Certificate No.

This certificate should be produced by

1. 2. Candidates who would like to avail first graduate fee concession Candidates who have not studied VIII, IX, X, XI and XII Std. from a School in Tamilnadu but claim Tamilnadu Nativity Application No.

Name of the Applicant : .

Note : This Certificate should be issued by an Officer of Revenue Department not below the rank of a Tahsildar in the Taluk concerned Certificate of Nativity in Tamilnadu Certified that Thiru / Thirumathi Parent / Guardian * of Thiru / Selvi /
Parent Name

Thirumathi ** an applicant for admission to B. E. / B. Tech. in Tamilnadu has / had

Applicant Name

permanent

residence

at

..

in

Tamilnadu

and

is

Native

of

District in Tamilnadu.

Signature of Village Administrative Officer

Signature of Revenue Inspector .. of in the ..Taluk of .District. (with office seal)

Signature Name Designation

: : : Tahsildar

of .... in the .Taluk of ..District. (with office seal)

Office Seal with Date :

* Applicable only when both parents are deceased 1(a) This Certificate should be signed by the Village Administrative Officer, Revenue Inspector and by the Tahsildar in the Taluk concerned. This Certificate should not be issued by Special Tahsildars, Deputy Tahsildars such as Loans, Land acquisition, Election, excise and HQs. Deputy Tahsildars, Special Deputy Collectors, Asst. Commissioner of Agricultural Income, Excise, Elections etc. (b) The Certificate should bear the stamp of the office and the Officer signing the Certificate.

** Nativity of husband only 2. If only one of the parents of a candidate is alive, the State of Nativity of the surviving parent can alone be taken into account. If both the parents are dead, the candidates may choose the State of Nativity of the father or mother. The State of Nativity of a candidates guardian be given (and will be taken into account) only if both the parents of the candidate are dead. The relationship of the guardian to the candidate should also be mentioned. If both the parents are alive, only the State of Nativity of father should be taken into account. 3. Srilankan Tamil Refugee candidates need not produce Nativity Certificate for availing First Graduate Fee concession.

Only this format is accepted

Certificate No. II Name of the applicant : . Application No.

First Graduate Certificate

It is certified that there is no Graduate in the family of Selvan / Selvi . S/o / D/o Thiru. ... presently residing at .. and who has applied for professional courses during the year 2013, is eligible for Tuition Fee exemption as per the G.O. (St) No. 85 Higher Education (J2) Department, dated: 16.04.2010. Sl. No. (1) Relationship Name (2) Applicant Father Mother Fathers Father Fathers Mother Mothers Father Mothers Mother Brother / Sister Brother / Sister Brother / Sister Brother / Sister
Father / Mother / Brother / Sister / Grand Father / Grand Mother

Age (4)

Educational Qualification (5)

Whether Degree holder (6)

(3)

Station: Date: Office Seal: Head Quarters Deputy Tahsildar Taluk: District:

FIRST GRADUATE CONCESSION JOINT DECLARATION FORM

I hereby declare the following details of my family members and their education qualifications to avail the tuition fee waiver for my studies in Professional Courses under the scheme of waiver of tuition fee to the students from the family where there are no graduates. Sl. No. (1) Relationship Name (2) Applicant Father Mother Fathers Father Fathers Mother Mothers Father Mothers Mother Brother / Sister Brother / Sister Brother / Sister Brother / Sister
Father / Mother / Brother / Sister / Grand Father / Grand Mother

Age (4)

Educational Qualification (5)

Whether Degree holder (6)

(3)

I hereby solemnly and sincerely affirm that I am the first person from my family to claim the waiver of Tuition Fee for entire Professional Course of study and there is no graduate in my family so far. The particulars furnished above are true. Should it, however, be found that any information furnished therein is false in material particulars on verification at a later stage, I am liable for criminal prosecution and I also agree to return the amount equal to three times the tuition fee waiver availed by me. Date: Place: SIGNATURE OF THE CANDIDATE I solemnly and sincerely affirm that I am fully aware of the above declaration and the particulars furnished in the declaration are correct. I am liable for the criminal action / recovery of amount equal to three times the fees waived for incorrect particulars furnished. Date: Place: SIGNATURE OF THE PARENT / GUARDIAN