(CAM-2018 / RTU DAT-2018 Admission)
1.Name of Candidate *
2.Father’s Name *
3.Registration Number (CAM / RTUDAT-2018) *
4.Admission category (Tick the Category) *
5.Reason of Seeking Refund (Tick the Category) *
Note:Please note that In case of double payment / transaction failure / choice exhausted, details given at S. No. 6 is mandatory to fill, failing which refund application will not be considered. 6. Challan Nos (RTU DAT/CAM-2018)(This may be taken from admission Portal at the link of “FORGET APPLICATION NO.”) . 6(a) Transaction successfully made (REG. FORM FILLED): *
6. (b) Transaction failed but amount debited from my bank a/c (REG. FORM NOT FILLED) *
7. I hereby undertake that the information given above is correct and It is requested kindly make the refund of excess amount through RTGS/NEFT into following bank a/c and I shall be liable for any claim arising out of reconciliation:- *
Bank Name: *
Account Holder Name: *
Bank A/c no: *
IFSC Code: *
Bank Branch address: *
(scan copy of cancel cheque/ pass book must be enclosed) *
Mobile No. *
Upload signed application in prescribed format(available on website) *
Never submit passwords through Google Forms.
This form was created inside of Rajasthan Technical University. - Terms of Service - Additional Terms