Symbiosis Law School, Pune

Symbiosis Campus, Opp Pune International Airport, VIP Road, Viman Nagar,
Pune, Maharashtra

Name of the Candidate:

PRN Number:

Father’s / Spouse Name: Occupation:

Contact Number:

Policy Number: Expiry Date:

Mother’s Name: Occupation:

Contact Number:

Policy Number: Expiry Date:

Number of Dependants: (Infinal relations other than spouse not to be included)

Name- Relation - Policy number – Expiry date

1.
2.
3.
4.

I hereby declare that my parents/spouse are covered by a comprehensive health policy and are
not vulnerable to any medical bills. This declaration is a party of student-family wellness
programme.

Signature of the Candidate Signature of Parent

Date: Date:

Place: Place:
 APPLICATION FOR CONFIRMATION OF ELIGIBILITY AND PROVISIONAL
ADMISSION FOR THE ACADEMIC YEAR: 2024-2025

To
The Registrar
Symbiosis International (Deemed University)
Gram: Lavale, Tal: Mulshi, Pune-412 115

Through
The Director
Symbiosis Law School, Pune
Symbiosis Campus, Opp. Pune International Airport VIP Road Viman Nagar, Pune - 411014

I, SANATH D HEGDE (AADHAR NUMBER -3206-6988-0648), age 24 yrs., son of Divakar J

Hegde & Gangamma, resident of 6/22/21 Aradhya Vinu Nagar Hebri, Udupi District, Karnataka-
576112 seeking provisional admission for the academic year 2024-25 in Bachelor of Laws
programme at Symbiosis Law School, Pune (hereinafter referred to as Constituent), which is a
Constituent of Symbiosis International (Deemed University), Pune (hereinafter referred to as SIU),
do hereby solemnly affirm, state and declare as under: -

1] THAT, MY ADMISSION IS PROVISIONAL AND SUBJECT TO FULFILLMENT OF ALL

THE ELIGIBILITY CONDITIONS, AS LAID DOWN IN THE ELIGIBILITY RULES OF THE
SYMBIOSIS INTERNATIONAL (DEEMED UNIVERSITY) (SIU) FOR THE PROGRAMME TO
WHICH HAVE BEEN PROVISIONALLY ADMITTED.

I ALSO UNDERSTAND THAT NO CAPITATION FEE/ DONATION IS CHARGED FOR

ADMISSION TO ANY PROGRAMME AT ANY CONSTITUENT OF SYMBIOSIS
INTERNATIONAL (DEEMED UNIVERSITY). I UNDERTAKE TO PAY ALL MY FEES TO
SYMBIOSIS THROUGH BANKING CHANNELS AND NOT IN CASH.

2] THAT, I have furnished the true facts in the online application for entrance test/ selection process
(group exercise/ personal interaction/ writing ability test/ studio test)/ admission/ finance/
examination and shall abide by the Rules(s)/ Guidelines(s)/ Process(s) prescribed and as amended
time to time therein.

3] THAT, the admission is being offered to me on the basis of information furnished and documents
submitted by me.

4] THAT, SIU may cancel my admission at any stage/ time, if it is revealed that admission has been
secured by using fraudulent means or in case of any information or particulars found wrong/ false or
any fact concealed and I shall have no claim what-so-ever with respect to my admission at any point
of time. I understand the SIU/ Constituent may change or reverse any other decision made on the
basis of incorrect or incomplete information submitted by me.

5] THAT, I have gone through the admission and eligibility rules of the University for the Bachelor
of Laws Programme; and that, I also have read carefully the applicable eligibility criteria for the said
Programme which is as below:

Graduate from any recognized University or Institution of National Importance with a

minimum of 45% marks or equivalent grade (40% marks or equivalent grade for Scheduled
Caste/Scheduled Tribes)

6] THAT, I shall NOT be eligible for admission to Bachelor of Laws Programme unless I
successfully complete 3/4/5 years of an undergraduate degree and/ or earned prescribed number of
credits for an undergraduate degree, through the examinations conducted by a University/
Autonomous Institution or possesses such qualifications as recognised by the concerned University
as equivalent to an undergraduate degree.

7] THAT, I am required to submit following documents for scrutiny of eligibility and confirmation of
provisional admission in originals for verification and have also noted the last date to produce
applicable documents in original/ self-attested photocopy:

(i) XIIth Standard/ Diploma Mark List*

(ii) Statement of Marks of all Semesters/Trimesters/ Years of Qualifying Examination*
(iii) Migration Certificate issued by last attended University/Institution in original*
(iv) Transference/ Leaving Certificate Issued by last attended Institute/ University in
original*
(v) Passing Certificate/ Provisional Degree/ Degree Certificate*
 (vi) Caste Certificate*#
(vii) Category Certificate #*
(viii) Domicile Certificate #*
(ix) Gap Certificate (break before or after college/university during which students
engage in various educational and developmental activities, such as travel or some
type of regular work) #*
(x) Experience Certificate #*
(xi) Registration Certificate (wherever required by respective council)#*
(xii) Bonafide Certificate (if applicable)#
(xiii) Certificate of Change in Name issued by Appropriate Authority#
(xiv) English Test#
(xv) Passport (Only for International Students)*
(xvi) PIO Card (Only for International Students)*
(xvii) OCI Card (Only for International Students)*
(xviii) Nepal/ Bhutan Citizenship Card #*
(xix) Visa/ Residential Permit #*
(xx) Equivalence of qualification issued by recognized body/ authority#
(xxi) AADHAR Card#
(xxii) Photo Identity Proof (Driving License / PAN Card/ Passport or any other such
document as proof of identity issued by Govt. Authority)#
(xxiii) Entrance Test Admit Card (If applicable)#
(xxiv) Entrance Test Score Card (If applicable)#
(xxv) Selection Process (GE/PI-WAT) Admit Card (If applicable)#
(xxvi) Anti-Ragging Affidavit (Student)*
(xxvii) Anti-Ragging Affidavit (Parent)*
(xxviii) Indemnification/ Healthcare, Recreation and Sports Undertaking (Student)*
(xxix) Indemnification/ Healthcare, Recreation and Sports Undertaking including
compulsory insurance (Parent)*
(xxx) Medical Undertaking*
(xxix) (* Mandatory) (# if applicable)

7.1 THAT, I am required to produce all the original documents for scrutiny and verification on the
day of commencement of the programme.

7.2 THAT, I will apply to the concerned University/ Board/ Institute immediately, if I do not produce
any of the above document(s). I shall submit the pending document(s) by the given due date.

7.3 THAT, failing to produce above mentioned documents and obtain Eligibility Certificate in the
stipulated time, I will not be permitted to appear first and or subsequent semester/ annual
examination(s) and authorise the University/ Constituent to cancel my admission.

8] THAT, the facts mentioned below are correct and complete:

a) Academic Qualifications

Qualification Mode of Board/ University Year of Passing Percentage/

Education Grade
(Regular/
Distance)
XII Standard / Regular Karnataka Pre 2017 91.5%
Diploma University Board
Bachelor Degree Regular Bangalore City 2023 8.88 CGPA
(If applicable) University
Master’s Degree Not Applicable Not Applicable Not Applicable Not
(If applicable) Applicable
Pre – Doctoral Not Applicable Not Applicable Not Applicable Not
Degree Applicable
(If applicable)

b) Work Experience

Designation Organization Period Work Organization Contact

From To Experience Details
st th
High School Sri-Chaitanya 21 July 05 April 9 Months Principal-
Social Techno 2023 2024 Principalpeenyadasarahalli
Science School @srichaitanya.net
Teacher

9] THAT, I authorise the University/ Constituent to confirm facts submitted and documents produced
by me from previously attended School/ College/University/ Institute or from any other appropriate
body/ authority.

10] THAT, I am aware of the rules, procedures and requirements of the eligibility process and agree
to abide by the decision related to my eligibility. I shall fulfil the eligibility criteria set by the
University/ Constituent for the programme | have applied for.

11] THAT, I have carefully read and understood the details given in the prospectus and noted the
rules, the process of admission and the rules pertaining to refund of fees as given in the prospectus
and shall in matter of interpretation accept the decision given by the Registrar of SIU/ Director of the
Constituent in every respect as final and binding. I am well aware of the Non Refundable component
of fees. If I cancel my admission, I will give notice to the Constituent well in advance and abide by
the process laid down by SIU.

12] THAT, I agree to pay the fees regularly as per the schedule informed to me. I agree that a per day
fine will be applicable after the due date of payment of academic/ hostel/ mess fees as follows:
** Subject to revision.
** One month is considered for 30 days for the calculations.
In case of non-payment of fees by the due date, I shall accept any decision/ action taken by the
University including cancellation of admission.

13] THAT, SIU/ Constituent has got the right to cancel my admission in case of situations like, Non-
submission of eligibility documents in stipulated time, Non-Payment of fees for more than one
semester and/ or Non-reporting to the Constituent for more than 30 days, without prior intimation in
writing to the concern authority.

14] THAT, I shall take note of all communication sent to me by post/ courier/ email/ Institute LMS/
uploaded on the website of the University/ Institute and/ or affixed on the Notice Board of the
Institute/ Hostel [as applicable from time to time] and follow the same and act accordingly. I
understand SIU/ Symbiosis Law School, Pune will not be responsible for delays of any kind due to
reasons beyond its control.

15] THAT, if there is any change in facts submitted by me prior/ during/ after studentship, I agree to
inform the Constituent/ Department/ University as soon as possible.

16] THAT, I am not pursuing any other degree programme from this University or any other
University/ Institution in regular/ distance/ online mode simultaneously, and if I am found pursuing
the same, it will be subjected to the rules of University Grants Commission and/ or the concerned
Statutory Body and violation if any in this regard will be under the disciplinary action.

17] THAT, I should have minimum mandated attendance in theory and practical classes (if applicable
for the programme) of the semester to be eligible to appear for examinations and or placements (if
applicable). I understand that, in this regard, if my attendance is less than 75%, I will be given a TNG
(Term Not Granted) or CNG (Course Not Granted) as the case may be.

18] THAT, upto a maximum of 25% leave of absence (on medical grounds, Institute related work,
personal leave requirements or any emergencies) from lectures is permissible with or without prior
sanction of the Director.

19] THAT, I am expected to attend and/ or participate in all the curricular/ co-curricular/ extra-
curricular sessions/ activities, seminars, conferences & guest lectures which are considered for
summer/ final placement.

20] THAT, all orientation programmes/ camps/ seminars/ meets/workshops/ gym etc. are essential
and significant for me, therefore, I am expected to attend the same as per schedule given. I shall take
note of all communication sent to me from SIU/ Symbiosis Law School, Pune and follow the same
from time to time.

21] THAT, I have read and understood Examination Rules of the University and Section III-10
regarding resorting to unfair means during examinations and Section III-1.1C regarding validity of
terms of the Bachelor of Laws and shall abide by the same.
22] THAT, I am aware, if I do not pay the academic fees for the Semester/ Year, I will not be
permitted to register and appear for Term End Examinations and my result will not be declared.

23] THAT, I agree to pay the revised fees as per the University rules with respect to examination fess
(backlog fees/ revaluation fees/ practical fees/ late fees/ super late fees as applicable), convocation
fees, transcript fees, attestation fees, fees for issuing of duplicate documents (degree/ diploma
certificate/ grade sheet/ statement of marks, consolidated grade sheet/ consolidated statement of
marks/ passing certificate/ hall ticket etc.), review of answer script postal/ courier charges, if any, etc.

24] THAT, I am aware, once the admission process is over for the respective programme, the inter
institute transfer is not permitted for any reason(s) whatsoever.

25] THAT, I will NOT involve myself directly or indirectly in any kind of RAGGING activities
inside or outside Symbiosis Law School, Pune campus. I am fully aware that I will be liable for
action under relevant penal law/ ragging law in case I am found to be a part of any ragging activity.

26] THAT, I have read the hostel rules and undertake to abide by the same [as I am availing hostel
accommodation]. If I fail to do so, the University/ Constituent has the right to take action as per rules
and regulations and code of conduct of SIU/ Symbiosis Law School, Pune.

27] THAT, I will not indulge in any action of using technology and/ or social media causing disrepute
to institution/ students, hurting sentiments of other students, abusive in nature, abusing, amounting to
racial discrimination or moral turpitude or any such effort which is prohibited under any law in India;
and if I am found indulging in such acts, I will be liable for strict disciplinary action which may lead
to termination of my admission. I further undertake that I will not indulge in any act of indiscipline or
/and misconduct; and if I am found to be involved in any act of indiscipline or misconduct, I am
aware that I shall face the consequences for the same; and I am also aware that if fine is imposed for
the act of indiscipline or/and misconduct, the amount will be recovered from the security deposit for
any misconduct.

28] THAT, I will neither install/ access/ use/ copy nor assist in installation/access/ use/ copying of any
unauthorized or unlicensed electronic files/ programs/ softwares/ applications onto the computer
system/ mobile phone of my own or University/ Institute or of any other person, either within or
outside the campus of University/ Institute. I further undertake that I will not indulge in any
unauthorized act of duplication, dissemination, removal, installation, damage or alteration of files,
passwords, computer systems or programs of the University/ Institute. I am aware that I shall face the
consequences including fine/ cost/ penalty/ damages if I am found to be involved in any such acts as
mentioned above.

29] THAT, during the course of my studentship at Symbiosis, I would not carry/ possess/ consume
alcohol or any drug that is banned/ prohibited or directly or indirectly, aid & abet consumption or
possession or delivery of such alcohol or drug on campus, and I would not enter Symbiosis Campus
under influence of alcohol or any prohibited substance.

30] THAT, I will not indulge in any act of indiscipline; and if I found to be involved in any act of
indiscipline or misconduct, I shall face the consequences for the same in accordance with the
Symbiosis International (Deemed University) [Code of Conduct, Procedure to inquire and decide with
Misconducts/ Indiscipline by students] Rules, 2019 and amended from time to time.
31] THAT, I shall NOT be eligible for the award of the Bachelor of Laws degree unless I have
successfully completed the programme with minimum requirements prescribed for the award of
degree.

32] THAT, I shall have read and understand/ understood the Rules(s)/ Guidelines(s)/ Process(s)/ Code
of Conduct governing curricular/co-curricular/ extra-curricular activities as prescribed by the
University and its Constituent/ Department/ Sponsoring Society, and amendment(s) therein from time
to time, and shall undertake to abide by them;

33] THAT, the above information is correct and complete in all respects. THAT if any of the
information is found to be false, concealed, incomplete, misleading and/ or that I fail to disclose all
the information and/ or suppress any information and/ or misrepresent the information, the University
shall be free to take any action, including withdrawal of my provisional admission at any stage/ time
and/ or any other action as deemed fit against me according to the law of judicature.

34] THAT, if there is any change in the information furnished, I shall intimate the University/
Constituent from time to time.

35] THAT, ALL THE DISPUTES WILL BE SUBJECT TO EXCLUSIVE JURISDICTION OF

PUNE, MAHARASHTRA, INDIA ONLY.

Name of Applicant: SANATH D HEGDE

Category: Open SET ID: 245300231

GE-PIWAT ID: LLB/D1/S1/G07/05 NAD ID:

P.R.NO: 245300231 Batch: 2024 - 2027

Programme: Bachelor of Laws

Name of Constituent : Symbiosis Law School, Pune

Mother's First Name: Gangamma Father's First Name: Divakar J Hegde

Contact No.: +91-9902758535 Contact No.:+91-9449492551

Permanent address:

6/22/21- Aradhya, Behind Abharana Showroom, Vinu Nagar, Hebri Post-

Udupi District, Karnataka -576112

-----------------------------------

(Signature of the Applicant)

Name: SANATH D HEGDE

Dated: 31-May-2024

Deponent

----------------------------

Signature of Witness

(Signature of the Parent(s)/Guardian(s))

Name:

Dated:

Solemnly affirmed and signed before me by the Deponent and witness/parent(s)/guardian(s) on this-
day of ___/__/20____ at my office.

VERIFIED

BEFORE ME

Notary Public
 RENTAL AGREEMENT

This Rental Agreement made & executed on 01-07-2024 at Bangalore By & Between:
Sri. B.T. RAJU aged about 61 years, Residing at #546/N, 11th Cross, Vinayaka layout, Nagarabhavi
2nd Stage, Bangalore-560072.Hereinafter called the OWNER of the One Part;
AND:
Sri. ARUN KUMAR SK. aged about 30, S/o Late Mr. Krishnappa Residing at #94 Seesandra
Village,Kolar Taluk, Kolar District, Karnataka Aadhar No: 313318473885 and
Sri. BHARATH KUMAR MN aged about 25 S/o Nagaraj M.V Residing at Marishettihalli,
Mattanavile Post, Channarayapatana Taluq, Hasan District,Karnataka -573116 are Hereinafter called
the TENANT of the Other Part.

The expression OWNER & TENANT which shall mean & include all their legal heirs,
representatives, successors, executors, nominees & assignees:

IT IS HEREBY AGREED BY BOTH PARTIES HERE TO AS FOLLOWS:-

01) This agreement shall be in force for a period of 11 months initially effective from 01-07-2024 and
with option for renewal for the same period with mutual consent. Rent shall be enhanced by 05% (
Five) on the agreed rent for once in a year.

02) The Tenant undertakes to pay a monthly rent of 6000/- p.m. (Rupees Six Thousand only) as a rent
for the premises.Including the Water charges electricity charges. The rent is payable on or before 10th
of every month.

03) The Tenant has paid as rental advance of Rs. 30,000/- (Rupees Thirty Thousand only) by cash
to the owner as a security deposit, the receipt of which the owner do hereby acknowledges & admit.
The said amount is refund able to the tenants on the day of vacating the premises.

04) The Tenant shall use the premises for Residential purpose and shall not indulge in unlawful
purpose.

05) The Tenant shall not sub-let or underlet the house premises to anyone at any time.

6) The Tenant shall keep the premises in good condition as it is given to Tenant and shall not cause
any damage/alteration to the premises. If any damages are caused the Tenant should get it rectified/
bear the total cost of repair

07) The Tenant shall paint the house premises at the time of vacating the same or The Tenant shall
pay the painting charge as one month Rent.

08) Either of the parties shall give two (02) months’ notice for the termination of the tenancy.
 SCHEDULE

The Residential premises situated at #546/N, 4th Floor, 11th Cross, Vinayaka layout, Nagarabhavi
2nd Stage, Bangalore-560072, North facing, Fourth Floor consisting of One hall, Kitchen, Attach
bathroom, toilet, electricity, water, RCC roofing & sanitary connections thereon.

In Witness Whereof the parties have signed this agreement on the day, month & year first above
written in the presence of;

Witnesses:

1) Owner

2) Tenant