Proforma for submission of the information by way of Affidavit by lnstitutions of EminenceDeemed-to-be-Universities for establishing/starting Off-Campus Centre(s)

PART-.I

*Processing Fee (Rs. Five Lakhs)

S. No

The processing fee to be sent through RTGS / NEFT to following accounts: -

Name of the Bank - Canara BankBranch - UGC, New DelhiAccount No. - 8627101002314IFSC Code - CNR80008627N4ICR No. - 1 1001 5170

The lnstitute to sent the following details about the processing fee senl:-

Name of the lnstitution -Address -Name of the Bank -Branch -Branch Code -Account No. -IFSC Code -Amounl -UTR No. -

(*Processing fee may also be submitted to the Ministry of HRD along with the submissionof the Affidavit through Demand Draft in the name of Secretarv. UGC)

Pa rtic u la rs

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Particulars of lnstitution of Eminence:

lnformation to be provided

Basic information about lnstitution of Eminence

NameAddress:Location (Metropolitan / Non-metropolitan / Non-urban area):Whether multi-disciplinary/inter-disciplinary/single disciplinary:Notification No. & Date of establishment as Deemed to be University:Notification No. & Date of establishment as lnstitution of Eminence:Headquarter of the lnstitution of Eminence Deemed to be University:

(Copy of the Notification declaring Deemed to be University and lnstitution of EminenceDeemed to be University to be provided at Annexure: (Pages _ to _))

Name, Contact No., Email, Address, etc. of Directors / Vice-Chancellor andRegistrar of the applicant lnstitution of Eminence:

Desig nation

Name:

Designation

Address

Name

S. No.

Email

l\,ilobile

Phone

Fax

Details about lnstitution of Eminence Deemed to be University

Name & location of approved Off Campuses, if any:

Name & location of approved Off shore Campuses, if any:

Name & location of approved Constituent Unit i lnstitutions, jf any

(Approval of the Government to be provided at Annexure: (Pages _ to _))

Ema

Phone

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PART _ 2

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iv.

vi.

vii.

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lAddress:

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Mobile:

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4 Society / Trust / Company promoting the lnstitution of Eminence Deemed to beUniversity

(ln case of Government controlled lnstitutions, Sponsoring Society / Trust / Company may

be either Central / State Government, Certificate of Registration may be provided atAnnexure: (Pages _ to ))

Composition of the Governing Body of the lnstitution of Eminence Deemed to beUniversity

Name of the Society i Trust i Company

Composition of the Society / Trust / Company

Corpus Fund

Whether Corpus Fund as required under the Regulations / Guidelines has beenmainlained? Yes / No

(A copy of the FDR to be provided at Annexure : (page_ to ))

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t_7. Accreditations

NIRF

NAAC

Others

(Supporting documents to be provided at Annexure: (Pages _ to _))

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PART - 3

lnformation about proposed Off-Campus

lnformation to be provided

Basic information about proposed Off-Campus

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Name

Address:

Location (Metropolitan / Non-metropolitan / Non-urban area)t

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2 Resolution of the Board of Management to start new Off-Campus Centre (lndicate

reference number & date)

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Seeking approval of the Government

OR

Seeking Letter f lntent for establishment of the off-campus

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Whether NOC from the concerned State / UT Government has been obtained where

the off-campus(s) is proposed to be started?

Yes / No

(Documentary proof may be provided at Annexure: (page _ to )

No. of Faculty recruited/ tobe recruited (as perrespective Council(s)norms)

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S.No. Name of theCourse

Proposedstudentintake

Proposed year ofstarting of course

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Application is made for:-

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Courses proposed to be introduced with students intake capacity & faculty to be

recruited (for alleast first flve years)

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7 (a) Land details (for permanent off campus)

Land Area (in acres.) -Built up area (available/proposed)Whether freehold or leasehold (ln case of leasehold, indicate period also) -Title of the Land -Location of the Land -

Land Area (in acres.) -Built up area -Whether freehold or leasehold (ln case of leasehold, indicate period also) -Title of the Land/Building -Location of the Land/Building -

(Documentary proof may be provided at Annexure: (page _to_)

(b) lnfrastructure facilities (Built-up area in Sq meter may be provided)

Academic facilities:Administrative facilitiesOlher facilities:

(c) Land/Building details (in case of inte.im campus till the permanentcampus is ready)

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(Documentary proof may be provided at Annexure: (page _to_)(d) Time line for completion of lhe permanent off-campus

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Whether prior approval ofthe relevant Statutory/ Regulatory body has been obtained

for courses lo be started?

i. Fees from sludents:ia. Funds from Government:iii. Earnings from consultancy:iv S upport from alumni:v lncome from donation:vi. Any other source of income

Finance facilities

Expected source of income (in crore)

Total expected income:

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Yes/No

(Documentary proof may be provided at Annexure (page....,.to .......)

Expected expenditure (in crore)

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Salaries:[.i]aintenanceCapital.Any others.

Total expenditu re:

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The proposed Off-Campus Centre(s) shall be operated and maintainedunder the overall supervision and control of the lnstitution of EminenceDeemed to be University as its constituent lnstitution.

The proposed Off-Campus Centre(s) shall be administered by thelnstitution of Eminence Deemed to be University.

t The proposed Off-Campus Centre(s) shall offer only those programmesof study which are approved by the appropriate bodies of the Institutionof Eminence Deemed to be University and the statutory / regulatory bodyconcerned such as UGC, AICTE, MCl, DCl, PCl, NCTE, BCl, lNC, etc.,wherever applicable.

Admissions in the courses in the proposed Off-Campus Centre(s) shallbe made only after it is formally approved by MHRD by issuing anotification.

Certificate

This is to certifo that all the information provided by the lnstitution of Eminence Deemed to be University is

conecl, to the best of my knowledge and belief. The lnstitution of Eminence Deemed to be Unlversity shall

adhere to the rules, regulations and guidelines of the Empowered Expe( Committee and Central

Government issued from trme to time. lf the information provided by the lnstitute is found to be incorrect /

false at any stage, the Ministry of HRD may withdraw the approval.

Note: The information provided in the Annexures of the Affidavit should be clearly reflected

and the entire documents should be page numbered.

Signed by the head ofthe Sponsoring Society / Trust / Company

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Undertaking to the effect of the following:

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