I, _________________________________ (Name of the Student, son of ___________________ ___________________  (Name of Father/Gaurdian) residing at __________________________ _____________________________________________________________________  (address)

 do hereby solemnly affirm and state as under:

  1. I say that at the time of my admission, I have paid a sum of Rs. ____ /- (Rupees ___________ __________________ only  (subject to change by Shikshan shulka Samiti) towards tuition and development fees (interim fees) for the year 2012-13 for First year Engineering course.

  1. I say that I am fully aware that the aforesaid fees paid by me are interim fees and are subject to revision by Shikshan Shulk Samiti at any time. In the event of the fees being increased by Shikshan Shulk Samiti, I hereby undertake to pay the difference amount of the fees within a period of one month from the date the fees are revised and notified.

  1. I hereby also undertake that I will not object to or challenge the increase in the amount of the fees for any reason whatsoever.

Place: _________

Signature of the Student _________________


Name of the Student___________________