LOYOLA COLLEGE (AUTONOMOUS), CHENNAI- 600034

DECLARATION FORM No. 1

(To be filled in by applicant)

I, JAYANTHRAJ R (24-UPH-016) do hereby solemnly and portal for admission in Loyola

College are correct in all particulars to my knowledge,instructions and I am bound by the same
and express my willingness to abide by the declaration.

I vouch forth to produce all the required documents in original on the day of reopening of the
college for regular classes, failing which or if any or all the documents attached are found to be
fake /false/forged or contain incorrect or false particulars either at the disqualified and my
admission shall stand cancelled automatically. I am also aware that all legal consequences
arising thereon and I shall be solely responsible for the same.

Date :
Station : Signature of the Applicant
 LOYOLA COLLEGE (AUTONOMOUS), CHENNAI- 600034
DECLARATION FORM No. 2
(To be filled in by applicant)

I, JAYANTHRAJ R (24-UPH-016) hereby declare that I have read the prospectus carefully
wherein the guidelines and regulations of the College are clearly written. I shall not violate
them in any circumstance. I understand that I accept the offer of admission into Loyola College
only on the basis of my adhering to the obligations. I promise that I shall abide by the Rules
and Regulations of the college. I also promise that if I am found in violation of the following
obligations, I shall be summarily dismissed from the college at any point of time.

1. I shall not engage in unauthorised online activities.

2. I shall refrain from any kind of online bullying.
3. I shall avoid forging and tampering with college documents/properties.
4. I shall refrain from bringing disrepute to the name of the college and
5. I shall not misuse the images of faculty, students and the personnel of the college in

6. I shall avoid involving in any kind of unethical practices inside and

Date :
Station : Signature of the Applicant
 ANNEXURE I
AFFIDAVIT BY THE STUDENT
I, JAYANTHRAJ R (24-UPH-016) (full name of student with Institute Roll Number) S/O Mr.RAJAKUMAR S ,
having been admitted to LOYOLA COLLEGE (AUTONOMOUS), CHENNAI- 600034(name of the institution) ,
have received or downloaded a copy of the UGC Regulations on Curbing the Menace of Ragging in Higher
Educational Institutions, 2009, (hereinafter called the “Regulations”) carefully read and fully understood the
provisions contained in the said Regulations.

1. I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes

2. I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware of the
penal and administrative action that is liable to be taken against me in case I am found guilty of or
abetting ragging, actively or passively, or being part of a conspiracy to
3. I hereby solemnly aver and undertake that
a. I will not indulge in any behaviour or act that may be constituted as ragging under clause 3 of the
Regulations.
b. I will not participate in or abet or propagate through any act of commission or omission that may be
constituted as ragging under clause 3 of the Regulations.
4. I hereby affirm that, if found guilty of ragging, I am liable for punishment according to clause 9.1 of the
Regulations, without prejudice to any other criminal action that may be taken against me under any penal
law or any law for the time being in force.
5. I hereby declare that I have not been expelled or debarred from admission in any institution in the country
on account of being found guilty of, abetting or being part of a conspiracy to promote, ragging; and further
affirm that, in case the declaration is found to be untrue, I am aware that my admission is liable to be
cancelled.

6. Along with the above mentioned points I do hereby declare that

a. I will obey the code of conduct of the institute and do not indulge in any kind of in-disciplined activity while
in and off the institution campus.

b. I will be solely responsible for any kind of accident/mishap caused on account of the above mentioned
clause (6.a).
Declared this 20 day of May month of 2024 year.

Signature of deponent
Name : JAYANTHRAJ R

VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and no part of the affidavit is false
and nothing has been concealed or misstated therein. Verified at Thiruvarur on this the 20 (day) of May (month)
, 2024(year ) .

Signature of deponent
Solemnly affirmed and signed in my presence on this the 20(day) of May (month) , 2024(year ) after reading the
contents of this affidavit.

OATH COMMISSIONER
Note : It is mandatory to submit this affidavit in the above format, if you desire to register for the forthcoming
academic session.
 ANNEXURE II
AFFIDAVIT BY PARENT/GUARDIAN
I, JAYANTHRAJ R (24-UPH-016) (full name of student with Institute Roll Number) S/O Mr.RAJAKUMAR S ,
having been admitted to LOYOLA COLLEGE (AUTONOMOUS), CHENNAI- 600034(name of the institution) ,
have received or downloaded a copy of the UGC Regulations on Curbing the Menace of Ragging in Higher
Educational Institutions, 2009, (hereinafter called the “Regulations”) carefully read and fully understood the
provisions contained in the said Regulations.

1. I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes
2. I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware of the
penal and administrative action that is liable to be taken against my ward in case he is found guilty of or
abetting ragging, actively or passively, or being part of a conspiracy to promote ragging.
3. I hereby solemnly aver and undertake that
a. My ward will not indulge in any behaviour or act that may be constituted as ragging under clause 3 of
the Regulations.
b. My ward will not participate in or abet or propagate through any act of commission or omission that
may be constituted as ragging under clause 3 of the Regulations.
4. I hereby affirm that, if found guilty of ragging, my ward is liable for punishment according to clause 9.1 of
the Regulations, without prejudice to any other criminal action that may be taken against my ward under
any penal law or any law for the time being in force.

5. I hereby declare that my ward has not been expelled or debarred from admission in any institution in the
country on account of being found guilty of, abetting or being part of a conspiracy to promote,
ragging; and further affirm that, in case the declaration is found to be untrue, the admission of
my ward is liable to be cancelled.

6. Along with the above mentioned points I do hereby declare that

a. My ward will obey the code of conduct of the institute and do not indulge in any kind of in-disciplined
activity while in and off the institution campus.
b. My ward will be solely responsible for any kind of accident/mishap caused on account of the above
mentioned clause (6.a).

Declared this 20 day of May month of 2024 year.

Signature of deponent
Name:
Address:
Telephone/ Mobile No.:
VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and no part of the affidavit is false
and nothing has been concealed or misstated therein. Verified at Thiruvarur on this the 20 (day) of May (month)
, 2024(year ) .

Signature of deponent
Solemnly affirmed and signed in my presence on this the 20(day) of May (month) , 2024(year ) after reading the
contents of this affidavit.

OATH COMMISSIONER
Note : It is mandatory to submit this affidavit in the above format, if you desire to register for the forthcoming
academic session.