Dibrugarh University

APPLICATION FORM FOR REQUESTING RE-EVALUATION/RE-SCRUTINY

(TO BE SUBMITTED WITHIN twenty(20) DAYS FROM THE DATE OF THE PUBLICATION OF THE RESULTS)

(*) Indicates Mandatory Fields.

To
The Controller of Examinations
Dibrugarh University,
Dibrugarh

Application Type:

Batch

Name in full(in Capital Letters):

Mobile No

Email:

Name of the college:

Registration No. with year under D.U. No:

Year

Examination Name:

Roll No:

Year

Date of declaration of Result:

Subject and Paper(s) of which Re-evaluation/Re-scrutiny sought

Program & Semester	Paper	Obtained Marks/Grade

Marksheet/Grade Card:

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Signature:

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Declaration:

I hereby declare that the particulars furnished above are true to the best of my knowledge and belief.I have gone through the rules governing Re-evaluation/Re-scrutiny on overleaf and I shall abide by the said rules.

APPLICATION FORM FOR REQUESTING RE-EVALUATION/RE-SCRUTINY

(TO BE SUBMITTED WITHIN twenty(20) DAYS FROM THE DATE OF THE PUBLICATION OF THE RESULTS)

To The Controller of Examinations Dibrugarh University, Dibrugarh

Declaration:

To
The Controller of Examinations
Dibrugarh University,
Dibrugarh