Sryurywse$qr$ur(Hrd fir6r, *4-d +6 di6 ifrqr Fi qtqlhr ?nm 6r rgar 3!r6q)

0entralluladilyr Pmdmh 0ramin Bank(Ajoint venturc ofGo(. oflndia, Cenral Bankollndia and Go( ofMadhya fradeih)

vtrr+ qrqtoq Head Office9.or./0 zztrq.ail-{.S./ 2 o 1 z- 1 4 / ffio 14.08.201s

Of.FER O'f' PROV[S[ON.& L APPOM{IMENT

a-*eqr+ieqr, sir/Madam

Fdsq - +6 +{r # orqfds rr6retE rr( rr{ fiFa-r+a Ergffr sknrrReg - Offer for Provisional Appointment for the post of Office Assistant in Bank's Service

ao +rad qfr-d 6rA E fu $r€.ff.fr.ur+. trRr ar6 frriq{ 2ot2 q+ d-trq frfud,r$eil d vff dkiT Ed ft, 6 26.07.20r s t 03.08.201 3 a-o zraq.a giT{TqTrcFrr + Briid qrqTio1 + a-gffi fr6qrc-4 * sTrtrrt q? Tirb?r +e A st-(,snq+J +-6 d oTerff,q r{6rel-.F rrs q{ B6i Qtd d srfia Hgfu ors-{f,rq Bqr uror B -We are glad to inform you that on your being successful in the written examination heldby l.B.P.s. in september2012 & interview hetd between26.07.2013 to 03.08.2013, weare pleased to offer you Provisional appointment in the Bank as Office Assistant subjectto following condition

r. 3ilqfr] 6rqid-q tr6rq.F qE tg o. 72oo - 4oo/3 - 8400 - s00/39900 - 600/4 - 12300 - 700/7 - 17200 - 1300i1 - 18500800/r - 1e300 + a-d-d-dla-fr rsr ura-drTr gs$ 3ftFfi aiaun$ arrr,a-un aftr1tr HTTT, a6r-d fu{rfl emr, fre}s efiIT, 3ra[ e{t d snqfrt q<E€ft

&d A ftilS, +cF ffi d srgu" s-sfti-d r{ q{ d zrqq ?Ere1 qg arlt d,d ftil+ q-{ 6ti I

For the post of Office Assistant, You will be placed in the Pay Scale of Rs 7200 -400t3 - 8400 - 500/3 - 9900 - 600t4 - 12300 - 700t7 - 17200 - 1300/1 - 18500 -800/1 - 19300. In addition, you will be entitled to dearness Allowance, Citycompensatory allowance, house rent allowance, Special allowance and otherallowance applicable to the area of your posting as per the Bank's rules at the rateprevailing from time to time.

Cont. .. .2

800/19, srerftkoor{q, frcdrgt (c.v.)ft-c - +so oor KqrsE qis :0it6z - 247 48s,245 5308ffi : 07r62 - z4z ttz800/19, South Civil Lines, Chhindwara (M.P.) 480 001 * Tel : 07162 - 247 485, 245 530Fax:07162 - 242 ll2E-mail ID : cmpgbho@gmail.com, cmpgbho@rediffmail.com

3rrqe) orqfd-ft-d ?rdrq-o d q< d ft4'i rflsTl..Erl A +{ra gil-q-A 6r+5rdr

rnrd fr enu-d 6rgr rrtgd drd-or$ d zroela fr zra-ta qd <-{irI}q q-{gd

o-s-ar *onryou have to Submit all the originat documents in support of information submitted

by you in your Bio-data form aithe time of interview for the post of Office Assistant.

3. 3iTrI 3Ig. urftusrg. qa qfrrsrq frE-.sT E-df M A E, fl{d zrq{.tgnEi z+erd ;ifarFI-S eer qr$ urfrru-gilq -qT"I

qq, qft srru-d

"rfisre1 o;r-d d z+rer-ir-{ d +{rd *g" a-fr fuqr B d 3{tq-o1

dEifErd qiflrot rlr rtga o-rar airun I

ln case you belong to SC/ST/OBC category, lf you iave not submitted Caste/

Community Certificite at the time of interview in your Bio-data form issued by the

competeniauthority prescribed by the Govt. of lndia, you have to submit the same

as may be aPPlicable.

4. srq ft6{r q-df M a graqrfi, a-44 grq frE-$r e-d q-rrlul !-I ffi.frtfi +q{, rrrgl rFT 3;ddT d, rrga orar *un I gdIIUI qq 3ilt(4 Fdi6t uo Ed fr 3Tfiro g?rdr arq s-& +flr t

Candidates belonging to OBC category, should submit the latest (Should not later

than One year fro-m date of application) OBC certificate specifically mentioning the

'creamy layei clause.

s. qfr enq fufi-dirr d d arrra rr{m'rg il{r BeIfFd CIq4l d sidrfd AB6-i{

*d aro qrS fuo-aiuror rrdlu q;i u-qa orar fran r

ln case you belong to PH (Physical Han'dicapped) category, should submit the PH

certificaie issued -by

the competent authority prescribed by the Medical Board, you

have to submit the same as may be applicable.

6. srgqfi+a urft, 3rg"&-d qaT drfr, 3Tq fr6{r {, -?tg, S€{FTo to-,.rdrintr snfr t

"ftfrr6 .bt$ qta-fiT-fr/qft'and A qlt fr sp-o't <ril qft El-{

d arsa frrg esu si-E qE qrsrsrdr Erd d ff aT-$ qrd-6T-S aro-o ftrg g€

d kdl AftRr -pq 3nqo1 ffi zrom o1 qr zro-& B r

lf your claim of belonging to Scheduled Caste, Scheduled Tribe, Other Backward

Ctlss, Age, Qualificaliori, Domicile etc is later on found to be false, and if the

informatijn given in the Bio-data form is found to be false, your services are liable

to be terminited solely in the discretion of the Bank without any further notice.

7. qfr sTlqe ued u-ugd a H E] fr, t-6 # t g* eg ""ft"fro.r-&m fr sifta ftrefr Eft B Ed e)q' 02, ?rqqBd gTfffi * drS 6tdlqrB-$

r

il{r6l.{Icrlrt

You will have to produce, if not already produced, at the time of reporting to the

Bank, you have to furnish 03 character certlficates, out of which 01, must be issued

from school/college last attended, remaining 02 from Gazetted officer.

3ilr+l fuflr fr{fud E-d-d/eEoE ild A ?idrdT srsqgz{T{ AB6-d ftE-d+fl

q-flrq qT q{gd 6-adr *JIr I

you have to produce the medical fitness Certificate given by District Civil Surgeon/Medical

Board as per prescribe enclosed format.

10.

11.

3il-q!)) gz+ s{TQTzr q,r dqlTr q5r }dT +rn fu 3ilqs fu{'€ E'fr a)t$

3rrq?TfErd HrdtEII <-d afi fuw alurrorgft frz qs snq+] tneft oI€ uT

"fi ff or$ r qR Er< fr t-u' o1 5a siera u't o'rn*T-ff fl=' +ff ts *

ftrfl. fr={i ffi + 3ilrftl a3d ?tirrrEd o-{ a qrffi r snqrflrro

o-ar** a Elfl& fr qR 3il-EeqtF g3Ir d slz sfErq' ffi o-sa E'-r

d.o or s{oru gzf}ra ? r

You have to give an undertaking of having no history of criminal case/conviction

against you a,id antecedents, if a'ny, found iubsequently by.th9 bank, your services-

would be terminated *iif,ort inquiry.'Bank also reseives iis right to investigate further if

necessary in the matter of criminal case/conviction'

qft-fl T{crTrrEr ftlts - gft=r zrdrqa q=I 6I qeFT gE gfr., ,-r\nrft gffir,o B, G) t-u, sfEu,ft* .-{flreTpd B r 'tr

rlr rl-{ saqtelt, 3rqA

E-j.o gE" ?rrqr/ gft* $fiern u;rqfa-q u;I ardl ftndl tr1 zre*ra

n*e *t hd" qft d 3reqTfi Tfii A uril 3rQzIT ilfi-f,d-dT mJzI Bq-ot o-r

"-,ft" #, .rr*.ff, ffi gd En Fr+-crer S"" ^o-'q"-" ^3lefter6E5T-qtdq fr u-lga q;t Ed q-d qrfrT E)f qrd-s srqT e5t t gftT-a sfdro-rtt zl q*

,=fr .d ,fr'd-o eTftr&s fu q*. 6T-qfd-q fr u-rga of r

Police Verification Report - First page of the police veriflcation letter is addressed to the

potice Authorities wniih is signed' Ui tfre Official of the Bank. The candidate has to write

name of the nearest police stition/ Cbmmissioner's Office on the said letter' On the second

prg" "t fotice verification report candidate has to affix his/her recent photograph duly

attested by him/her. Candidates have to subfnit both the pages to hisiher nearest Police

Station/ police CommLiionef s office and obtain their acknowledgement of having received

the report on pnotocopV'ot16" same. The acknowledged copy by the police Authority be

sunmiited to his/her Head Office for the Bank's record'

3ilqs)1 t-d' fr qiilfl d-d ad tt sTdfEr dE' +{rrd ?6-dT 6}-11 3t{ffitur of frlaitn b ft-d qd d ftu *{r ds 5. ............ (5.- ':""':""':'.-....-) # Ar" r qE 3nq ftd dd ot sroQ $ *e A f,d frr-S fr*r#., t-6 or *"dr ffi B d snq+} fn o1 lr. ............ (5: """::""'::........) zrRr or u".- *-* aro,, r ENlft-a ftu E.Ie il-& i-dT Ers fr

d znesl ( Sureties) * Address proof Eti ldentity proof wga o-{4r

etur r

*e ,- 0) zrqrq urft fu s. 10000p! (u. uo, drs are)

(ii) sra frE-a a-d I fuo-aiur I aG-ar sraqrlef?ji eg l. 50000/-(u. uars ron ar*) A *-4T ms FTqrBd Bu sri dfr r

You will have to serve the Bank for minimum period of three years and submit Servlce

BondforthreeyearssecuritydepositRs.............'.(Rs.time of reportinj'. tn case yoi terue the Bank before expiry of period of three years for

the reasons of whatsoever nature you will have to pay Rs' """"""" (Rs'

.) to the Bank.You should submit Address & lD proof of two sureties for service Bond execution'

NOTE :- (i) For General caste service Bond Rs. 100000/' (Rs. One Lac

OnlY)(ii) roi'oeclpuMoMEN Service Bond Rs. 50000/- (Rs. Fifty

Thousand OnlY)

12. qft srq q-5& * ftF?ff *-dT fr B fr d-d' sq-ft€Ifr d zrryq- tg *ft.rfta """ qd cTe]-q6 or r1-orgftffi sErq q-{ u-rga o-rar frun r

At the time of reporting, you have to produce the necessary discharge certificate from

the previous employer, if you are already in employment'

13. 3IIq d.6 fr, *<-d ats-qaei il-s"r dcD (srftrorft ud o-ffi) ry frFF"2oto Uq zral-q^e-d-q q-{ qFqfrfd dru1 3IgQIErd EIqm i srf}euftro d-ir

You will be governed by Central Madhya Pradesh Gramin Bank (Officer and

Employee) Sirvice Regulation,2010 and rules of discipline in force from time to

time in the Bank.

14. 3nqoJ 01 sS q't qft-ftelT 3rsRr q{ ?-e-r uIra-JIr ffi frrgfu qrFleFrft gRT

e 6 arg fr sraFro ffi sIEftI d ftili d.6r{II EI zrfiun r

You will be on probation for a period of one year which may be extended by the

appointing authority for a period not exceeding six month'

ls. qEffeTr srdfEr d 3nqfi arEr sruremq 3tErDrQT fri qs eT q8-ffeTl 3rdfEl a€lza. 3IrtlcFI or-dHqr<-a Crgfu qTErcTff of zrq fr sftrflrena[E qr, 3rg+q

tftor a-o o-ar$ or e-ffi r

probation period shall be liable to be extended within the permissible limits to the

extent of extraordinary leave availed by you or in opinion of Appointing Authority

your performance was dissatisfactory during probation'

I 6. qEfieTr sEfEI S dT< 3ilq-o] +qr fr gw ftn+r trrildTl qft kgfu qrfhoTff

"1 ?Tq fr srq-B 6rrr srq-fi qEftsTI JrqFr srne r-qq-{ a.q d Wf -u d

+rot

you will be confirmed in the service of'the Bank if in the opinion of the Appointing

Authority, you have satisfactorily completed your probation'

17. wd' qFften grqfti d +{I4 ffi sfdrrd qft-&eTr of ft-{drr 3rdEr, qftA* t, Egfu qrfffi u,t srtT t fu qen ft€rfr, qE qr gfu +dq afr B6 3nwot n=d uq' ara of rf,a.4r qr 3-s-d e-<-e a-d-4 te t orq zrorw dzrffir

Where during the period of probation, including the period of extension of

probation, if iny, the Appointing Authority is of the opinion that you are not fit for

confirmation in'the said post, ybur services may be terminated after giving one

month's notice or pay in lieu there of'

18. 6) GIgfu urftroTff o1 s{|q srq-fi i!Td, uTrff q-& rs} qr q4 rqrJr a' .ni* E'f frftild fr f,d zp+ar ftd fu4r, frEr q'I rqlrT ffi ot& wdE afr zr#&r

a) you have not to leave or discontinue your services in the Bank without first

giving notice in writing to the Appointing Authority of your intension to leave

or discontinue your service or resign.

u) z5a-ar of srqfu t. {qrs alffi of <en d 0 3 EIT6, I l. qEffeTr

gqB +1 een fr o t a;-5 sfiftm *uft r

b) The period of notice required shall be - i. Three months, in case of confirmed' empioyee, ii. one month, in case of employee who is on probation.

rr) 3ftr eu-s .s, d airr qit EQ11 fr, $f]|-qi-rff 3T{ 3ritfi elqfu d ftil}'

sTq-a tra d zrqra ffi z-o-o E,] qfrtFT{ d oq fr d-6 q)} aa Aftri fir.{r$ +ur-r t

c) ln case of breach of clause 'b' employee shall be liable to pay to the.Bank as

compensation "

ru* equal to his payior the period of notice required of him'

le. sTrq*t ffi uderd d frffi*',. s sraala t"6 + 6T-d*q of ffi +ft' ;r*r^*f"" fr ffi eft zrryq zerraraFo d qr zrffi r

Your services are liable to be transferred at any time at the discretion of the

management to any of the branches/offices within the area of operation of the

Bank.

zo. do;i o-rqk{T zrdrq?F & o.q d snq-o} *o aru nill-q zrrf'I Il{ fr} rr}

zraff ord ora EI-n i .no-d 6rd fr der ftnor, a11 -6rd -r ^dq 3d'

;ffi" ord atc -*fd.*,

6fr'ul, o-rTIe{ oTd sxfr .t bf, ?fl1}d

^\461 6r

Your duties as a office Assistant in the Bank will be such as may be,qssigned to

you from time to time, nV tne e"l.k. Your duties will include b'ut not tlmited to Cash

Department, nccouni Work / Field Work, Office work and Followup, Typing,

Computer Work etc.

zr. frBo-o ffin r{Ed, frgfu qd effi qof. qr t* ftf6o2.os.2o1s r

-;;.; r.ior. h *' 10'30 it+ t+ ar$ l.na qr ffiJ

o_rar *an r

4ilqdE_d' aTr.T{.ft., t-qd qeqg'ter uIs-f tE5, geIIEI Otsioq' 800/1e

"{rsel ft{fud Eir56?{, ftl-d-qrs-r (4.u.) +aooot

You are required to report on the date 02,09.2013 / 03.09.2013 at 10 30 a'm' at the

place given Oefow t,ir completion of your pre-recruitment formalities including

medicalfitness.

GeneralManagerH'R.D.,CentralMadhyapt-'9q:!GraminBank'HeadOffice'800/19 Soutfr Civit Lines, Chhindwara (M P ) 480 001

22. ffi fi qftfrqftrql fr Ffi,E4T tg swftmrgz{z -e T$ E-{d FF fr-- qftqdd I gk u-A mr inq;nffi oTqfuq fr scffmrgilTr frfer^E,}

sqft€rd dfi frA- E- d) flq-+t st{ t ffi qflqrt of u-ft€Tr ft+ fuar

3lprcFr alfl T{la Tlfr + 6dI F{[I qr}an r

Reporting date will not be changed/extended in any condition' lf you do not report

to the above mentioned office on the date mentioned above, your name will be

removed from the selection list without awaiting any further communication from

you.

2 3 ' Q!-{IT +d 6t fu Ergftfl Ed frtr-6-'{ qfiqn' tr{r fr znrd"rd'T o-r} t-g ut-*t

qq qt 3rq @t$ @q Urmla q}-l+ s-fr d-& r

Please note that traveling or any expenses for pre-recruitment medical examination

and joining dutY are not PaYble.

za. ekrrerl(i areqq] qr1 tft d ft{} t-6 3-drdrff "ffi frant

The Bank will not be responsible for any delay caused by transport services, etc'

2s" srcr arof fr fre sTfr tS rn ffi z[+ar -3T14r

ftnzfr q-flIur q{ o1 4 drtlqra sI .*-, t ifr" ffi q-A-s "d ftil+ ?n g{rfrt eIfr A ffi d-6

s-c-rcr$ u6 frm t

The Bank will not be responsible for any delay in receipt or loss in postal transit of

,ny *rrrnication orioi not connecting any lertificate(s) or other documents sent

separately.

This offer.of appoiritmeni:i$,$-uief)lrProvisonal.and'Snatt not'b'e claimed as a Right

of emPloYm€nt in the bank,

2r. qtr 3ilqo} rm B."+a ati Qrd Tffi E a) qq-qr .Efl qr q "*-^"--

Ed" qfr o.{ e* *# .Seft, aoqtie-rfi trE.3rl-{.g1., i-Ea a*-seQl af,rfrur

#, o* olq1--q, 800/l s ?TBq ft{fd-d f,Is-6g, p;.ql$ a'q' 480 001

o] 't-o

tqrq-6"T tg "oftelft

S u-flq u-zga of r

lftheabovetermsandconditionareacceptabletoyou,please^submitunconditionar

""""piun"" on the enclosed duplicate copy of this letter to General

Manager HRD C;;traiMaOnya Prad_esh Gramin Bank, Head Office,800/19, South

Civit Lines, Chnindwara (M P i 480 001 at the time of reporting to the Bank'

(S.P. Sharma)General Manager

zd;orifur RcerPrnruce

u.6 u{flrcl g-S ft-fl ald Tffi B s}{ zffirfu lEsrr, ff gc{ qil-ft1 ffi'qqfr q{ srqa a{fleru 6-{ dl-qfl EF-{ Tdl ( t}z t-6 fr or-d"rEUT o-ri qr' toErrr z{nq or, ; qrt $rteil E?i I# cF'I qIEIEI 99-eg 1ea z{un r f,

ffi,"t- {'m, oa,A-fr,,frt '8,.,,u,.9'Gdo1o' t;;' gfp,-ors or

Erdr a-e qIq,l ,qIa"TI.t

lhereby accept the above offer unconditionally and.in token of my acceptance' l,return

herewithacopyofthisletterdulysignedbymeandagree.tobeboundb.ylh?.':l:"ndregulations of the Bank from time io time, on ,y appointment.the Bank' I am fully aware that

this offer is purely Piovisonal and shall not Oe ciaimbd as a Right of employment in the bank'

Place............

Date..............

3Taqrff d Ar(IreI{ / Signature of the Candidate

E{T alJI/ Name in full .............

*el ruote - ffi afr dt6 e)f ftqfr fr rrarq qq or sId-fr qr6 siftla arar uri-un I /ln case of anv

doubt in interpretation English version of the offer letter will be considered as final'

*ryffiryt{ffiAaTffi*ur($na m6rl, +{E {6 sir iEqT Iq qasfur pm]-d 6r dgrd ic-6c)

tsntral lJlrdhyn Pradcsh Gramirr [mk(Ajointventure ofGow oflndia,Cent6l Sankoflndia and Go*. ofMadhya Pradesh)

gc1!{s'rqipl-{ Head C)ffice

q.or./o 2ruq.fi-{.S. t 2 o t a- t 4/

The Superintendant of PoliceThe Dy. Commissioner of Police

Dear Sir,

Reg - History of

E-#6 r4.oB.2ol3

criminal case/s/conviction against (roll no'Shri/Smt .. address

Shri/Smteligible toBank.

; ; ;; ; ;il ; ;; i; ; ; p J3',ifl:".i: JT "'#

::"i"'il #i fl'31?Before considering for appointment ShriiSmt

as a Office Assistant we would like to ascertainShri/Smt antecedent.

The above mentioned candidate is residing in the area which comes

under your jurisdiction. We, therefore request you to inform us whetherany criminal caseis/conviction is registered/pending against above refer

candidate in your record in the enclosed format under your signatureand seal.

lf we do not receive any communication/reply in this matter within 30

days on receipt of this letter, we will presume that, there is no criminal

case/s/conviction against the above mentioned candidate.

Yours faithfully

Senior Manager HR

Enclosed - a proforma

soo/rc, qrcerfrksor{q, fu-<arg (q.s.)fr-c - +eo oor qrnvxui+ : 07162 - 247 48s,245 530*-tr: 07162 - z4z ttz800/19, South Civil Lines, Chhindwara (M.P.) 480 001 * Tel : 07162 - 247 485, 245 530Fax:07162 - 242ll2

ail.com, cmpgbho@rediffrnail.com

Medical Report

Name of candidateAddress.......

part History: Name of the family members suffering from & since when

1.

2.3.

HypertensionMental diseasesAsthmaSkin DiseasesTuberculosisLeprosy

General Examination

BuiltWeightPulseNails

Svstematic Examination

BPHeart SoundMurmursPeripheral circulationAbnormal findingsRespiratory System

lnspectionPercussionPalpitation

' Per Abdomen

Operative ScanHorniaHydroceleLiverSpleenAny finding

Central Nervous System

Ear, Nose, Throat

Ophthalmic Examination

Eye sightColour blindnessSquintAbnormal findings

CancerCardiac ailmentParalysisTumorPleurisyMajor AccidentSurgical Operation

HeightConjunctivetongue

conti - 2

-2-Gynecological Examination

M.C.Last M.C.Obstetric historyAbnormal findings

Urine SugarAlbumin

Advice to candidate for the correction of abnormal findings

RecheckConsultant's opinionRemark

ln my opinion, Mr./MrsiMiss:...,............... is physically and

mentally fiUunfit to join his/her service.

Signature

Name

Qualification

Registered no.

Address

Date

DISTRICT MEDICAL BOARD DISTRICT HOSPITAL

MEDICAL. REPORT

Signature of candidates

DATE ................

Name of Candidate S/O W/O DiO ............'..

Post for which appliedPradesh Gramin Bank

age..................... Department - Central Madhya

Height.................... cm Weight........."........ kg

Any evidence of veneral diseases.J

Eye

Distance visionNear visionColour visionAny abnormalityHearing

Obstratic HistorvFemale reproductive Organs :

RTRTRTRT

c.v.s.

LTLTLTLT

Nervous system ResP. SYstem

Any Deformity of muscles and Joints :-

Temporary unfit due to ..................

Advice given

Dectared FiUUnfit for the post of Office Attendant

MedicalSpecialist Asstt. Surgeon Eye Specialist SecretaryDistt. Medical Board Distt. Medical Board Distt. Medical Board Distt. Medical Board

Chairman

Distt. Medical Board

Form of Certificate to be produced by a candidate belonging to a Scheduled Caste or

Scheduled Tribe in Support of his claim

Form of Caste Certificate

1. This is to cetify that ShriiShrimathi*/Kumari* son/daughter* of

of village/town* tn

State/UnionDistricUDivision*..........Territory*..... .......belonngs to the Caste/Tribe* which is recognised as

a Scheduled Caste/Scheduled Tribe under:

*The Constitution (Scheduled Caste) Order, 1950*The Constitution (Scheduled Tribe) Order, '1950*The Constitution (Scheduled Castes) (Union Territories) Orders, 195'l;*The Constitution (Scheduled Tribes) (Union Territories) Orders' 1951;

[as amended by the Scheduled Castes and Sheduled Tribes Lists (Modification) Order, 1956; the

Bombay Reorganisation Act, 1960; the Punjab Reorganisation Act, 1966, the State of Himachalpradesir Act, 1970, the North-Eastern Areas (Reorganisation) Act, 1971, the (Constutution)

Scheduted Castes and Scheduled tribes Order (Amendment) Act, 1976; the Constitution

(Scheduted tribes) Order (Amendment) Act, 1987; the Constitution (Scheduled tribes) Order(Amendment) Act, 1991; and the Constitution (Scheduled tribes) Order Second Amedment Act,

1ee1l* The Constitution (Jammu and Kashmir) Scheduled Castes Order, 1956* The Constitution (Andman and Nikobar lslands) Scheduled Tribes Order, 1959 as amendment by* The Scheduled Castes and Scheduled Tribes Orders(amendment) Act' 1976;* The constitution (Dadra and Nagar Haveli) scheduled castes order, 1962;* The constitution (Dadra and Nagar Haveli) scheduled Tribes order, 1962;* The Constitution (pondicherry) Scheduled Castes Order, 1964;* The Constitution (Uttar Pradesh) Scheduled Tribes'Order, 1967;* The Constitution (Goa, Daman and Diu) Scheduled Castes Order, 1968;* The Constitution (Goa, Daman and Diu) Scheduled Tribes Order, 1968;* The Constitution (Nagaland) Scheduled Tribes Order, 1970;* The Constitution (Sikkim) Scheduled Castes Order, '1978;* The Constitution (Sikkim) Scheduled Tribes Order, 1978;* The Constitution (Jammu and Kashmir) Scheduled Tribes Order, 1989;* The Constitution (Scheduled Castes)Orders, (Amendment)Act' 1990

2. Shri/Shrimathi*/Kumari* and/or* his/her* family ordinarily reside(s) in

DistricVDivision* of thevillage/town*State/Union Territory* of

Signature:

Designation:

Place............. .. State............ ....Union Territory.......................

Date

Note - The term ,'Ordinarily resides" used here will have the same meaning is Section 20 of the Representation of the

Peoples Act 1950 .

* Please delete the words which are not applicable

No. F. 1 01/30/94-SCT(B)Dated 10.04.1995

of

of

Form of Certificate to be produced in the case of Scheduled Castes/ Scheduled Tribespersons who have migrated from one State/Union Territory Administration

1. This is to cetify that Shri/Shrimathi"/Kumari* son/daughter* of

of village/town* ln

DistricuDivision*.................1.............,,.. ..................of the State/Union

Territory*..... .......belongs to the .......... .. Caste/Tribe* which is recognised as a

Scheduled Caste/Scheduled Tribe under:

*The Constitution (Scheduled Caste) Order, 1950*The Constitution (Scheduled Tribe) Order, 1950*The Constitution (Scheduled Castes) (Union Territories) Orders, 1951;*The Constitution (Scheduled Tribes) (Union Territories) Orders, 1951;

[as amended by the Scheduled Castes and Sheduled Tribes Lists (Modification) Order, '1956; the

Bombay Reorganisation Act, 1960; the Punjab Reorganisation Act, 1966, the State of Himachal

Pradesir Act, 1970, the North-Eastern Areas (Reorganisation) Act, 1971, the (Constutution)

Scheduled Castes and Scheduled tribes Order (Amendment) Act, 1976; the Constitution(Scheduted tribes) Order (Amendment) Act, 1987; the Constitution (Scheduled tribes) Order(Amendment) Act, 199'1; and the Constitution (Scheduled tribes) Order Second AmedmentAct,19911

* The Constitution (Jammu and Kashmir) Scheduled Castes Order, 1956* The Constitution (Andman and Nikobar lslands) Scheduled Tribes Order, 1959 as amendment by* The scheduled castes and scheduled Tribes orders(amendment)Act, 1976;* The Constitution (Dadra and Nagar Haveli) Scheduled Castes Order, 1962;* The Constitution (Dadra and Nagar Haveli) Scheduled Tribes Order, 1962;* The Constitution (pondicherry) Scheduled Castes Order, 1964;* The Constitution (Uttar Pradesh) Scheduled Tribes Order, 1967;* The Constitution (Goa, Daman and Diu) Scheduled Castes Order, 1968;* The Constitution (Goa, Daman and Diu) Scheduled Tribes Order, 1968;* The Constitution (Nagaland) Scheduled Tribes Order, 1970;* The Constitution (Sikkim) Scheduled Castes Order, 1978;* The Constitution (Sikkim) Scheduled Tribes Order, 1978;* The Constitution (Jammu and Kashmir) Scheduled Tribes Order, 1989;* The Constitution (Scheduled Castes)Orders, (Amendment)Act' 1990

2. The certificate is issuedShri/Shrimathi*/Kumari*Shri/Shrimath i*/Ku mari*

": :::'::: :: :::':::o'"0'::*:T:'"0'::: TliffrHJ,TJ:'toof

in DistricUDivision* .......... ...of the State/Union Territory*..... .... who belong

to the.. ..................,........caste/tribe* which is recognised as Scheduled Caste/Scheduled Tribe in the

State/ Union Territorry*.... ....... issued by theprescribed athority) vide their No. ............................. dated

.... (Name of the

Place

Date

Signature:

Designation:State.................Union Territory.......................

- The term "Ordinarily resides" used here will have the same meaning is Section 20 of the Representation of the

Peoples Act 1950 .

* Please delete the words which are not applicable

No. F.1 01/30/94-SCT(B)Dated 10.04.'1995

Form of the Certificate to be produced by Other Backward Classes applying forappointment to posts under the Government of lndia

This is to certify that ........... .. son/daughter* ofof village ..... .:........... ...... DistricUDivision.

... .'... ::the State belonging to thecommunity which is recoghised as a Backward Class under -

i) Government of lndia, Ministry of Welfare, Resolution No. 12011/68/93-BCC(C), dated 10

th September, 1993 published in the gazette of lndia, Extraordinary, Part - l, section l,

No. 186, dated the 13 th september, 1993

ii) Government of lndia, Ministry of Welfare, Resolution No. 1201119193-BCC, dated the 10 th

October, 1994 published in the gazette of lndia, Extraordinary, Part - l, section l, No.

163, dated the 20 th October, 1994.

lll) Government of lndia, Ministry of Welfare, Resolution No. 1201117195-BCC, dated the24 th May, 1995 published in the gazette of lndia, Extraordinary, Part - l, section l, No.

BB, dated the 25 th May, 1995.lV) Government of lndia, Ministry of Welfare, Resolution No. 12011144196-BCC, dated the

06 th December, 1996 published in thegazette of lndia, Extraordinary, Part- l, section l,No.210, dated the 11 th December, 1996

Shri ........... ....... and/or. his family ordinarily reside (s) in theDistricVDivision* of the ............ .. State. This is also to certify that he/she* doesnot belong to the persons/section (Creamy Layer) mentioned in Column 3 of the Scheduledto the Goverment of lndia, Department of Personal & Training, O.M.No. 36012122193-

Estt.(SCT) dated 8.9.1993. r

signatureName & Designation

of the issuing authority

Dated

Seal

' * Srike out whichever is not applicableNB - (a) The term "Ordinarily resides" used here will have the same meaning is Section 20 of the Representation of

the Peoples Act 1950 .

(b) The authorities competent to issue caste certificate are indicated below :-

1. District Magistrate/ Additinal District Magistrate/ Collector/ Deputy Commissioner/ Additional DeputyCommissioner/ Deputy Collector/ 1st class Stipendary Magistrate/ Sub Divisional Magistrate/Taluka Magistrate/ Executive Magistrate/ Extra Assistant Commissioner (not below the rank of First

Class Stipendary Magistrate) .

2. Chief Presidency Magistrate/ Additional Chief Presidency Magistrate/ Precidency Magistrate

3. Revenue Officer not below the rank of Tehsildar4. Sub-Divisional Officer of the area where the candidate and/or his family normally resides.

F