Dr.B.R AMBEDKAR OPEN UNIVERSITY
STUDENT SERVICES BRANCH
ROAD NO.46, JUBILEE HILLS,HYDERABAD-500033
APPLICATION FOR DUPLICATE IDENTITY CARD
1) Admission Number : …………………………………………………………..
2) Name of the candidate : ………………………………………………………….
3) Father’s Name : …………………………………………………………..
4) Course of Study : …………………………………………………………..
5) Address for Communication : ………………………………………………………………………………………
with Phone No.
: ………………………………………………………………………………………
: ………………………………………………………………………………………...
6) Study Centre Code & : …………………………………………………………………………………………
College Name : ………………………………………………………………………………………...
Place : ………………………………………………………………………………………
7) Fee particulars : D.D./ Challan No. ………….Date………………………………………Rs.50/-
Bank /Branch ………………………………………………………………………
Note: 1) Apply with two passport photos ( one to be pasted on the ID Card and one on the application
2) A SELF – ADDRESSED ENVELOPE
DECLARATION
I hereby declare that the information provided in the application is true to the best of my knowledge and
belief..I shall be responsible for any false information provided and come to the notice, the University has right to
initiate as per the rules in force.
Signature of the Student
………………………………………………………………………………………………………………………………
FOR OFFICIAL USE ONLY
Verified with the office records and the details mentioned in the application are found correct.
Identity card (Duplicate) may be issued.
JACT Superintendent Office In charge.
Photo should be
Attested by the
Study Centre
Head with seal