GENUINENESS VERIFICATION REQUISITION
Instructions to fill the form
Scan QRCODE on the right and Pay using any BHIM UPI App & get the reference No. after successful payment before proceeding.
** Enter the reference number into the "Payment Reference No." text field in the below form.
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@paytm
1) Name of the Employer/ Candidate :
2) Mobile No :
3) Email ID :
4) Designation :
5) Company where working :
6) Employee/candidate ID.No. /Ref.No. (If any) :
7) Name of the College/Institution :
8) Register No. :
9) Name of the Programme :
Payment Details :
10) Details of Payment mode :
11) Payment (UPI) Reference No. ** :
12) Payment Date :
13) Mode of Study :
Choose an option
Regular
If Regular :
Choose an option
Full Time
Part Time
14) Enclosures of Documents (Tick whichever is applicable) :
A)
No of Marks Statement enclosed
B)
Provisional certificate
C)
Degree Certificate
Enter the digits from the image into this box
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