From: Name of the Student QIP Scholar‐ Name of Department……………, IITG To, The Professor & Coordinator QIP, CET IITG Through the Supervisor Through the Head of………………………………… Department Sir, Sub: Seeking extension beyond the mandatory 3 years period for QIP‐PhD Academic work. I will be completing 3 years of the QIP program (xx th of month 20xx to xxth Month 20XX) at IITG. I could not complete all the portion of my PhD work assigned by my Supervisor (give reasons for and estimated time required). Ex: I would need 6 months more from xx date‐ Month 20xx to xx date, month 20xx to complete my Thesis work. I request you to issue me a Provisional Release certificate for having completed 3 years to enable me to rejoin duty at my institution. I further request you to mention in the release certificate the continuation of my PhD Registration and that I will continue to work on my PhD. I request you to consider recommending my case for extending my study leave. I understand that beyond three years the rules of my employing institution will take effect. I understand that any arrangement that I make for continuation of my PhD work beyond the three years‐ is between me and my employing institution. I will produce the necessary NOC from my institution permitting me to continue working on my PhD at IITG. Further I request that I be permitted to retain my Hostel accommodation for a further period of 6 months subjected to my application for extension is approved. Yours sincerely, PhD Scholar Name and address of his/her sponsoring/ deputing Institution with Designation of Authority to whom the Provisional Certificate is to be addressed and sent by Registered Post by QIP Office