEXURE-XI

FORMAT OF ANTI RAGGING AFFIDAVIT BY PARENT/ GUARDIAN

(Notarized Affidavit on any amount stamp paper)
I, Mr. /Mrs./Ms. _____________________________________________________ (full name of parent /
guardian) father/mother/guardian of ________________________ (full name of student with admission/
registration/ enrolment number), having been admitted to _________________________ (name of the
institution) have received a copy of the UGC Regulations* on Curbing the Menace of ragging in Higher
Educational Institutions, 2009, (hereinafter called the “Regulation”), carefully read and fully understood the
provisions contained in the said Regulations.
(* The copy is also available on www.thapar.edu)

2. I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes ragging.
3. I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware of
the penal and administration action that is liable to be taken against my ward in case he/she is found
guilty of or abetting ragging, actively or passively, or being part of a conspiracy to promote ragging.

4. I hereby solemnly aver and undertake that: 1. My ward will not indulge in any behaviour or act that
may be constituted as ragging under clause 3 of the Regulations.

2. My ward will not participate in or abet or propagate through any act of commission or omission
that may be constituted as ragging under clause 3 of the Regulations.

5. I hereby affirm that, if found guilty of ragging, my ward is liable for punishment according to clause
9.1 of the Regulations, without prejudice to any other criminal action that may be taken against my
ward under any penal law or any law for the time being in force.

6. I hereby declare that my ward has not been expelled or debarred from admission in any institution in
the country on account of being found guilty of, abetting or being part of a conspiracy to promote,
ragging; and further affirm that, in case the declaration is found to be untrue, the admission of my
ward is liable to be cancelled.
Declared this ________________ day of ________________month of ____________year.

_______________________
Signature of Deponent
Name: ____________________________
Address: __________________________
__________________________
__________________________
Telephone / Mobile No.: _____________

VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and no part of the affidavit is
false and nothing has been concealed or misstated therein.

Verified at ____________________ (place) on this the _____________day of ______ of month,

________________ year.

__________________________
Signature of Deponent

Solemnly affirmed and signed in my presence on this the ____________ day of ______ month of
_____________ year after reading the contents of this affidavit.

OATH COMMISSIONER
 ANNEXURE-XII
FORMAT OF ANTI RAGGING AFFIDAVIT BY THE STUDENT
(Notarized Affidavit on any amount stamp paper)

I, _____________________________________________________ (full name of student with admission/

registration/ enrolment number), S/o D/o Mr. / Mrs./ Ms. ________________________ (full name of parent /
guardian) having been admitted to _________________________ (name of the institution) have received a
copy of the UGC Regulations* on Curbing the Menace of ragging in Higher Educational Institutions, 2009,
(hereinafter called the “Regulation”), carefully read and fully understood the provisions contained in the said
Regulations.
(* The copy is also available on www.thapar.edu)

2. I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes ragging.
3. I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware of
the penal and administration action that is liable to be taken against me in case I am found guilty of
or abetting ragging, actively or passively, or being part of a conspiracy to promote ragging.

4. I hereby solemnly aver and undertake that: 1. I will not indulge in any behaviour or act that may be
constituted as ragging under clause 3 of the Regulations.

2. I will not participate in or abet or propagate through any act of commission or omission that
may be constituted as ragging under clause 3 of the Regulations.

5. I hereby affirm that, if found guilty of ragging, I am liable for punishment according to clause 9.1 of
the Regulations, without prejudice to any other criminal action that may be taken against me under
any penal law or any law for the time being in force.

6. I hereby declare that I have not been expelled or debarred from admission in any institution in the
country on account of being found guilty of, abetting or being part of a conspiracy to promote, ragging;
and further affirm that, in case the declaration is found to be untrue, I am aware that my admission is
liable to be cancelled.

Declared this ________________ day of ______________month of __________year.

_______________________
Signature of Deponent
Name: ____________________________

VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and no part of the affidavit is
false and nothing has been concealed or misstated therein.
Verified at ____________________ (place) on this the _____________day of ______ of month,
________________ year.

__________________________
Signature of Deponent

Solemnly affirmed and signed in my presence on this the ____________ day of ______ month of
_____________ year after reading the contents of this affidavit.

OATH COMMISSIONER
 ANNEXURE XIII
FORMAT OF ANTI-ALCOHOL/DRUG ABUSE AFFIDAVIT BY PARENT/ GUARDIAN
(Notarized Affidavit on any amount stamp paper)

I, _____________________________________________________________ Mr./Mrs./Ms. (full

name of parent/guardian) father / mother/guardian of ______________________ (full name of
student with admission /registration/enrolment number) having been admitted to THAPAR
INSTITUTE OF ENGINEERING & TECHNOLOGY, PATIALA have received a copy of the ANTI-
ALCOHOL/DRUG ABUSE Policy (hereinafter called the “Policy”) carefully read and fully understood
the provisions contained in the said Policy.
1) I have, in particular, perused and fully understood the clause 5 of the Policy and am fully
aware of the penal and administrative action that is liable to be taken against my ward in
case he/she is found guilty of the purchase, possession, use, consumption, sale, distribution
or storage of any alcoholic beverage, controlled substance, smoking or illegal drug on
Institute campus, training sites and at all INSTITUTE sponsored student events, conferences
and activities actively or passively, or being part of a conspiracy to promote such activities
on the Institute campus.
2) I hereby affirm that, if my ward is found guilty as mentioned in clause 2 above, he /she is
liable for punishment according to clause 5 of the Policy, without prejudice to any other
criminal action that may be taken against me under any penal law or any law for the time
being in force.

Declared this ___________day of___________ month of ________ year______________

Deponent
Address:
Telephone/Mobile No:

VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and no part of the
affidavit is false and nothing has been concealed or misstated therein.

Place: Deponent
Date:

Solemnly affirmed and signed in my presence on this the (day) of month, (year) after reading the
contents of this affidavit.

OATH COMMISSIONER
 ANNEXURE XIV
FORMAT OF ANTI-ALCOHOL/DRUG ABUSE AFFIDAVIT BY THE STUDENT
(Notarized Affidavit on any amount stamp paper)

I, (full name of student with admission/registration/enrolment number) s/o - d/o

Mr./Mrs./Ms______________________________________________________ having been
admitted to THAPAR INSTITUTE OF ENGINEERING & TECHNOLOGY, PATIALA have received a copy
of the ANTI-ALCOHOL/DRUG ABUSE Policy (hereinafter called the “Policy”) carefully read and fully
understood the provisions contained in the said Policy.
1) I have, in particular, perused and fully understood clause 5 of the Policy and am fully aware
of the penal and administrative action that is liable to be taken against me in case I am found
guilty of the purchase, possession, use, consumption, sale, distribution or storage of any
alcoholic beverage, controlled substance, smoking or illegal drug on Institute campus,
training sites and at all INSTITUTE sponsored student events, conferences and activities
actively or passively, or being part of a conspiracy to promote such activities on the Institute
campus.
2) I hereby affirm that, if found guilty as mentioned in clause 2 above, I am liable for
punishment according to clause 5 of the Policy, without prejudice to any other criminal
action that may be taken against me under any penal law or any law for the time being in
force.

Declared this ___________day of___________ month of ________ year______________

Deponent

VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and no part of the
affidavit is false and nothing has been concealed or misstated therein.

Place: Deponent
Date:

Solemnly affirmed and signed in my presence on this the (day) of month, (year) after reading the
contents of this affidavit.

OATH COMMISSIONER
 Annexure-XV

FORMAT OF AFFIDAVIT FOR CANDIDATES SEEKING ADMISSION UNDER PUNJAB STATE

QUOTA ON THE BASIS OF PUNJAB RESIDENCY CERTIFICATE (WHO HAVE DONE 10+2
FROM OUTSIDE PUNJAB)

(Notarized Affidavit on any amount stamp paper)

I______________________________(Name) S/D/o Shri__________________________________ and

resident of _____________________________________________________(address as per Punjab

Residency Certificate) have done 10+2 from ______________________ (State). I hereby declare that I have

not claimed / will not claim State quota benefit from any other State/UT.

(Candidate Signature) (Parent’s Signature)

 Annexure-XVI

Undertaking from the Student and Guardian

I,Mr./Ms……………………….................................................................................,Date of Birth………………………………………..………………Roll
No:/TIET application number……………………………………………….., seeking admission in
Programme:………….……………………………………………………………….. at TIET, Patiala do hereby declare, affirm and undertake on this
day……..………….month………………..……………. year……….…………….the following:

1. That the information provided by me in the application form is true, correct and nothing has been concealed
therein. The documents appended with the check list/ application form is/are genuine. I have gone through the
eligibility criteria laid down by the TIET, Patiala for the Admission to the above mentioned programme and I
hereby confirm that I fulfill the same.
2. That I have not used any incorrect, manipulative, forged, illegal, misrepresentation or other inappropriate
means/informations/documents/details to secure the admission in the above said mentioned programme. The
University shall have the right of cancellation/termination of my admission in case it is found that I have used
any of the above mentioned means/informations/documents(s) to secure the admission or given wrong
information or facts.
3. I shall abide by the admissible rules and regulations of TIET University, Patiala. I acknowledge that the University
has the authority of taking disciplinary action on me for non-compliance of the same.
4. I understand that as per rules and regulations of the University, I will not be permitted to possess or use any
motorised vehicle inside the Instititute campus, unless I am permitted to do so by a written prior authorization
from the Dean (Students’ Affairs).
5. In the event of my involvement in any activity outside the campus which is punishable by the law of the land, the
Institute shall in no way provide any support to me and will be not be responsible either for my action.
6. I also declare that I am not suffering from any serious/contagious ailment including psychology related
symptoms.

Signature of Student

I hereby fully endorse the undertaking made by my child/ward.

Signature of Mother/ Father and or Guardian