Indian Institute of Technology Kharagpur

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INDIAN INSTITUTE OF TECHNOLOGY KHARAGPUR

Application for refund of Institute/Hall Caution money


(To be submitted to the Accounts Section)
To
The Deputy Registrar (F&A)
IIT, Kharagpur.
Sir,
I deposited Rs. 6000 as Caution money on 21-07-2010 for admission to 5 YRS M.SC Course. Please refund my
Institute/Hall Caution money and Mess deposit, if any. I append below the following particulars :
1. Full Name :YASH LADHA
2. Roll No. :10GG20038
3. Programme Course of study:5 YRS M.SC
4. Year of admission :2010
5. Department/Centre/School :GEOLOGY & GEOPHYSICS
6. Hall of Residence :NHR
7. Permanent Address :

C/O Ganesh Kumar Ladha


M.G Road, Islampur Bazar
Islampur
West Bengal
India
733202

8. Bank Name :STATE BANK OF INDIA


9. Bank IFSC Code :SBIN0000202
10. A/C No. of the student :31286868378
(Caution Money will be credited to the concerned student's A/C only.)
I am leaving the institute campus immediately and request that the admissible amount be remitted to my above mentioned
A/C, as I cleared the all dues of the institute.

Date :

---------------------------------------------------(Full Signature of the student)

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