TERI School of Advanced Studies

New Delhi

Students’ Clearance Certificate

Name ____________________________________________________________
Registration No. ____________________________________________________________
Department ____________________________________________________________
Programme __________________________ Batch ________________________
Is clearing the University on/approximately on
__________________________________________
Reason ____________________________________________________________

Date __________________________ Manager (AA)__________________

1. Department (Supervisor/Head of the Department)

Nothing is due from him/her in respect of:
 Research material/project reports:
 Books etc. :
 Unfinished work:
 Instrument:
 Electronic version of the major project on CD received:

Supervisor __________________________ Head __________________

Date __________________________ Date __________________

2. TERI Library (IHC)

Signature __________________________ Date __________________

3. TERI SAS library

Signature __________________________ Date __________________

4. TERI SAS CITIN

Signature __________________________ Date __________________
5. Personnel (TERI SAS)
 Photocopy:
 Courier/Fax:
 Travel
 Any other
Signature __________________________ Date __________________

6. Accounts Section (TERI SAS)

Name as per bank account _______________________________________________
Payable at _____________________________________________________________
Signature __________________________ Date __________________
Please attach a copy of your cancel cheque for NEFT transfer (Mandatory)
7. Recorded in the alumini database

Company joined __________________________________________________________

Designation _______________________ Place _________________________

Rebacca
Certificate from Student
(a) Address for future correspondence __________________________________________
________________________________________________________________________
________________________________________________________________________
Email id: _______________________________Landline/Mob no __________________
(b) Certified that no dues are pending from/to me except the following:
________________________________________________________________________
________________________________________________________________________

Student
Registrar’s office
Correspondence addressed noted in records

I-card surrendered on ___________________________________

Migration certificate issued on ___________________________________

Date __________________________ (Manager - Academic Administration)