(
उच्चत्तर शिऺा विभाग, मानि संसाधन विकास मंत्राऱय, भारत सरकार के तहत एक स्िायत्त संगठन) An autonomous organization under the
Department of Higher Education, Ministry
of Human Resource Development, Government of India)
To be filled by Observers / Special Observer and submitted to CC IT IS MANDATORY TO PROVIDE ALL DETAILS IN 1 ANNEXURE FOR UGC NET EXAM (20-30 Nov, 1-5 Dec 2021) Centre Code _____________ Name of Centres __________________________ 1 Name (strictly as per bank record)
2
Observer NTA Test Admin ID 3
Address for Communication 4 Registered Contact Nos)
5 PAN No.
6
CC’s full name (with contact no)
7
RC’s
full name 8
Bank Name and Branch 9 Bank Account No. (As per bank record in full digit)
10 IFSC Code (As per bank record in full digit)
I hereby certify that as per appointment letter, I have received below mentioned payments from CC, for 
