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Lokmanya Tilak Municipal Medical College

and Lokmanya Tilak Municipal General Hospital

Sion Mumbai

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Home / Ethics Committee / Acknowledgement Form Format

Acknowledgement Form Format

B. Acknowledgment Form Format

Project Title  Please  type project title

For use of the SRS Office Staff & IEC HR only

Do not issue Acknowledgement till Title page has clearance.

ACKNOWLEDGEMENT

( SRS ) Inward Dispatch No.                 IEC  Inward No.

 Received in SRS Office on    Date < YYYYMMDD>     at  Time <  hh: mm >

Stamp    

For Office Use only      IEC NO
SRS Project Application Fee R. No. Amount
DD / Cheque /CashDD/ Cheque NoDate
Bank NameBranchAccepted by
NoParticulars        Details      Status / Sign
1File Location in Office  
2Data Entry Status  
3Project Status Register  
4Financial Status  Register  
Received acknowledgement slipNameSignature with date
Reported to the IEC HR Secretary  

Cut Here and hand over to person submitting document    IEC No.

ACKNOWLEDGEMENT                                

( SRS ) Inward Dispatch No.                 

Received in SRS Office on    Date < YYYYMMDD>     at  Time <  hh: mm >

Stamp

( To be returned to applicant )

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Acknowledgement Form Format

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Acknowledgement Form Format

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