Challege Revaluation form - MUHS

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(ANNEXURE –‘C’)
APPLICATION FOR CHALLENGE TO VALUATION OF ANSWER BOOK(S)
( FOR PG )
To,
The Controller of Examinations,
Maharashtra University of Health Sciences,
Nashik – 422 004
Sir,
I the Undersigned student, hereby submitting, application for re-evaluation of answer books for
following subjects. Following are my details:
SR
NO.
1
2
3
4
5
6
7
a) Name of Examinee : ------------------------------------------------------------------------------------
b) Course & Year : ------------------------------------------------------------------------------------
c) Name of College : ------------------------------------------------------------------------------------
d) Name of Examination: Summer / Winter 20____
e) Seat No. : : ----------------------------
f) P.R.N. : -----------------------------
g) Name of subject for which challenge to valuation application is made.
(Attach separate sheet if required)
NAME OF SUBJECT &
PAPER
Q. NO.
MARKS
JUSTIFICATION FOR
AWARDED
MARKS
EXPECTED
CHALLENGE TO
VALUATION WITH
REFERENCES
The details of fee paid at college are as under :-
D.D/Cheque No. :---------------------------- Drawn on Bank : --------------------------------
Dated:---------------------------- Amount : --------------------------------

DECLARATION
I ________________________________________________________in presence of Dean /
Principal / Head of Institute, hereby declare that, the information furnished above, by me is true and
correct to the best of my knowledge. I have read all the provisions under concerned Direction very
carefully and declare that, I will accept the decision of scrutiny committee constituted as per provisions
under said Direction and I Will accept the result of challenge to valuation ( Revaluation) whatever it
may be, negative or positive against my previous obtained marks / result. I will not challenge the result
of re-evaluation, in any court of law.
Place :
Date : Signature of Applicant
FOR COLLEGE OFFICE USE ONLY
The application for challenge to valuation, along with prescribed fees is received by this office on
______________. The candidate in front of me signs the above declaration; therefore, it is forwarded to
the University.
Place :
Date: Signature with seal
Dean / Principal / Head of Institute
_____________________________________________________________________________________
FOR UNIVERSITY OFFICE USE ONLY
The application is received with fees of Rs. __________________ Inward No ____________________
and placed before scrutiny committee along with Photostat copies of concerned answer books. The
decision of scrutiny committee is as follows.
1) Rejected for following reason
2) Accepted for revaluation.
Therefore the application is forwarded to concerned section on _________________________________
for further processing. The decision of committee (only in case of rejection of application) is
communicated to Dean / Principal / Head of Institute, through speed post bearing postal receipt No.
____________ Date __________________ with intimation to candidate by SMS / e-mail-no _________
beating postal receipt No. _____________________ Date:_____________________
Faculty Incharge