SYMBIOSIS INTERNATIONAL (DEEMED UNIVERSITY)

(Established under Section 3 of the UGC Act, 1956)

Re-accredited by NAAC with 'A' Grade (3.58/4) | Awarded Category – I by UGC

Procedure to be followed for the issuance of duplicate certificate(s) OR Correction in Name OR Gender

Candidate has to apply for Duplicate Degree / Diploma Certificate OR Correction in Name or Gender in
prescribed application form. The fees shall be paid in the form of Demand Draft in favour of Symbiosis International
University, payable at Pune / By cash at the Finance Department, Symbiosis International (Deemed University),
Gram: Lavale, Dist. – Pune Pin Code – 412115 or via online mode.

The filled application form with requisite documents will be sent to Controller of Examinations, Symbiosis
International (Deemed University), Gram: Lavale, Tal.: Mulshi, Dist.: Pune, Pin Code – 412 115.

Fees:

Sr.
Nature of Certificates Amount ( Indian / Foreign Students ) Bank details for online payment
No

INR 3000 / USD 50 in Equivalent Indian Rupees

a) Duplicate Degree Certificate
1) b) Correction in Name or Gender in
the Degree Certificate
a) Duplicate Diploma Certificate
2) b) Correction in Name or Gender in
the Diploma Certificate
Inclusive postage within India Symbiosis International University
Type of Account : Savings Account
(Additional amount of INR 1500/- to be paid by the
Account No. : 050310210000023
student for receiving the certificate outside India)
Bank Name : Bank of India
IFSC code : BKID0000503
MICR No. : 411013011
INR 1500 / USD 25 in Equivalent Indian Rupees
SWIFT Code - BKIDINBBPMB
Inclusive postage within India
Branch Address: Erandvane, Karve
Road, Pune 411 004
(Additional amount of INR 1500/- to be paid by the
student for receiving the certificate outside India)

Candidate should submit Affidavit cum Indemnity on Rs. 100/- stamp paper duly notarized (as per the
specimen given on Page 3).

Candidates should attach photocopy of the Statement of Marks / Grade Sheet, Certificate of Passing, Consolidated
Grade Sheet, Degree or Diploma Certificate along with application form.

Duplicate Certificate will be dispatched by Courier / Speed Post to the concerned candidates within fifteen days
from the receipt of application.

Gram: Lavale, Tal. Mulshi, Dist. Pune. Pin – 412 115 | Tel.: +91-20-28116223, 6839 Fax: +91-20-28116206
Website: siu.edu.in | E-Mail: convocation@siu.edu.in
 SYMBIOSIS INTERNATIONAL (DEEMED UNIVERSITY)
(Established under Section 3 of the UGC Act, 1956)
Re-accredited by NAAC with 'A' Grade (3.58/4) | Awarded Category – I by UGC

To

The Controller of Examinations

Symbiosis International (Deemed University),
Pune

Subject: Application for issue of Duplicate Degree / Diploma Certificate OR Correction in Name or Gender

Sir / Madam,

I, the undersigned request you to kindly issue me the duplicate certificate of Degree / Diploma OR Correction in
Name or Gender (as detailed below), as the original is lost / misplaced / not traceable and hence is not available
with me,

A] ACADEMIC DETAILS -
1) Name of the Alumnus:
2) Name of the Institute:
3) Name of Degree / Diploma:
4) PRN:

B] PERSONAL DETAILS

1) Address ( for dispatch of

Degree / Diploma Certificate )
State: Pin Code:
2) Telephone No. (R) Mobile:
3) E-Mail ID:

C] PAYMENT DETAILS -
Bank Name:
Transaction Reference
OR IMPS No. / Demand Dated : Amount:
Draft / Cash Receipt No.

Enclosed herewith the Affidavit cum Indemnity, duly notarized to enable you to consider my request for issue of
duplicate certificate.

Yours faithfully,

(Signature of alumnus)

Encl: Affidavit cum indemnity

Gram: Lavale, Tal. Mulshi, Dist. Pune. Pin – 412 115 | Tel.: +91-20-28116223, 6839 Fax: +91-20-28116206
Website: siu.edu.in | E-Mail: convocation@siu.edu.in
 Text of Specimen Affidavit cum Indemnity to be submitted for issue of Duplicate Certificate
(to be executed on non-judicial stamp paper of Rs. 100/-)

AFFIDAVIT CUM INDEMNITY

I, …………………………………………….……………….., (name of the candidate as per mark sheets) son /

daughter of …………..……………..…..…………….. aged …….. (years), residing at
………………………………………………...
…………………………………..………………………………………….. do hereby solemnly state on oath and affirm
as under:

1. I state that I was a bonafide student of _______________ and appeared for _______________ programme
and successfully completed the same in the year _____________.

2. I state that I have lost/misplaced my ___________ degree / diploma certificate issued by Symbiosis
International (Deemed University), Pune from my custody and the same could not be found or traceable with
all my efforts.

3. I state that in the event, if the said certificate is found, I undertake to return the same to Symbiosis
International (Deemed University), Pune.

4. I state that I have not given and/or handed over the original certificate to any person/entity for any purpose
and that I will not misuse the duplicate certificate issued to me.

5. I state that I swear that this Affidavit cum Indemnity, being produced before Symbiosis International (Deemed
University), Gram: Lavale, Tal. : Mulshi, Dist.: Pune, Pin Code: 412115, is submitted solely for the purpose to
obtain duplicate certificate in lieu of the original certificate.

6. I declare that the contents of the above Affidavit cum Indemnity are true and correct to the best of my
knowledge and belief and no part of it is false.

Solemnly affirmed at _______________________, on this _______________ day of ___________________.

_________________ _______________
IDENTIFIED BYDEPONENT
(WITNESS)

BEFORE THE NOTARY PUBLIC OR EXECUTIVE MAGISTRATE

Gram: Lavale, Tal. Mulshi, Dist. Pune. Pin – 412 115 | Tel.: +91-20-28116223, 6839 Fax: +91-20-28116206
Website: siu.edu.in | E-Mail: convocation@siu.edu.in