*DECLARATION TO BE SIGNED BY OBC CANDIDATES ONLY

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1 Form No.-01 *DECLARATION TO BE SIGNED BY OBC CANDIDATES ONLY I.Son/daughter/wife of Shri resident of village/town/city..... district. state.... hereby declare at I belong to e community which is recognized as a backward class by e Govt. of India for e purpose of reservation in services as per orders contained in Deptt. of Personnel and Training Office Memorandum No /22/93-Estt (SCT) dated It is also declared at I do not belong to e persons/sections (creamy layer) mentioned in Column 3 of e schedule to e OM No-36102/22/93-Estt (SCT) dated and modified vide Govt. of India Deptt. of Personnel and Training OM No /3/2004-Estt (Res) dated Date (Signature of candidate) (In running handwriting) NOTE: The closing date for receipt of application will be treated as e date of reckoning for OBC status of e candidate and also, for assuming at e candidate does not fall in e creamy layer. The candidate should furnish e relevant OBC Certificate in e format prescribed for Central Government jobs as per Form-04 issued by e competent auority on or before e Closing Date as stipulated in e Notice.

2 Form No.-02 UNDERTAKING TO BE GIVEN BY THE EX-SERVICEMAN CANDIDATE I understand at, if selected on e basis of e recruitment /examination to which e application relates, my appointment will be subject to my producing documentary evidence to e satisfaction of e Appointing Auority at I have been duly released /retired/discharged from e Armed Forces and at I am entitled to e benefits admissible to Ex-Servicemen in terms of e Ex-Servicemen (Re-employed in Central Civil Services and posts rules, 1979, as amended from time to time). I also understand at I shall not be eligible to be appointed to a vacancy reserved for Ex-S in regard to e recruitment covered by is examination, if I have at any time prior to such appointment, secured any employment on e civil side (including Public Sector Undertakings, Autonomous Bodies/Statutory Bodies, Nationalized Banks, etc.) by availing of e concession of reservation of vacancies admissible to Ex-S. I furer furnish e following information: a) Date of appointment in Armed Forces : b) Name of e Armed Force : c) Leng of service in Armed Forces : d) Date of discharge : e) If serving, e date of discharge is wiin one year from e date of publication of 06 Advertisement. Date: (Signature of e Candidate)

3 Form No.-03 ( The format of certificate to be produced by Scheduled Caste & Scheduled Tribe candidates applying for appointment to posts under e Government of India) A Candidate who claims to belong to one of e Scheduled Caste or e Scheduled Tribes should submit in support of his claim an attested/certified copy of a certificate in e form given below, from e District Officer or e Sub-Divisional officer or any oer officer as indicated below of e District in which his parents (or surviving parent) ordinarily reside who has been designated by e State Government concerned as competent to issue such a certificate. If bo his parents are dead, e officer signing e certificate should be of e district in which e candidate himself ordinarily resides oerwise an for e purpose of his own education. Wherever photograph is an integral part of e certificate, e Commission would accept only attested photocopies of such certificates and not any oer attested or true copy. This is to certify at Shri/Shrimati/Kumari* son/daughter of village/town/*in District/Division* of e State/Union Territory* belongs to e Caste/Tribes which is recognized as a Scheduled Castes/Scheduled Tribes* under:the Constitution (Scheduled Castes) order, 1950 The Constitution (Scheduled Tribes) order, 1950 The Constitution (Scheduled Castes) Union Territories order, 1951* The Constitution (Scheduled Tribes) Union Territories Order, 1951* As amended by e Scheduled Castes and Scheduled Tribes Lists (Modification) order, 1956, e Bombay Reorganization Act, 1960 & e Punjab Reorganization Act, 1966, e State of Himachal Pradesh Act 1970, e Nor Eastern Area (Reorganization) Act 1971 and e Scheduled Castes and Scheduled Tribes Order (Amendment) Act, The Constitution (Dadra and Nagar Haveli) Scheduled Castes order 1962 The Constitution (Dadra and Nagar Haveli) Scheduled Tribes order The Constitution (Pondicherry ) Scheduled Castes Order 1964@ The Constitution (Scheduled Tribes) (Uttar Pradesh) order, 1967@ The Constitution (Goa, Daman & Diu) Scheduled Castes order, 1968@ The Constitution (Goa, Daman & Diu )Scheduled Tribes order, 1968@ The Constitution (Nagaland) Scheduled Tribes Order, 1970@ The Constitution (Sikkim) Scheduled Caste Order 1978@ The Constitution (Sikkim) Scheduled Tribes Order 1978@ The Constitution (Jammu & Kashmir) Scheduled Tribes Order 1989@ The Constitution (Jammu & Kashmir) Scheduled Caste Order 1956@ The Constitution (SC) orders (Amendment) Act, 1990@ The Constitution (ST) orders (Amendment) Ordinance 1991@ The Constitution (ST) orders (Second Amendment) Act 991@ The Constitution (ST) orders (Amendment) Ordinance 1996 % 2 Applicable in e case of Scheduled Castes, Scheduled Tribes persons who have migrated from one State/Union Territory Administration. This Certificate is issued on e basis of e Scheduled Castes/ Scheduled Tribes certificate issued to Shri/Shrimati Faer/ moer Sh./Smt. of village Distt. Division* of e State/Union Territory* who belong to e Caste/Tribe which is recognized as a Scheduled Caste/Scheduled Tribe in e State/Union/Territory* issued by dated. %3 Sh./Smt./Kumari and /or* his /her family ordinarily reside(s) in village/town* of District/Division* of e State/Union Territory of. Place Date Signature **Designation (wi seal of office) * Please delete e words which are not Please quote specific presidential order % Delete e paragraph which is not applicable NOTE: The term ordinarily reside(s) used here will have e same meaning as in section 20 of e Representation of e People Act, **List of auorities empowered to issue Caste /Tribe Certificates: State/Union Territory (i) District Magistrate/Additional District Magistrate/ Collector/Deputy Commissioner/Additional Deputy Commissioner/Dy. Collector/ Ist Class Stipendiary Magistrate /Sub-Divisional Magistrate/Presidency Magistrate/Extra-Asst Commissioner/ Taluka Magistrate / Executive Magistrate. (ii) Chief Presidency Magistrate/Additional Chief Presidency Magistrate/Presidency Magistrate. (iii) Revenue Officers not below e rank of Tehsildar. (iv) Sub-Divisional Officers of e area where e candidate and/or his family normally resides. NOTE: ST candidates belonging to Tamil Nadu state should submit caste certificate ONLY FROM THE REVENUE DIVISIONAL OFFICER.

4 Form No.-04 (FORMAT OF CERTIFICATE TO BE PRODUCED BY OTHER BACKWARD CLASSES APPLYING FOR APPOINTMENT TO POSTS UNDER THE GOVERNMENT OF INDIA.) (G-1 Dept of per. & Trg. OM NO 36033/28/94-Estt. (Res), dated This is to certify at Shri/Smt./Km.* Son/daughter/wife of Sh./Smt.* of village/town District/Division in e state belongs to e community which is recognized as a backward class under: i) Resolution No /68/93-BCC dated e 10 Section I, No. 186 dated 13 ii) iv) v) vi) vii) viii) ix) x) xi) September, Resolution No /9/94-BCC, dated published in Gazette of India extraordinary Part I Section I No. 163, dated 20 iii) September, 1993, published in e Gazette of India Extraordinary-Part I, October 1994 Resolution No /7/95-BCC, dated e 24 May 1995 published in e Gazette of India extraordinary Part I Section I No. 88, dated 25 May, Resolution No /96/94-BCC dated 9 March, 1996 Resolution No /44/96-BCC, dated e 6 December, 1996 published in e Gazette of India extraordinary Part I Section I No. 210, dated e 11 December rd Resolution No /13/97-BCC dated 3 December, 1997 Resolution No /99/94-BCC dated 11 December, 1997 Resolution No /68/98-BCC dated 27 Resolution No /88/98-BCC, dated e 6 Part- I Section I No. 270 dated 6 Resolution No /36/99-BCC, dated 4 Section I No.71 dated 4 Resolution No /44/99-BCC, dated published in e Gazette of India extraordinary Part- I Section I No. 210 dated Shri_/Smt/Km and/or his/ her family ordinarily reside(s) in e District/ Division of e State. This is also to certify at he/she does not belong to e persons/sections (Creamy Layer) mentioned in Column 3 of e Schedule to e Government of India. Department of Personnel and Training O.M. No /22/93-Estt. (SCT) dated and modified vide Government of India, Department of Personnel & Training OM No /3/2004- Estt(Res) dated \ Dated: Seal : District Magistrate or Deputy Commissioner/ etc. *Strike out whichever is not applicable Note-1: (a) The term Ordinarily used here will have e same meaning as in Section 20 of e Representation of e people act 1950 (b) The auorities competent to issue caste certificates are indicated below: (i) District Magistrate/additional Magistrate /Collector/Deputy Commissioner/additional deputy Commissioner/Deputy Collector/first Class Stipendiary Magistrate/Sub-Divisional Magistrate/Taluka Magistrate /Executive Magistrate /Extra Assistant Commissioner (not below e rank of First Class Stipendiary Magistrate) (ii) Chief Presidency Magistrate /additional Chief Presidency Magistrate /Presidency Magistrate (iii) Revenue Officer not below e rank of Tehsildar; and (iv) Sub Divisional Officer of e area where e candidate and/or his family resides. Note-2: The closing date of receipt of application will be treated as e date of reckoning for OBC status of e candidate and also, for assuming at e candidate does not fall in e creamy layer The candidate should furnish e relevant OBC certificate in e format prescribed for Central Government jobs as per Form-05 issued by e competent auority on or before e Closing date as stipulated in e Notice

5 Form No.-05 (FORMAT OF CERTIFICATE TO BE SUBMITTED BY PERSONS WITH DISABILITIES (PWD)) NAME & ADDRESS OF THE INSTITUTE/HOSPITAL NAME: ADDRESS: CONTACT NO. Certificate No. Date DISABILITY CERTIFICATE A. Locomotor or cerebral palsy: (i) BL-Bo legs affected but not arms (ii) BA- Bo arms affected (iii) BLA-Bo legs and bo arms affected (iv) OL-One leg affected (right or left) (a) Impaired reach (b) Weakness of grip (c) Ataxic (v) OA-One arm affected (a) Impaired reach (b) Weakness of grip (c) Ataxic (vi) BH- Stiff back and hips (Cannot sit or stoop) (vii) MW-Muscular weakness and limited physical (a) Impaired reach (b) Weakness of grip Affix here recent photograph of candidate clearly showing face wi affected portion of e body duly attested by e Chairperson of e Medical Board endurance. B. Blindness or Low Vision: (i) B-Blind (ii) PB-Partially Blind (i) D-Deaf C. Hearing Impairment (ii) PD-Partially Deaf (DELETE THE CATEGORY WHICHEVER IS NOT APPLICABLE) 2. This condition is progressive/non-progressive/likely to improve/not likely to improve. Reassessment of is case is not recommended /is recommended after of period of..years.mons. 3. Percentage of disability in his/her case is..percent. 4. Shri/Smt/Km meets e following physical requirements for discharge of his/her duties:(i) F-can perform work by manipulating wi fingers. (ii) PP-can perform work by pulling and pushing (iii) L-can perform work by lifting. (iv) KC-can perform work by kneeling and crouching (v) B can perform work by bending (vi) S-can perform work by sitting (vii) ST-can perform work by standing (viii)w-can perform work by walking (ix) SE-can perform work by seeing (x) H-can perform work by hearing/speaking (xi) RW-can perform work by reading and writing (Dr ) (Dr ) Member, Medical Board Member, Medical Board * Strike out which is not applicable (Dr ) Chairperson, Medical Board Countersigned by e Medical Superintendent/ CMO/ Head of Hospital (wi seal)

6 Form No.-06 (FOR CENTRAL GOVT. CIVILIAN EMPLOYEES/DEPARTMENTAL CANDIDATES ONLY) I hereby declare at I am informing my Head of Office/Department/Ministry in writing at I have applied for is examination. Date : (Signature of candidate) (In running handwriting) Note-1: Application wiout e umb impression and not signed by Candidate will be rejected. All signatures affixed on e Application Form must be in running script (not in Block letters), in e same language and in e same manner. Note-II: Please ensure at e Application Form filled up by you is identical in format/size to e one appearing in e advertisement in e Employment News/Rozgar Samachar and e paper on which your Application Form is printed/photocopied, is white in colour and of good quality so at it can be scanned easily. *Strike out whichever is not applicable

7 Form No.-07 (FORMAT OF CERTIFICATE TO BE SUBMITTED BY CENTRAL GOVERNMENT CIVILIAN EMPLOYEES /DEPARTMENTAL CANDIDATES SEEKING AGE-RELAXATION) (To be filled by e Head of e Office or Department in which e candidate is working). It is certified at Shri/Smt/Km.* is a central Government Civilian employees and is holding e post of Non-technical post of in e pay scale of Rs. wi 3 years regular service in e grade as on closing date of -06 Advertisement. The detailed nature of duties performed by him/.her during e last ree years duly certified is enclosed. Date: Signature Name Official seal Strike out whichever is not applicable

8 Form No.-08 (FORMAT OF CERTIFICATE FOR SERVING DEFENCE PERSONNEL) I hereby certify at, according to e information available wi me (No.) (Rank) (Name) is due to complete e specified term of his engagement wi e Armed Forces on e (Date). Date : Official Seal (Signature of Commanding Officer)

9 Form No.-09 (FORMAT OF CERTIFICATE TO BE SUBMITTED BY THOSE CANDIDATES WHO INTEND TO AVAIL RELAXATION IN HEIGHT OR CHEST MEASUREMENT) Certified at Sh./Smt./Km. Son / Daughter of Sh. is permanent resident of village Tehsil/Taluka District of state. 2. It is furer certified at: Residents of entire area mentioned above are considered as (Garhwali, Kumaoni, Dogras, Maraas, Sikkimies)for relaxation in height measurement for recruitment in e para military forces of e Union of India. He/she belongs to Himachal Pradesh/Leh and Ladakh /Kasmir valley/nor-eastern States which is considered for relaxation in height measurement for recruitment in e para military forces of Union of India. He/she belongs to Scheduled Tribe. Date: Signature District Magistrate/Sub-Division Magistrate/Tehsildar * Delete whichever is not applicable.

INSTRUCTIONS FOR FILLING APPLICATION FORM

INSTRUCTIONS FOR FILLING APPLICATION FORM 1. It may be noted that the Commission uses Common Application Form for its recruitment. Please go through the notice for the Recruitment and also these instructions