Ahsec Migration Form – Fill Out and Use This PDF

	Assam Higher Secondary Education Council
Form No. Regn 03	Bamunimaidam, Guwahati - 781 021
	APPLICATION FORM FOR MIGRATION CERTIFICATE

1.Name in full (in block letters) :

2.Father’s name & Home Address :

3.AHSEC Registration Certificate No. :

Examination passed	Name of the Board/ University	Exam. Roll No.	Year of passing	Div./ Class
HSLC
H.S. (Arts/ Sc./Com)

5.Name of the College/School where studied last :

6.Name of the Institution (outside Assam)

Where he/she is studying now/intending to study :

7.

Course :

Class :

Roll No. :

8.Cause of obtaining Migration Certificate :

Amount paid	Council’s Challan No. & Date	Crossed Bank Draft No. & Date
Rs. 300/-

10.Address to which Migration Certificate should be sent :

11.I declare that I have not been debarred from appearing in any Examination or prosecuting any course of studies by the Council.

12.	I surrender my Original Registration Certificate bearing No.	........................... of
Date	.........................	Signature of the Applicant
		RECOMMENDATION OF THE PRINCIPAL

13.The particulars stated above have been checked, verified and found correct, Migration Certificate may be issued.

Memo No. Date Signature of Principal with Seal

1)An applicant for a Migration Certificate should pay FEE of Rs. 300/- (Three hundred) only and submit the application THROUGH THE HEAD OF THE INSTITUTION in which he/she is prosecuting or prosecuted his/her studies last.

2)Migration Certificate is issued only to a registered student of this Council. Registration Certificate issued by the Council should be SURRENDERED for the purpose.

3)No action will be taken unless the prescribed fee is received in the office.

4)I.P.O. or Money Orders are not accepted. Fees should be sent by Bank Draft payable to the Secretary, Assam Higher Secondary Education Council, Bamunimaidam, Guwahati – 21

5)A self addressed stamped envelope is to be attached with the application form.

Accounts Br.	Exam. Br.
Fee Receipt No	Issue Book No	Sl. No
Date	Date

**Rate per Duplicate/Additional Mark-sheet : Rs.100.00

***The application must come through the Head of the Institution through which the candidate appeared in the Examination.

DOCUMENTS TO BE ENCLOSED –

i)In case of loss or theft of the original certificate the applicant must first inform immediately to the local police station or outpost about the loss or theft of the original certificate. The police report is to be attached with the application form.

ii)Photo copy of Admit Card duly attested.

If the original Marks Sheet is damaged, the damaged marks sheet should be enclosed along with the application form.

A self-addressed stamped envelope is to be attached with the application form.

TO STRUCK OFF WHICHEVER IS NOT REQUIRED

RULES

1.The application complete in all respects with required documents and dully filled in all columns to be submitted along with prescribed fee. Otherwise it will be summarily rejected without further communication.

2.No action will be taken unless the prescribed fee is received.

3.In the Challan of the Assam Co-operative Apex Bank Ltd., the name of the candidate, his/her Examination, Year, Roll and No. Etc. must be quoted.

4.In case of Private candidate, the application must be countersigned by the Principal of the recognized Institution from where he/she passed the Examination.

5.Fees : Duplicate Certificate Rs. 100/- (Rupees on hundred only).

6.The duplicate copy of the fee receipt is to be enclosed along with the application.

7.In case of loss or theft of the original Certificate, the applicant must first inform immediately to the local police station/outpost about the loss or theft of the certificate and a report of the enquiry in original is to be attached with the application.

8.In case of partial damage of the original certificate, the same should be attached with the application.

9.A self addressed stamped envelope is to be attached with the application form.

N.B. Money Order/I.P.O. are not accepted. All prescribed fees should be sent by Bank Draft of any Nationalised Bank located at Guwahati in favor of the Secretary, Assam Higher Secondary Education Council, Bamunimaidam, Guwahati - 21 or payment may also be made by the Council’s Challan at Noonmati Branch, Bamunimaidam, Silpukhuri Branch, Guwahati - 3 of the Assam Co-operative Apex Bank Ltd. Guwahati available at the said branches.

Enclosed :

A)Attested copy of Marks Sheet of H.S. Examination.

B)Attested copy of Registration Certificate

C)Attested copy of Admit Card

STATE MADRASSA EDUCATION BOARD : ASSAM

KAHILIPARA, GUWAHATI – 19

		APPLICATION FORM FOR ISSUANCE OF DUPLICATE CERTIFICATE & DUPLICATE	MARK-SHEETS AND OTHER RECORDS
		(Please read the instructions carefully before filling up the forms)
To	:	The Secretary, State Madrassa Education Board, Assam, Kahilipara, Guwahati – 19.
Through : The Principal / Superintendent, …………………………………………….. Madrassa / Arabic College
Sub	:	APPLICATION FOR ISSUANCE OF ……………………………………………………………... .

(Here you write the name of the document required)

Sir,

With reference to the subject cited above, I beg to request you kindly to issue me the document referred to above at your earliest possible convenience. My necessary particulars are furnished below for favour of your kind perusal and necessary action :

1.Applicant’s name in full (in capital letters) :-

2.Name of the concerning examination :-

3.Status of the applicant’s candidature :-

(Regular / Compartment / Private / Teacher private)

4.	Other particulars of the examination :-	YEAR : ……………….. Roll………… No. ………… .
5.	Registration No. with Madrassa Board (if any)	:- No ……………………... of ………………………... .
6.	Applicant’s result of the Examination	:- Passed in …………………………………... division / failed.

7.Name of the institution from/through which

The applicant appeared in the above Examination :-

8.Father’s name of the applicant in full :-

9.	(a) Permanent Home Address :		(b) Present address for correspondence :
	Vill. / Town	P.O.	Vill. / Town	P.O.
	P.S.	Dist.	P.S.	Dist.

10.(a) Whether the documents is to be sent by Post / to be delivered through authorized

Person / to be collected personally by applicant ? :-

b)If the document is to be collected through an

	Authorized person please get him	:-
	Signed his full name in his own writing	(Full signature of the Authorised person)
11.	Purpose for which the document is necessary	:-

12.What happened to the original document ? :-

13.

Enclosed (any one as may be relevant)

:-

(a) Police Report No. ………………., Date …………

of …………………………………….. P.S.

(b) Affidavit dated ……………………… .

(c) Damaged piece / pieces of the original document of which duplicate is applied for.

14.Fees deposited Rs. ………………. Bank Draft No. …………… dated. …………… of ………………………. Branch.

CERTIFIED that the particulars furnished above are true to the best of my knowledge and belief and the documents if received shall be used only for bonafide purposes.

Yours faithfully,

(Full Signature of the appellant)

Contd. P – 2

-2-

FOR USE IN THE OFFICE OF THE SUPERINTENDENT / PRINCIPAL OF THE MADRASSA

Memo No.

Date ……………………

Verified the particulars carefully and found correct and forwarded to the Secretary, State Madrassa Education Board, Assam with request to issue the document as requested for.

Superintendent / Principal with date & Seal

FOR OFFICE USE IN THE BOARD’S OFFICE

Particulars furnished above are verified and found CORRECT / INCORRECT & therefore the document requested for MAY BE / MAY NOT be issued.

Date …………………………..

	Dealing Asstt.
	SECRETARY’S ORDER
Compared by :
	The documents MAY BE issued / MAY NOT be issued
	(Secretary with date)
ACCOUNTANTS RECORD	ISSUE RECORD
The aforesaid Banik Draft / P.S. Counterfoil is received.	The document (……………………………has been
And accounted for properly.	Issued under No. ……………, dated …………. and
	Recorded at Sl. No. …………………. of page of the
	Register.
Account with date
SEEN	D.A. with date
	Secretary with date

INSTRUCTION

1.Only one application should be submitted for any one document.

2.The application must come through the Head of the institution concerned.

3.Incomplete applications in any from or manner shall be rejected & fees forfeited.

4.The application must accompany the prescribed fee in full through BANK DRAFTS only drawn in favour of the SECRETARY, STATE MADRASSA EDUCATION BOARD, ASSAM with 6 (six) months validity and encashable on the UCO BANK, DISPUR or on the STATE BANK OF INDIA, DISPUR. The fee may also be deposited to directly the Bank’s Account of the Board at UCO Bank, DISPUR (Ganeshguri) by filling up of the Pay-in-Slip in this office and enclose the COUNTERFOIL OF the Pay-in-Slip to the application.

5.If the document is to be collected through an Authorised person then his signature in full should be inscribed in the space provided against item 9(b) and his full name should be mentioned in the space against item 9 (a) of the application form and if it is to be sent by post then the application must accompany a self addressed & stamped (of the value of a Registered latter) envelope in 120 cm / 25 cm / 25 cm size.

6.In case of total loss, damage or theft of the original document, the application must accompany a POLICE REPORT or an AFFIDAVIT authenticated by a first Class Magistrate. In case of partially damaged document, the same must be enclosed with the application in lieu of Police Report of the Affidavit.

7.For Migration Certificate the application must accompany the Registration Certificate in original and a Photostat & Attested copy of the Transfer Certificate the applicant received / obtained from the institution he/she last attended.

8.As said in Rule 2 above the Head of Institution in case of applications of Private candidates shall mean the Head through whose institution the applicant appeared in the Test Examination.

Board of Secondary Education, Assam

Bamunimaidam, Guwahati-781021

APPLICATION FOR MARKSHEET/ADMIT CARD/PROVISIONAL CERTIFICATE/MIGRATION CERTIFICATE

(DUPLICATE OR ADDITIONAL)

(ONE APPLICATION FORM CAN BE USED FOR ONE DOCUMENT ONLY)

To:	The Secretary
	Board of Secondary Education, Assam, Bamunimaidam,
	Guwahati-781021

Through the Headmaster/Headmistress/Principal/Superintendant

____________________________________________________________

Sir,

I have the honour to request you kindly to issue me a__________________________

_____________________________________My particulars are given below:

1.Name in Full(IN BLOCK LETTERS)____________________________________________________

2.Name of Examination_____________________________________________________________

3.Whether the examination is Regular/Private/Supplementary/Compartmental (1st , 2nd , 3rd chance)

(a)Roll____________________No._____________________Year__________________(Regular)

(b)Roll____________________No._____________________Year__________________(Private)

(c)Roll____________________No._____________________Year__________(Compt. 1st , 2nd , 3rd

(d)Roll____________________No._____________________Year__________________(Suppl.) 4.Total Marks Obtained_____________________________________________________________

5.Result : Passed in _____________________________________Division/Failed_______________

6.School from which the candidate appeared in the above Examination______________________

______________________________________________________________________________

7.Father’s name in full______________________________________________________________

8.Home Address	Address for Correspondence
Village/Town_____________________________		C/o_____________________________
P.O._______________________Pin___________		Village/Town_____________________
P.S._______________________Dist______________			P.O._________________Pin_________

9.Whether the said document is to be sent by post /to be delivered to authorized person (The certificate shown over-leaf per column 14 must be filled up and signed properly/ to be collected personally by the candidate.

10.Purpose for which document is necessary__________________________________________

11.Challan of the Assam Co-operative Apex Bank, Bamunimaidam Branch, (SEBA Complex) Guwahati-21

Challan No._________________________Rs.___________________Date____________

12.Bank Draft No.______________________Rs.___________________ Date____________

(Any Nationalized Bank)

1.What happened to the original documents____________________________________________

Yours faithfully

Date

Memo No.

Forwarded and recommended for issue of the above document(s). Particulars furnished have been

checked and found correct.

12.____________________________________________________________	May/may not	be issued
	Approved/not	approved
	Secretary/Dy. Secretary

Rates of fee:

Rs. 500.00 for Migration Certificate Rs. 100.00 for Provisional Certificate Rs. 100.00 for Duplicate Admit Card Rs. 300.00 for Duplicate Marksheet

**The Application must come through the Head of the Institution through which the candidate appeared in the Examination. In case of a candidate appearing in the old course without Test Examination, he/she may submit application through a Gazetted Officer also.

2.In case the document is to be delivered on authority letter, the applicant must attest the signature of the authorized person

Full particulars along with attested signature of the person authorized must invariably be furnished.

14.Document will be sent by post if the candidate does not collect his/her document within 30 (thirty) days from the date of submission of the same.

15.If the original document is lost/stolen, a police report testifying the loss/theft mentioning the Roll & No.-must be enclosed with the application. In case of Triplicate Copy of the Marksheet and Admit Card paper notification must be enclosed with the application.

16.If the original one is partially damaged, the remaining portion must be attached with this from (In such an event, police report is not necessary provided, the remaining portion bears the Roll and No. of candidate.).

17.For obtaining Migration Certificate the Original Registration is to be surrendered to the Board, and an attested copy of the Marksheet is to be enclosed with this application form.

18. Delivery After 3.30 pm (every day) .

Board of Secondary Education, Assam

Bamunimaidam, Guwahati-781021

	FEES Rs.500/-
To:	The Secretary
	Board of Secondary Education, Assam, Bamunimaidam,
	Guwahati-781021
	Through the Headmaster/Headmistress/Principal/Superintendant
	________________________________________________________________________________________________________________________________________________
Sir,
	I have the honour to request you kindly to issue me a DUPLICATE/TRIPLICATE copy of the Original Pass CERTIFICATE. Necessary particulars in
	support of my appeal are furnished below:

1.Name in Full (IN BLOCK LETTERS)____________________________________________________

2.Father’s name in full______________________________________________________________

3.Name of the Examination with course (NEW/OLD)and year_______________________________

______________________________________________________________________________

4.Roll_______________________________No.________________________Year______________

5.Result passed in_______________________________________Division____________________

6.Regular/Private/Supplementary/Compartmental(with chance)

7.Group (In case of HSSLC Examination)________________________________________________

8.School from which appeared_______________________________________________________

______________________________________________________________________________

9.Home Address

Home Address	Address for Correspondence
Village/Town_____________________________	Vill/Town_____________________________
P.O._____________________________________	P.O._________________________________
Dist_____________________________________	P.O._________________Dist_____________

10.Purpose for which the document is necessary_________________________________________

11.What happened to the Original Certificate____________________________________________

12.Encl.: Apex bank Challan No._______________________________________________________

Yours faithfully

Date: Memo No.

Forwarded and recommended for issue of the above DUPLICATE/TRIPLICATE Certificate. Particulars furnished are checked and found correct. The applicant received his Original/Duplicate Certificate from this Institution.

PLEASE SEE RULE OVERLEAF

1.In case of loss/theft of the Original/Duplicate copy of the Original Certificate a Police Report from the concerned police Station clearly mentioning the Roll No. and year of examination must be enclosed.

2.In case of damage of the Original certificates (including duplicate one) the damage documents are to be submitted along with the application. No police report will be necessary with damaged documents.

3.The applications are to be submitted through the Head of the School from which the candidate appeared along with necessary fees of Rs.500/-(Five hundred) only through Bank Draft of any nationalized Bank / Challan in Assam Co-operative Apex Bank ,Bamunimaidam(SEBA complex) in favour of the Secretary Board of Secondary Education Assam, Guwahati-21.

4.DUPLICATE/TRIPLICATE certificate will be handed over directly to the candidate/Applicant or an authorized person subject to submission of authorization letter with attestation of signature of the Authorized person along with the original Marksheet and Admit Card of the applicant.

5.DUPLICATE/TRIPLICATE Certificate will be sent to the Head of Institution concerned by post under Registered post if not collected personally/by Authorised person from the office.

FOR THE USE IN BOARD’s OFFICE ONLY

1.Police Report No.______________________________Date___________________________

2.Damaged Certificate submitted /not submitted

3.Age/Date of Birth_________________________________on__________________________

4.Fees deposited Rs.____________________________________________Date____________

Particulars furnished overleaf are checked and found correct/incorrect.

DEALING ASSISTANT	may/may not be issued
REMARKS OF CONTROLLER
	Superintendent
	BRANCH OFFICER
Controller of Examinations,
Board of Secondary Education, Assam
Guwahati-781021
	APPROVED/REJECTED
SECRETARY
Board of Secondary Education, Assam
Guwahati-781021

DUPLICATE/TRIPLICATE CERTIFICATE issued SL.NO.____________________________________________

Signature of Dealing Assistant.

Book No._______________________________________Date___________________________________

		Accounts Br.	Exam. Br.
		Fee Receipt No	Issue Book No.	......................... Sl. No
		Date	Date
	**	Rate per Duplicate/Additional Mark-sheet : Rs.100.00
	***	The application must come through the Head of the Institution through which the candidate appeared in the Examination.
		DOCUMENTS TO BE ENCLOSED –
i)	In case of loss or theft of the original certificate the applicant must first inform immediately to			the local police station or outpost about the loss or theft of the original certificate. The police report is to be
	attached with the application form.

ii)Photo copy of Admit Card duly attested.

iii)If the original Marks Sheet is damaged, the damaged marks sheet should be enclosed along with the application form.

iv)A self-addressed stamped envelope is to be attached with the application form.

Board of Secondary Education, Assam

Bamunimaidam, Guwahati-781021

APPLICATION FOR MARKSHEET/ADMIT CARD/PROVISIONAL CERTIFICATE/MIGRATION CERTIFICATE (DUPLICATE OR ADDITIONAL)

(ONE APPLICATION FORM CAN BE USED FOR ONE DOCUMENT ONLY)

To:	The Secretary
	Board of Secondary Education, Assam, Bamunimaidam,
	Guwahati-781021
	Through the Headmaster/Headmistress/Principal/Superintendant
	____________________________________________________________
Sir,
	I have the honour to request you kindly to issue me a__________________________ _____________________________________My particulars are given
	below:

1.Name in Full(IN BLOCK LETTERS)____________________________________________________

2.Name of Examination_____________________________________________________________

3.Whether the examination is Regular/Private/Supplementary/Compartmental (1st , 2nd , 3rd chance)

(a)Roll____________________No._____________________Year__________________(Regular)

(b)Roll____________________No._____________________Year__________________(Private)

(c)Roll____________________No._____________________Year__________(Compt. 1st , 2nd , 3rd

(d)Roll____________________No._____________________Year__________________(Suppl.)

4.Total Marks Obtained_____________________________________________________________

5.Result : Passed in _____________________________________Division/Failed_______________

6.School from which the candidate appeared in the above Examination______________________

______________________________________________________________________________

7.Father’s name in full______________________________________________________________

8.	Home Address	Address for Correspondence
	Village/Town_____________________________	C/o_____________________________
	P.O._______________________Pin___________	Village/Town_____________________
	P.S._______________________Dist______________	P.O._________________Pin_________

9.Whether the said document is to be sent by post /to be delivered to authorized person (The certificate shown over-leaf per column 14 must be filled up and signed properly/ to be collected personally by the candidate.

10.Purpose for which document is necessary__________________________________________

i)Challan of the Assam Co-operative Apex Bank, Bamunimaidam Branch, (SEBA Complex) Guwahati-21

Challan No._________________________Rs.___________________Date____________

ii)Bank Draft No.______________________Rs.___________________ Date____________

(Any Nationalized Bank)

11.What happened to the original documents____________________________________________

Yours faithfully

Date Memo No.

Forwarded and recommended for issue of the above document(s). Particulars furnished have been checked and found correct.

12.____________________________________________________________ May/may not be issued	Approved/not approved Secretary/Dy. Secretary
Rates of fee:
Rs. 500.00 for Migration Certificate
Rs. 100.00 for Provisional Certificate
Rs. 100.00 for Duplicate Admit Card
Rs. 300.00 for Duplicate Marksheet

**The Application must come through the Head of the Institution through which the candidate appeared in the Examination. In case of a candidate appearing in the old course without Test Examination, he/she may submit application through a Gazetted Officer also.

12.In case the document is to be delivered on authority letter, the applicant must attest the signature of the authorized person

Full particulars along with attested signature of the person authorized must invariably be furnished.

14.Document will be sent by post if the candidate does not collect his/her document within 30 (thirty) days from the date of submission of the same.

15.If the original document is lost/stolen, a police report testifying the loss/theft mentioning the Roll & No.-must be enclosed with the application. In case of Triplicate Copy of the Marksheet and Admit Card paper notification must be enclosed with the application.

16.If the original one is partially damaged, the remaining portion must be attached with this from (In such an event, police report is not necessary provided, the remaining portion bears the Roll and No. of candidate.).

17.For obtaining Migration Certificate the Original Registration is to be surrendered to the Board, and an attested copy of the Marksheet is to be enclosed with this application form.

18. Delivery After 3.30 pm (every day) .