UNIVERSITY OF KABIANGA
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1 UNIVERSITY OF KABIANGA UoK/F/ADM/007 OFFICE OF THE DEPUTY VICE CHANCELLOR (ACADEMIC & STUDENT AFFAIRS) FROM: EXAMINATION SECTION DATE: TO: STUDENTS FINANCE NAME OF STUDENTS REG. NO. PLEASE CERTIFY WHETHER THE STUDENT NAMED ABOVE OWES/DOES NOT OWE (DELETE WHERE APPLICABLE) THE UNIVERSITY AND IS THEREFORE CLEARED/NOT CLEARED (DELETE WHERE APPLICABLE) TO COLLECT HIS/HER TRANSCRIPTS AND DEGREE CERTIFICATE. CHECKED BY: FOR: FINANCE OFFICER SIGNATURE:
2 UNIVERSITY OF KABIANGA UoK/F/ADM/007 OFFICE OF THE DEPUTY VICE CHANCELLOR (ACADEMICS& STUDENT AFFAIRS) STUDENTS CLEARANCE FORM This form has to be handed over to the Academic Registrar s Office after completion. FILL AND DELETE AS APPROPRIATE Part A to be completed by the student Part B to be completed by the Head of Department Part B to be completed by the Dean of School Part B to be completed by the Librarian Part B4 to be completed by the Hostel Officer Part B5 to be completed by the Games Tutor Part B6 to be completed by the Catering Officer Part B7 to be completed by the Finance Officer Part B8 to be completed by Dean of Students Part B9 to be completed by Admissions Officer Part B0 to be completed by the Registrar (A&SA) Part C to be completed by the Finance Officer (Before processing of the Certificate) Part D to be completed by the Deputy Vice Chancellor (A&SA) PART A: BY THE STUDENT Name of student (Surname) (Other names) Registration number School Department Room Number Hostel Home address
3 PART B HEAD OF DEPARTMENT ) I certify that all records have been checked and the following items are still in possession: Total value of outstanding possession (ii)there is nothing outstanding against: Signature of Head of Department Date PART B : DEAN OF SCHOOL ) I certify that all records have been checked and the following items are still in possession: Total value of outstanding possession Dean of School
4 PART B: LIBRARIAN ) I certify that all records have been checked and the following items are still in possession; Total value of outstanding possession Librarian PART B4: HOSTEL OFFICER ) I certify that all records have been checked and the following items are still in possession: Total value of outstanding possession Hostel Officer
5 PART B5: GAMES TUTOR ) I certify that all records have been checked and the following items are still in possession; Total value of outstanding possession Games Tutor PART B6: CATERING OFFICER ) I certify that all records have been checked and the following items are still in possession: Total value of outstanding possession Catering Officer
6 PART B7: STUDENTS FINANCE OFFICER (Fill and delete where appropriate) 4) I certify that all records have been checked and the following items are still in possession/debts are still owned to Finance Department Total value of outstanding possession Finance Officer PART B8: DEAN OF STUDENTS 5) I certify that all records have been checked and the following items are still in possession: Total value of outstanding possession Dean of Students
7 PART B9: ADMISSIONS (Surrender of Student s College Identification Card) 6) I certify that all records have been checked and the following items are still in possession: Total value of outstanding possession In charge Admissions PART B0: REGISTRAR (A&SA) 7) I certify that all records have been checked and the following items are still in possession: Total value of outstanding possession Deputy Vice Chancellor (A&SA)
8 PART C: BY THE FINANCE OFFICER ) The student owes/ does not owe any outstanding possession of the following department (delete as applicable). Department. School. Library 4. Hostel 5. Catering 6. Games 7. Farm 8. Deputy Vice Chancellor (A&SA) Total The payment has been paid Date Receipts No. Confirmed By Finance office PART D: FOR OFFICIAL USE ONLY COMMENT BY THE DEPUTY VICE CHANCELLOR A&SA (to be filled before the degree certificate) Date as appropriate a. There is no claim against the student b. There is a claim which has to be settled by the student, and the chief accountant should confirm as soon as it is paid. c. There is no disciplinary case pending. (DEPUTY VICE CHANCELLOR, A&SA)
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