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, /1st floor,C BLOCK

/Railnilayam,
/Secunderabad-500071


SOUTH CENTRAL RAILWAY

Telangana
Phone Nos. 040-27788824
Closing Date: 26.11.2015

Railway Recruitment Cell


Date of Issue: 27.10.2015

GDCE Notification No.RRC/SCR/GDCE/01/2015


Applications are invited through proper channel from serving regular railway employees of South
Central Railway for filling up vacancies against General Departmental Competitive Examination (GDCE)
quota. The community wise breakup of vacancies to be filled is indicated below:Cat
No.
01
02

03

Name of the
post
Assistant
Station
Master
Goods
Guard
Ticket
Examiners

Pay
Band in

Grade
Pay in

Number of vacancies
SC

ST

OBC

UR

Total

Medical
Standard

Minimum Educational
Qualification

5200-20200

2800

14

07

25

46

92

A-2

A University degree or its


equivalent.

5200-20200

2800

11

06

21

38

76

A-2

A University degree or its


equivalent.

5200-20200

1900

05

02

08

15

30*

B-2

*Out of 30 vacancies, 07 vacancies reserved for PH candidates i.e.


02-VH (LV), 03-HH & 02-OH (OL,OA,MW)
04

Tech Gr. II
(Signal)

5200-20200

2400

02

01

03

06

12

B-1

05

Tech Gr. III


(Signal)

520020200

1900

02

01

03

04

10

B-1

12th
(+2
stage)
or
equivalent
examination
with not less than 50%
marks in the aggregate.
50% marks is not to be
insisted upon in case of
SC/ST.
Pass in 1st year of B. Sc.
(Physics) or Pass in 10+2
stage in Higher Secondary in
Science i.e. Math or Physics or
its equivalent.
(i) Matriculation Plus ITI Plus
Act
Apprenticeship
in
Electrician/Electrical
Fitter/Wireman/Electronics/
Information Technology/TV &
Radio/Instrumentation/
Computer/Computer
Networking/ Data
Networking OR
(ii) 10+2 with Physics and
Maths OR
(iii) Three (03) year Diploma in
Engineering in Electrical/
Electronics/Microprocessor/
TV Engineering/ Fiber Optical
Communication/Telecommuni
cation/Communication/
Sound & TV Engineering/
Industrial Control/
Electronics Instrumentation/
Industrial Electronics/Applied
Electronics/Digital
Electronics/
Power Electronics/information
science/Information
Technology/Computer
Application/Computer
Engineering/
Computer
Science/Computer Technology.

1. Age limit: 1.1 The upper age limit will be 42 years for General candidates reckoned as on 01.01.2016.
1.2 45 years for OBC candidates
1.3 47 years for SC/ST candidates
1.4 For Persons with Disabilities (PWD) 10 years for UR, 13 years for OBC and 15 years for
SC/ST candidates.
2. How to apply:2.1 Candidates should submit the applications in the format annexed as Annexure- 1 to this
Notification.
2.2 The application should be on good quality A-4 size bond paper (80-GSM) using one side
only.
2.3 Candidates should ensure that application on a single sheet conforms to the above
specifications. They can also download the application format from the website
www.scr.indianrailways.gov.in and clicking on scrolling link Railway Recruitment Cell
Secunderabad and NOTIFICATION. Candidates using printed application form from any
other source should also ensure that it conforms to the prescribed format.
2.4 Candidate should fill up the application form in his/her own handwriting either in Hindi or in
English with blue or black ball point pen only.
2.5 Photographs: One recent (not earlier than three months from the date of application) colour
passport size photograph with clear front view of the candidate without cap, scarf and sun
glasses should be pasted on the application form in the space provided. The candidate should
sign in the space provided in the box below the photograph. One identical extra colour pass
port size photograph should be enclosed with the application indicating candidates name and
date of birth on the reverse of the photograph. Candidates should note that RRC may reject the
candidature at any stage for pasting old/unclear photograph on the application or for any
significant variations between photograph pasted on the application and actual physical
appearance of the candidate.
2.6 Candidates should tick ( ) mark their community in the appropriate box at column No.5 of the
application. The candidates with Physical Disabilities shall tick ( ) mark in column No.7 of the
application form.
2.7 The candidate should fill the column No.8 of the application form in Capital letters in English
only indicating his address with PIN code, even though application is in Hindi. The candidates
belonging to SC/ST community should fill the nearest Railway Station for the purpose of
issuing free Railway Pass in column No.9.
2.8 Candidates belonging to SC/ST community should produce a community certificate in the
format given atAnnexure-2 of this Notification.
2.9 Candidates belonging to OBC community should produce a community certificate in the
format given at Annexure-3 of this notification. In addition, they should enclose selfdeclaration of non-creamy layer status in the proforma given at Annexure-4.
2.10 Persons with Disabilities (PWD) should enclose the latest disability certificate as per the
format given in Annexure-5.
2.11 The candidates seeking age relaxation under any category as mentioned at Para 1 above shall
tick ( ) in the appropriate box in the column No.10 of the application form.
2.12 The Candidates should copy the declaration at column No.14 of the application form in
his/her own handwriting (not in capital letters). Otherwise their applications will be rejected.
2.13 The candidates should put their left hand thumb impression at the designated box in the
application form. The thumb impression must be clear and complete. Applications
without/smudged left hand thumb impression will be summarily rejected.
2.14 In item No.11 of the application form the candidate should indicate any clear/visible marks
of identification on their body like a mole on the nose (or) cut mark on the forehead, etc. The
application form of the candidate is liable to be rejected if he/she does not indicate
identification marks.
2.15 ONLY ONE APPLICATION: Candidates should submit only one application for each category.
Candidates submitting more than one application for one category will be liable for
disqualification.
3

Recruitment Process:3.1 Standard of examination shall be like that of direct recruitment conducted by RRB.
3.2 The selection will be made strictly as per merit in the written examination.

3.3 There shall be negative marking in written examinations and 1/3 of the allotted marks for each
question shall be deducted for every wrong answer.
3.4 Aptitude test for the post of ASM will be conducted for the candidates shortlisted as per merit
in the written examination.
3.5 Shortlisted candidates will be called for verification of their original documents.
3.6 The date, time and venue of the written examinations will be fixed by RRC, Secunderabad and
will be intimated at the address for communication to the eligible candidates by post. Request
for postponement of the written examination or change of venue will not be entertained under
any circumstances.
3.7 The candidates recommended for appointment will have to pass requisite medical fitness test(s)
conducted by the Railway Administration to ensure that the candidates are medically fit to
carry out the duties connected with the post.
4. Enclosures to be attached:4.1 Self-attested copy of Matriculation certificate in proof of Date of Birth.
4.2 Self-attested copy of certificate/Marks sheet in proof of Educational/Technical Qualifications.
4.3 Self-attested copy of SC/ST certificate in the proforma prescribed for employment in Central
Government services. (Annexure-2)
4.4 Self-attested copy of OBC certificate in the proforma prescribed for employment in Central
Government services (Annexure-3).
In addition, OBC candidates should enclose self
declaration regarding their non-creamy layer status in the proforma given at Annexure-4.
4.5 One extra photograph should also be attached to the application.
4.6 Railway administration will not be responsible for loss of original certificates enclosed, if any by
the employee.
5. Procedure for forwarding the applications:5.1 The eligible employees should submit their application in the prescribed format on or before
the closing date i.e. 26.11.2015 to their immediate supervisor.
5.2 The immediate supervisor should forward all the applications of his unit along with the list to
concerned officer of Personnel Branch of GM office/DRM office/CWM office under a covering
letter by 30.11.2015.
5.3 Personnel branch of GM office/DRM office/CWM office will verify the application from the
Service Record and prepare post wise consolidated list of eligible and ineligible candidates.
5.3.1 The list of ineligible applications will be communicated to the respective immediate supervisors
of the employees concerned.
5.3.2 The list of eligible applications along with original applications should be Handed over to the
concerned cadre officer in CPOs office in hard and soft copy as per proforma given
below, by 15.12.2015.
Educational
Name of
Designati
qualification
Age
S.
the
Fathers
ComPF/NPS Divis
on &
Addre
DOB DOA
( as per
(as on
No. applican
name
munity
No.
ion
working
ss
service
1.1.16)
t
under
register)
5.4 Concerned cadre officer in CPOs office will prepare post wise consolidate list of all the
eligible applications received in the Personnel Branch and send the post wise applications in
single bunch to RRC, Secunderabad under a covering letter by 31.12.2015. Post wise
consolidated list should be sent in hard and soft copy.
6. General Instructions:6.1 Only serving regular Railway employees of South Central Railway who are working in Grade
pay lower than the grade pay for which GDCE is held are allowed in the GDCE.
6.2 RPF/RPSF personnel are not allowed to apply for this GDCE scheme.
6.3 Those candidates who are appearing in and/or awaiting results of final examination of
minimum qualification at the time of applying for the post are not eligible. Academic
qualification must be from recognized Educational Institution/Board, otherwise candidature
will be rejected. Candidates having higher educational qualification may also apply.
6.4 Eligible employees should submit their applications through proper channel to the concerned
Personnel officer only. Application directly received in Headquarters office will not be
entertained.

6.5 Candidates shall be free to apply for more than one category but he/she will be doing so at
his/her own risk as the written examination can be held for more than one category on the
same date & time.
7.

INVALID APPLICATIONS:
The applications having any of the following deficiencies, discrepancies or irregularities will be
summarily rejected:
7.1 Applications received after closing date.
7.2 Applications not submitted in prescribed format as given in the Notification.
7.3 Incomplete or illegible applications.
7.4 Unsigned/undated application/applications with unclear and smudged thumb impressions
and/or without Marks of identification.
7.5. Without colour photograph or affixing/attaching Xerox copy of Photograph.
7.6. Without/different signatures in box below the photo and on the bottom of the application
form.
7.7. Applications not filled in English or Hindi or not filled by candidate in his/her own
handwriting.
7.8. Without proper caste certificates in respect of SC/ST/OBC candidates. Certificate should be
obtained from the appropriate authority in the prescribed format.
7.9. Under aged/Over aged candidates.
7.10. Not having the requisite Educational qualification at the time of submitting application.
7.11. Application without enclosing copies of requisite certificates or enclosed without self
attestation.
7.12. Any other irregularity.

8. Important Instructions:8.1. Candidates who wish to be considered against vacancies reserved and /or seek age relaxation
must submit requisite certificate from the competent authority in the prescribed format along
with the application form itself. Otherwise, their claim for reserved status will not be
entertained and the candidature/applications of such candidates fulfilling all eligibility
conditions for General (UR) category will be considered under General (UR) category only.
8.2. In case wrong declaration/particulars given by the candidates, he/she is liable to be taken
up under D&AR also.
9. Abbreviations:SC Scheduled Caste
ST Scheduled Tribe
OBC Other Backward Classes
UR Unreserved
RRC Railway Recruitment Cell
LV Low Vision
OL One Leg
OA One Arm
MW - Muscular weakness
10. Misconduct:10.1 Candidates are warned that they should not furnish any particulars that are false or
suppress any material information while submitting application.
10.2 Candidates shall not bring or attempt to bring any political or other influence to further
his/her interest in respect of selection process.
10.3 Indulgence in any malpractice/misconduct on the part of a candidate at any stage of the
selection process is strictly prohibited and such misconduct will lead to disqualification of
his/her candidature besides appropriate disciplinary/criminal proceedings.
11. Final Authority:11.1 While every care has been taken in preparing this notification, the Railway Recruitment Cell,
Secunderabad, reserves the right to rectify the errors & omissions, if any. Decision of the
Railway Recruitment Cell, Secunderabad in the matter of selection will be final.
11.2 The Notification and application format may be downloaded from the website
www.scr.indianrailways.gov.in and clicking on scrolling link Railway Recruitment Cell
Secunderabad and NOTIFICATION
Chairman
Railway Recruitment Cell
South Central Railway
Secunderabad

Annexure-1

Application for Recruitment against GDCE Quota in South Central Railway


(Only for serving regular railway employees except RPF/RPSF staff)

Railway Recruitment Cell / South Central Railway


GDCE Notification Number RRC/SCR/GDCE/1/2015

For Office use only:


Control Number:
Roll Number :
Candidate must fill the application form with his/her own hand writing. Leaving any column blank will leads to rejection

1. Category / Post applied for:


2.

Name of Candidate:
(in capital letters)

3.
4.

Fathers name:
(in capital letters)
Date of Birth: (DD/MM/YYYY):

5.

Community: (Tick):

SC

Paste recent colour


passport size
photograph attested
by the controlling
Supervisor
ST

OBC

UR

a)If OBC please state whether belonging to Minority Community (Write Yes/No) (
b)If minority, indicate community: ________________________

6.

7.
8.

Employee details:
a) Present designation & Station: _____________________

b) Controlling officer _ _______________________

c) DOA: ________________
Are you Physically Disabled (Tick):

d) PF/NPS Number : _________________________


OH

VH

HH

Address for communication (in capital letters):

9.

Nearest Railway Station: _______________________

(In English only for issue of free Railway pass for SC/ST candidates)

10. Do you seek age relaxation under any


of the categories mentioned below:(Tickappropriate box)
State:
Pin Code:

SC

ST

OBC

Mobile No.

11. Visible Marks of Identification:


(moles etc on your body)

Physically
Disabled

1.

2.
12. Educational Qualifications:
Qualification
University/Board
Year of Passing
SSC/10th class
ITI
Degree
Others
13. List of Documents enclosed: (fill in the details of the copies of certificates/documents enclosed).
i)
iii)
v)
ii)
iv)
vi)
14. Declaration by the candidate: (Please copy the following declaration in the space provided below in running hand writing NOT in capital letters):
I hereby declare that all the particulars given above by me are true and to the best of my knowledge. I am aware that in the event of any
information furnished by me is found false / incorrect at any stage, my candidature will be rejected summarily and I am also liable for
criminal action. I will abide by the instructions given in the notification.

Place:
Signature of the candidate

Forwarded to_________________________

Left hand Thumb Impression

Date:

Date:______________

Signature of the Immediate Supervisor (with office seal)

Certified that the above service particulars are verified from the service records of the staff concerned and found correct. He/She is
eligible for the above post notified in GDCE notification.
Date:_____________

Signature of the Personnel Officer


(with office seal)

Annexure-2
FORM OF CASTE CERTIFICATE FOR SC/ST
The format of the certificate to be produced by Scheduled Castes or Scheduled Tribes candidates applying for appointment to
posts under the Government of India.
This is to certify that Shri /Shrimati/Kumari* ................................ ...................................................................................... ...
son/daughter* of .. ....................................................... of Village / Town* ...................................................... in
District/Division* ......................................................... of State / Union Territory* .belongs to
the..Caste / Tribe* which is recognised as a Scheduled Caste / Scheduled Tribe* under:The Constitution (Scheduled Castes) Order, 1950
The Constitution (Scheduled Tribes) Order, 1950
The Constitution (Scheduled Castes) (Union Territories) Order, 1950
The Constitution (Scheduled Tribes) (Union Territories) Order, 1951
(As amended by the Scheduled Castes and Scheduled Tribes Lists (Modification) Order, 1956, the Bombay Re-organisation
Act, 1960, the Punjab Re-organisation Act, 1966, the State of Himachal Pradesh Act, 1970 and the North Eastern Area (Reorganisation) Act, 1971 and the Scheduled Castes and Scheduled Tribes Orders,(Amendment) Act, 1976)
The Constitution (Jammu & Kashmir) Scheduled Castes order, 1956.
The Constitution (Andaman and Nicobar Islands) Scheduled Tribes Order, 1959 @ as amended by the Scheduled Castes
and Scheduled Tribes Order (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 Orders, 1964@
The Constitution (Scheduled Tribes) (Uttar Pradesh) 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 & Kashmir) Scheduled Tribes order 1989@
The Constitution (SC) orders (Amendment)Act,1990@
The Constitution (ST) orders (Amendment) Ordinance 1991@
The Constitution (ST) orders (Second Amendment) Act, 1991@
The Constitution (ST) orders (Amendment) Ordinance 1996.
% 2. Applicable in the case of Scheduled Castes, Scheduled Tribes persons who have migrated from one State/Union Territory Administration.

This certificate is issued on the basis of the Scheduled Castes/Scheduled tribes certificate issued to Shri/Shrimati _________________
___________ Father/mother of Shri/Srimati/Kumari* _________________________________ of village/town*________________
in District/ Division* _______________________ of the State/Union Territory*__________________________ who belong to the
_____________Caste/Tribe which is recognized as a Scheduled Caste/Scheduled Tribe in the State/Union Territory* issued by the
_____________ dated______________.
%3. Shri/Shrimati/Kumari * ___________________________and / or his / her* family, reside(s) in village/town* _______________
of*______________District/Division* of the State / Union Territory* of ________________________________.
Signature ......................................................................
**Designation .............................................................. .
(with seal of Office)
Place..
Date . ........................... .
* Please delete the words which are not applicable.
@ Please quote specific Presidential Order.
% Delete the paragraph which is not applicable.
NOTE: The term, ordinarily reside(s) used here will have the same meaning as in section 20 of the Representation of the People Act, 1950.
** List of authorities empowered to issue Caste/Tribe Certificates:
(i) District Magistrate/Additional District Magistrate/Collector/Deputy Commissioner/Additional Deputy Commissioner/Dy. Collector/
Ist Class Stipendiary Magistrate/Sub-Divisional Magistrate/Extra-Assistant Commissioner/Taluka Magistrate/Executive Magistrate.
(ii) Chief Presidency Magistrate/Additional Chief Presidency Magistrate/Presidency Magistrate.
(iii) Revenue Officers not below the rank of Tehsildar.
(iv) Sub-Divisional Officers of the area where the 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.

Annexure-3
OBC CERTIFICATE FORMAT
FORMAT OF CERTIFICATE TO BE PRODUCED BY OTHER BACKWARD CLASSES
APPLYING FOR APPOINTMENT TO POST UNDER THE GOVERNMENT OF INDIA.
This is to certify that Shri/Smt/Kum*_____________________________________________________________________
Son/Daughter* of Shri __________________________________ of Village /Town ________________________________
District ___________________ in __________________________

State belongs to ______________________ community

which is recognized as backward class under___________________: (indicate the Sub Caste)


1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.

Resolution No. 12011/68/93-BCC@dtd 10th September 1993, published in the Gazette of India- Extraordinary Part-I, Section 1.
No. 186 dated 13th September 1993.
Resolution No. 12011/9/94-BCC dated 19th October 1994, published in the Gazette of India-Extraordinary Part-I, Section I. No.
163, dated 20th October 1994.
Resolution No. 12011/7/95-BCC dtd 24th May 1995, Published in the Gazette of India-Extraordinary Part-I, Section I. No. 88
dated 25th May 1995.
Resolution No. 12011/44/96-BCC dtd 6th December 1996, published in the Gazette of India-Extraordinary Part-I, Section I. No.
210, dated 11th December 1996.
Resolution No. 12011/68/93-BCC, Published in Gazette of India Extra Ordinary No. 129, dated the 8th July 1997.
Resolution No. 12011/12/96-BCC, Published in Gazette of India Extra Ordinary No. 164 dated the 1st Sept. 1997.
Resolution No. 12011/99/94-BCC, Published in Gazette of India Extra Ordinary No. 236 dated the 11th Dec. 1997.
Resolution No. 12011/13/97-BCC, Published in Gazette of India Extra Ordinary No. 239 dated the 3rd Dec. 1997.
Resolution No. 12011/12/96-BCC, Published in Gazette of India Extra Ordinary No. 166 dated the 3rd August 1998.
Resolution No. 12011/68/93-BCC, Published in Gazette of India Extra Ordinary No. 171 dated the 6th August 1998.
Resolution No. 12011/68/98-BCC, Published in Gazette of India Extra Ordinary No. 241 dated the 27th Oct. 1999.
Resolution No. 12011/88/98-BCC, Published in Gazette of India Extra Ordinary No. 270 dated the 6th Dec. 1999.
Resolution No. 12011/36/99-BCC, Published in Gazette of India Extra Ordinary No. 71 dated the 4th April 2000.

Shri/Smt/Kum*_____________________________________________________ and / or his/her family ordinarily reside(s) in the


____________________________District of the___________________________State. This is also to certify that he/she does not
belong to the persons / sections (Creamy Layer) mentioned in Column 3 (of the Schedule to the Government of India, Department of
Personnel and Training O.M. No. 36012/22/93/Estt. (SCT) dated 08.09.1993) and modified vide Government of India, Department
of Personnel and Training O.M. No. 36033/3/2004/Estt.(RES). dated 09.03.2004.

Place:
Date:

District Magistrate/
Dy. Commissioner etc
(with seal of office)

________________________________________________________________________________________________________
a.
b.

c.

The term ordinarily used here will have the same meaning as Section 20 of the representation of the People Act. 1950.
Where the certificates are issued by Gazetted Officers of the Union Government or State Governments, they
should be in the same form but countersigned by the District Magistrate or Dy. Commissioner (Certificates
issued by Gazetted officers and attested by District Magistrate/Deputy Commissioner are not sufficient).
The OBC certificate from the authorities only will be accepted.
1.
District Magistrate/Additional District Magistrate/Collector/Deputy Commissioner/Additional Deputy
Commissioner/Deputy Collector /I" Class Stipendiary Magistrate/Extra-Assistant Commissioner (not
below the rank of l" Class stipendiary Magistrate)/ *Subdivisional Magistrate/Taluka
Magistrate/Executive Magistrate.
2.
Chief Presidency Magistrate/Additional Chief Presidency Magistrate/Presidency Magistrate.
3.
Revenue Officer not below the rank of Tahsildar, and
4.
Sub-Divisional officer of the area where the candidate and/or his family normally resides.

Annexure -4
Proforma for declaration to be submitted by Other Backward Class Candidates along with the application
while applying for the posts against GDCE Notification No.RRC/SCR/GDCE/01/2015

DECLARATION
I ____________________________________son/daughter of Shri _________________________ resident of
village/town/city_____________________district

____________________State_____________hereby

declare that I belong to the ________________________(indicate your sub-caste) community which is


recognized as a backward class by the Government of India for the purpose of reservation in services as per
orders contained in Department of Personnel and Training Office Memorandum No.36012/22/93-Estt.(SCT)
dated 08.09.1993. It is also declared that I do not belong to persons/sections (Creamy Layer) mentioned in
column 3 of the Schedule to the above referred Office Memorandum dated 08.09.1993 and its subsequent
through O.M. No.36033/3/2004-Estt.(Res.) dated 09.03.2004

Place:

Signature of the Candidate ___________________________

Date:

Name of the candidate_______________________________

Annexure-5
FORM OF MEDICAL CERTIFICATE FOR PERSONS WITH DISABILITIES (PWD)
NAME AND ADDRESS OF THE INSTITUTE/HOSPITAL
Certificate No. ___________________
Date: __________
DISABILITY CERTIFICATE
1.

2.

3.
4.

This is certified that Smt/Shri/Kum______________________________________________


son/daughter of Shri __________________________________________________________
age ___________, sex Male/Female having identification marks as below:
___________________________________________________________________________
is suffering from permanent disability of following category :
A. Locomotor or cerebral palsy:
(i) BL- Both legs affected but not arms.
(ii) BA- Both arms affected
(a) Impaired reach
(b) Weakness of grip.
(iii) OL- One leg affected (right or left)
(a) Impaired reach
(b) Weakness of grip
(c) Ataxic
(iv) OA- One arm affected (right or left)
(a) Impaired reach
(b) Weakness of grip
(c) Ataxic
(v) BH- Stiff Back and hips (cannot sit or stoop)
(vi) MW- Muscular Weakness and limited physical endurance.
B. Blindness or Low Vision: (C) Hearing Impairment:
(i) B- Blind (ii) PB- Partially Blind (i) D- Deaf (ii) PD - Partially Deaf.
(Delete the category whichever is not applicable)

Paste here your recent colour


photograph showing the
disability (The photograph
should be attested by the
chairperson of the Medical
Board)

Signature of the candidate

This condition is progressive/non-progressive/likely to improve/not likely to improve.


Re- assessment of this case is not recommended / is recommended after a period of .. Years . Months
.
Percentage of disability in his / her case is ... Percent.
Smt./Shri/Kum... meets the following physical requirement for discharge of his/her duties.
.
Yes
No
(i) F-can perform work by manipulating with fingers
Yes
No
(ii) PP-can perform work by pulling and pushing
Yes
No
(iii) L--can perform work by lifting
Yes
No
(iv) KC-can perform work by kneeling and crouching
Yes
No
(v) B-can perform work by bending
Yes
No
(vi) S-can perform work by sitting
(vii) ST-can perform work by standing
Yes
No
(viii) W-can perform work by walking
Yes
No
(ix) SE-can perform work by seeing
Yes
No
(x) H-can perform work by hearing/speaking
Yes
No
(xi) RW-can perform work by reading and writing
Yes
No

(Signature of Doctor)
Name:
Registration No.:
Member Medical Board

(Signature of Doctor)
Name:
Registration No.:
Member Medical Board

(Signature of Doctor)
Name:
Registration No.:
Member Chairperson,
Medical Board

* Please delete the words which are not applicable


Place :
Date :
Counter Signature of the Medical Superintendent/CMO/
Head of Hospital (with seal)
Note : (i) According to the Persons with Disabilities (Equal Opportunities, Protection of Rights and Full participation) Rules, 1996 notified on 31.12.1996 by
the Central Government in exercise of the powers conferred by sub-section
(1) and (2) of Section 73 of the Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995 (1 of 1996), authorities
to give disability Certificate will be a Medical Board duly constituted by the Central or the State Government. The State Government may constitute a
Medical Board consisting of at least three members out of whom at least one shall be a specialist in the particular field for assessing locomotor/hearing &
speech disability, mental retardation and leprosy cured, as the case may be.
(ii) The certificate would be valid for a period of 5 years for those whose disability is temporary. For those who acquired permanent disability, the validity
can be shown as permanent.

Annexure-6
DECLARATION TO BE SUBMITTED BY VISUALLY HANDICAPPED CANDIDATES THOSE CANDIDATES WHO
WRITING SPEED IS AFFECTED BY CEREBRAL PALSY
PARTICUALRS OF THE SCRIBE PROPOSED TO BE ENGAGED BY THE CANDIDATE
1. Name of the candidate: ____________________________________
2. Date of birth of the candidate: ______________________________
3. Name of the scribe: _______________________________________
4. Fathers name of the scribe: ________________________________
5. Address of the scribe
a) Permanent Address: ___________________________________
____________________________________________________

Paste here recent colour


passport size photograph
of the scribe of size 4cm X
5cm (The colour
photograph should not
be more than 3 months
old)

____________________________________________________
b) Present address: ______________________________________
____________________________________________________

Signature of the scribe in the


above box below the photograph

6. Educational qualifications of the scribe: _______________________


________________________________________________________
7. Relationship, if any of the scribe to the candidate: _______________
8. DECLARATION:
We hereby declare that the particulars furnished above are true and correct to the best of our
knowledge and belief. We have read/been read out the instructions of the Railway Recruitment
Cell regarding conduct of the Visually challenged candidates/scribes at this examination and
hereby undertake to abide by them. We also declare that
(a) The academic qualification of the SCRIBE is below the qualification prescribed for the post
applied for.
(b) *The scribe can be of any academic discipline if the recruitment is for general post. If the
recruitment is for a specialized post, he/she should be from a discipline different from that
of a candidate.

_______________________________
(Signature of the candidate)

Left hand thumb impression of the candidate


in the box given above

_______________________________
(Signature of the scribe)

Left hand thumb impression of the scribe


in the box given above