Sata ates yen vr (ye sere) t eae m0 13, Sacer. ite, ‘aieh te, 3¢ fresh — 110003, eif-s2017 /(4)/01 7a ewrereh-2or7 /wl-sav4 eae 7/10/2007. To ‘ADG Airport Sector. ‘All Sector IsG Including APS & NISA ‘All Zonal/Piant DisG Including APS, GBS, Security, BN, DAE, DOS. ‘Al Gp Comats, Comdts, Dy Comats, Assit Comdts & Offceri-charges ‘Sub: RECRUITMENT OF ASSTT.SUS INSPECTOR (EXE)THROUGH LDGE=2017, {tis proposed to invite applications from eligible departmental candidates for filing Lp of 68 vacancies (UR-54, SC-10 and ST-04) of Asstt. Sub Inspector (Executive) in CCISF_ through Limited Departmental Competitive Examination (LDCE) against the recruitment year 2017. However, vacancies may Increaseldecresse at the time of final selection. ‘applications A" to this letter alonguith a certfcate to the ‘effec that no ciminal/DE/ vigilance cases is pending as per Appendix. B-, 8-2 and B- '3 through proper channel to their respective Zonal DisG (Le. DIG(NZ-) New Delhi, DIG(SZ) Chennai, DIG(WZ4) Mumbal, DIG(EZ) Patna and DIG(NEZ) Kolkata} provided they full the eligibty criteria’ as. mentioned In Paras below. Otver ‘appendices such as Appendix-C and Appendix are also fo be completed in cases ‘wherever applcabh 3. tls again reiterated that applications are to be submitted to Zonal DisG viz, DIQ(NzZ-1) New Delhi, DIG(SZ) Chennai, DIG(WZ4) Mumbal, DIG(EZ) Patna and DIGINEZ) Kolkata, 4. Applications of eligible candidates who are posted in the units under the ‘administrative control of DisG Plant or DisG DAE or DOS or Airports or BNs oF GBS of ‘SSG or In Training Insitutions willbe forwarded directly o the respective Zonal Dis ‘mentioned in Para-3 above by the respective Unit Commanders insiead of routing the same through their DIsG. For example, application in respect of personnel posted in RAPS Kola or VSSC Thumba wil be forwarded dlrecty by the respective Unit ‘Commanders to DIG, NZ-I and DIG, SZ respectively instead of routing the same through DIGIDAE or DIG/DOS. Applications in respect of eligible departmental candidates: ppostod In FHGrs will be forwarded to DIG, NZ-I, New Delhi through HOrs Estt Branch. The respective Branch wil forward applications of personnel attached with this Directorate, to ther respective unis from where tre same wil be forwarded to DIG, NZI, ‘New Deini after verifying the service particulars of the candidate. No apolleation will ‘be_sont to Recruitment Branch, Fo ‘of ‘apollcation_ submitted by the Individuals is the duty of concemed Unit ‘Commanders. :02 5. Applications duly completed, in respect of CISF personnel who are on deputation {o outside organizations wall be submitted through proper channel to the nearest Zonal ‘DisG under intimation to their parent unit. For example, a perscn is on deputation to 'SPG New Delhi from CISF Unit, DSP Durgapur, he will submit tis application to SPG ‘who in tur will forward the seme directly to DIG, NZ-, New Delhi under intimation to DIG SP Durgapur. 6. The other eligibility conditions for appearing in the aforesaid compettive ‘examination will be 2s under: ~ @) | Service Eligibility | Candidate should have completed five years of regular service including basic training in the ‘grade or five years combined regular service as ConstabielGD, Head Constable/GD and ‘Constable/TM as on 01.08.2017 as mentioned in Para-2 above. | ‘BY | Upper age limit [36 years as on 07.08.2077 ie, helshe must have ‘been born not earller than 02.08.1982. Relaxable by 5 years for SC/ST candidates. No age relaxation Is applicable for OBC candidates as | no vacancy Is reserved for OBC category. | OBC candidates can apply as General candidates. | | Educational Graduation fom ay recognized Universi, | qualification ‘@) | Clean Record "The candidates must Rave good ACR for fast 05 years and should have urblemished service record tl the issue of offer of appointment. ‘oy | Physical Standard’ As applicable to ASI (Dect erty) candidates which are 9s under: 7_| Height Male Female —| [For all candidates 170 Gms. | 187 Cm. [Ganda fating We catogoin of Gara, [165 Cme | 155.Gms. Kumacnis, Gorkhas, Dogras, Maraihes and candidates belonging to the States of Skim, Nagaland, Arunachal Pradesh, Tripura, Mizoram, | Manipur, Meghalaya, Assam, Himachal Pradesh and Jammu and Kashi. For candidates belonging to Scheduled Tribes | 1625Cme._| 164 Ome. categories. 1) Chest (For male only) For all candidates (20-85 Os. ‘All candidates belonging to Scheduled Wibes. | 77-82 Gms, Ty | Weight forall candidates ~ Corresponding fo Haight and age 6s per medical standard (For Male & Female) | Medical category: SHAPE -T ‘a) [No.of chances applicable to compate In| Thres chances — only. the LOE Canddates are allowed to _svail_only three7. _ SELECTION PROCEDURE “The selection wil consist the following: - {0 [Stage-1” [Checking of No marks are alotied. However, Rahould be ereured service that candidates must have good ACRs for the last 05, records. _| years and unblemished service reco til issue of offer a of appointment. | Siege] Wiion Wiiten Examinaton wil comprise of ONR Based Examination question paper. There shall be one question paper of bjective type multiple choice questions consisting of| 200 marks with 3% Hours duratcn to assess the candidates in the following subjects Time : 08 % Hours. Waris £200 1. General nteligence and reasoning 50 2. General awareness & Professional knowledge 50 3. Numerical ability 50 “4. Comprehension and corimuniction sk 50 [Important : It wil be necessary for each candidate secure at Teast 45% marks in each part and 50% in aggregate. Relaxation of 5% ‘marks will be given to candidates belonging to SC/ST categories. Ti) [Stage [Physical | As appicable to ASVExe (Oreck Enty) canddates a= ‘measurement | mentioned in Para6(e) above. No relaxation wil be Sven in case a candidate has been appointed in lower ‘nk with relaxed standard, such candidate wil not be eligible to appear in the Limited Departmental Competitive Examination. 19 Stoo Physi! |i be of quaint conasiy of Towra Efficiency vents. PET shall nt cary any mars, Test. Male candidates Female candidates: 3) 7.6 Kms race in | a) 800 Meters race in 4 minutes 30 seconds _| minutes 'B) 100 Meiers race in 16 |B) 100 Metre race in seconds 18 Seconds ‘) Figh Jump 39 76st |} High Jump 3 Testa . In 3 chances 3 chanoes ‘Long Jumo 12 feet |) Long Jump 9 feat in in 8 chances 3 chances ©) Shot Put (16 Lbs) = 148 feet in 3 chances W) | Stage-V | Detailed | Detailed mecical examinaiion of those candidates who Medical | come out successfully in the Written Examination & Examination | PET will be conducted as per existing instructions and guidelines issued vide MHA UO NoAWVI-1/2014- Recti(SSB) dated 20.05.2018. Each candidate will be dectared either “Fit” or ‘Unfit, and no one will be Categorized “Temporary Unfit.(v) Final Selection Name of candidates wil be placed in the meri ist subject the provision that candidate belonging to General category have secured minirum 60% agoregate ‘marks Le., 100 marks out ofa total of 200 marks and candidate belonging to SGIST category have secured minimum 45% aggregate marks ie, 90 marks. Final lection of eandidates will be made according to availablity of vacancies and ‘Subject to thelr declaring ‘FIT" in the Detailed Medical Examination, 8 EIPT OF. sTION Al eligible departmental candidates may submit thelr applications dul filed in ‘Appengin-A, 8-1, B-2 & B.3 to their respective Unit Commanders by 43.14.2097 ie, last ate fr receipt of applications from all eligible candidates by the Uni Commanders shal be 13.11.2017. Candidates must ensure that applicant's porton of AppendxcA including ColNo.1 to 13, Appendix B-1, B-2 & B-3 are filed in before appending hisher signature Last date of receipt of the above applications by the respective DisG (Application Receiving Centre) as mentioned in Para 2 above shall be 20.14.2017. The Unit Commanders while forwarding the applications wil eneure that the folowing documents are duly attested by a Gazetted Officer- 8) Cerifate in support of belonging to SC/ST & Hil areas on the format as prescribed in Appendix °C" & "D' crculated vide this Directorate letter No.E- '32017/0/06/Rectl 824 dated 25.05.2006. ») Matriculation cericate in support of date of bith ©) Plus two level of schooling (either through formal schoolng for 12 years or through open school system) recognized by the CentralSlate Government for this purpose or its equivalent. ) Degree certificate in support of educational qualification. ‘Note: If there is any changelamendment in the eligibility condition, the same will be published in CISF website. Candidates may check the same from the ‘website or from the office of Sector IsG/Zonal DisG. Mere submission of ‘the application does not give the candidate right to be considered unless he ‘moots the eligibility requirements prescribed at the time of Issue of admit cards, lication flor 13.19.2017 (the last date of llcation wil jccopted and be re 9. TENTA jOGRAMME OF RECRUITMENT ‘Subject fo any change, the folowing wil be the tentaive programme of fecruitmert. Therefore, all the eligible candidates may be asked to prepare themselves accordingly - Last dato of receipt of applications by the Unit Commanders | 13.41.2077 {Last date of receipt of application by respective Zonal DisG | 20.11.2017 ‘Checking of service records at CRF SSG Noida BAW Witten Examination z ao 28 ‘Declaration of result who quali in wren examination [502.2018 Physical measurement & PET 05082076 Medical Examination wopaz0Te ‘Conduct of Review Medical Examination 76.05 2078} [BasieTainng SSS a |10, :SPONSIBIILTY OF THE UNIT ERS Unit Commander wil personally ensure tha:- 2) A copy of this notficaton is circuated to all Coy Commanders and is also ‘affixed on the notice board and contents of the notation ae also brought to the notice of al eligible personne, ) Unit ander eh that nel on or ‘shoul "For appl ibmitted ©) Applications in respect of all egible personne ofthe unithave been obtained ‘on the prescribed format and forwarded to the (9, 7 New Delhi, DIGISZ) Chennal, DIG(WZ- 1 DIGIEZ} ‘and DIG(NEZ) Kolkaita as the case may be) s0 as to reach thom before 20.14.2017, 4) Latest coloupasspor size photograph ofthe candidate in uniform without cap Should be affixed on the right comer ofthe application form forthe post of ASVExe (LOCE)2017 ie, AppendacA. ©) Application form is filed correctly and the candidate ie fafling the ebigibity ‘itera as prescribed in Para-2 and 6 above, Particulars filed in the application form are correct and verid from the recor hel inthe unt. There should not be any column let without verification, which may lead complcacy ata later stage. ‘1 Applicaons are eccompanied with Photostat copies of required certincates, diy attested ‘9) Ensure that ail columns in candidates portion of AppendiA, B-1, B-2 & B3 are filed in by the candidate and also ensure that Unt Conmandat’s portion is. filed inlcompleted before the same is forwarsed to the Dis6. 1) Eligible personnel of the unit may also be informed that only three cha ‘ate applicable for appearing inthis LDCE. Therefore, trey must put all out ‘efforts to quaiy the LOCE within three chances availabe to them, |) Service documents of the individuals, whose applications are sent to the application ‘receiving authoriy, may ‘be updated incising Part Annu Remarks up to 30.11.2017 and SHAPE-| certificate for the year 2017 and sent to DIG, CISF Unit, SSG, Noida (UP) by 05.12.2017 repeat 06.12.2017, Positively io will hand over the same tothe recrutment board 1) Incase any candidate who is having clean record of serviee as on the date of ‘submission of application, is awarded any major or minor punishment Subsequently in between the date of submission of applicalion and te date of ‘appointment to the post of ASVExe(LDCE), his/her candidature. wil be fejected. it means a candidate should have clean record of service til his/her {inal selection and appointment tothe post of ASV/Exe though LCE. ‘') 1 wil be_the responsiblity of the Unit_ Commander not to forward any ‘application of candidate who have not mainiained Good ACRs for the last five Years and who have been awarded any major ot minor punishment(s) during Fis Mer entire service til the date of forwarding hismher appieation Further, it 280, a candidate is awarded any major or minor punishment after submission of hisher application, it will be the responsibility of the concemed Unit ‘Gommérnde to inform the facts tothe application receiving Zonal DieG os well {28 this Directorate and not to relieve such candidate for attending the tests ‘whenever he is called forthe same,26 : 1) In casé any candidate whois holding the postin Executve cadre on the date of application and subsequeriy accepts appointment to anyother cadre ofthe Force viz, Fite or Ministerial, etc, he will become ineligible to compete in this LLDCE and his candidature willbe rejected 11. ACTIONTO N LI Immediately on receipt ofan application twill be checked thoroughly and it must ‘be ensured that the candidate fulfils the prescribed eighty criteria a mentioned, ‘Number of applications found inorder and accepted will be intimated to thls Directorate as well as to DIGICISF SSG Noida latest by 26.12. 7, so that the ‘concerned DisG may be able to Issue call up letters tothe candidates accordingly, 42) A register wil be maintained inte following proforma and each application will be recorded therein immeciataly on receipt atthe Zonal Hers: - = Rank [Wa B | URE eA Resa] Ran Sa a no | ne | © Reeone | tr | atest | tone | ono rjecton. | spate | “no ecapot | ctoae area aber a ne ‘All the columns wil be filed up by Zonal Recept Branch and the remaining columns viz 7 & 8 will be filed up by the officer who will make fis ‘signature in column 10 after scrutiny of applications, Roll No. under column 9 will be writen by the person who has been authorized to allot the same fo the eligible candidates. ) The Roll Number which wil be alloted tothe candidates, wll be of 5 dig the first cigit wil indicate the Zone and the rest of the four digit will be alotled setially only to those applications which have been found in order and ‘accepted. The Zonal Code is indicated as:~ NZ-, WZ, 8Z°3, EZ-4 and NEZS. ©) The roll number so allotted to the candidates will be recorded in their respective application forms atthe space provided for the same as well as in ‘the register under column 3, 9) In case SC/ST certificate enciosed by the candidates with their applications are not found having mentioned therein all the Consttulonal amendments, as ‘mentioned inthe format, itmay be accepted, provided that rest of the format of {he certificate is same as per format and one af the Constitonal amendment (which is applicable) is mentioned therein, Call up letters to the candidates whose applications are accepted, may ‘be sont immediately on receipt of venue, dato and. address for ‘conducting written examination as well as PST/PET from DIGICISF SSC Nolda. 412, | For DIGIGISE, SSG, Noida only:- Necessary arrangements may also please be made for the holding Stage-wise recrultment programme a8 mentioned at Para? Le. checking of service records, conduct of physical measurement and PET, etc. at CISF Unit, SSG, Noida. Written ‘examination ‘wil be conducted on 28.01.2018 (Sunday). Place and venue of the writen examination wil be informed in due course by thie Directorate, °413, _No representation for acceptance of applications in respect of those (a) who havo ‘become over age as on 07.08.2017 (0) has been awarded even a minor punishment ‘and (€) not belonging to Constable (GD), Constable (Tradesmen) and Hoad ‘Constable/GD for which the vacancies are noted, wil be forwerded to tis Drectorate ‘as no provisions for grant of relaxation exist in the reviseg scheme of ASVEx® (LOGE) cireuated by the MHA 44. The Application rovelving DisG will submit detalled repor. regarding number of ‘application found in order and accepted to tis Directorate as well as DIGIGISF, SSS Noigs 0 to each ron o before 25.12.2017, Wh plications DIGICISE 8: i in az SRS] Rae | PRE NSW BSE | TO Name TF Sree aan ass Bis |e7alexe Daeof [als] Eaucaue ] Cateye [What —]Ralgon | Remar, Aopttin jot | nal | (GenSCis | Himan my cISF Birth | Qualificat D Len seo iSamijestga leat ans dere wen eG \r wee ridh Copy forwards to the following witha request to bring the contents ofthis letter tothe notice of CISF personnel who are on deputation in their orgenizaions and forward ‘appications of eligible personnel In she prescribed proforma directy to the concerned Zonal DIG of CISF by 20.41.2017 Under intimation to their paren CISF Unit from where ‘the subject person is taken on deputation: - 4. Thel0P (086), NAA" Floor, Spender Forum, sea Dist. Cee, New De 10028. ET Atta On eth cm, Beak NO. Fe, COCs Cais, Lh Ron, Nw Ooh 3. The Grup Coma Est), NEG, Eat Branch, Mehra Nagar, Pala, New Deh, 4 The AG (usm), S96, 6G Comp, Secus, Dwar, Papan Kale, New Osis Tre Rent Seer wines Seat 35, 8PM New 2 8 he Persone! Oscetest) NTP. NTPC Srawan, Scope Complex, ?neeainsl Area, Lodhi qe Under Seay PM, Cae Secu, Roam No.7, lane Hout, Shan Red ‘The Under Shoretary (Est), NHAC, Fariskot House, Copemicus Marg, ei0t 5, The Aum OffearPe), inst of Eat Alors, Suh Bloc, New Ov {o. me Drevin NCB, Bods, Wing RK Param, Now Ozh {1 The Asst Broce (Ad), BPRD, Sok 1, 34 Noor, OGOS Complex, Lod Road, DeB-09 {2 The Chit Adm Gear, 100 Li, rina zea, New De-03 43. The Ast Adm Ofer SVP, NPA Hyderabad (AP) {4 The Dy Soeretary (Ac. CVC, SatntarsGhavay, Blok A GPO Conitx, NA New Deh 18. The BY Besar (Avion Reseren Cente, Do, General of Saciy, £8 BS RK Pram. ‘AIGIAGM (for HO Est) ~for necessary action please. ‘Al Branches rer nformaton tal personne.ppai ono os, 0 1" 12 13, Appendix Roll No. (To be filled in te Zonal Hare ) FORM OF APPLICATION FOR RECRUITMENT TO THE POST OF ASSTT. SUB INSPECTOR (EXECUTIVE) IN CISF THROUGH LIMITED DEPARTMENTAL ‘COMPETITIVE EXAMINATION ~ 2017, CSF No. Rank Cadre (Only Constabie/GD, Consiable( Tradesmen) Aff recent ad Constable/GD are eligible] Head ConstablerGD are elie} I passport Father's Name. size photograph Date of birth (Attach Tid ceticate as per instructions) without cap Date of appointment in CISF Bex Present Unit (in case on sepitalon, please indicate name and address of the present department and also the name ofthe parent uit where from you had joined for deputation) ‘Whether belong to SC/ST (Altach certificate as per instricTons) ‘Whether belong to Hillman ete. {Attach certificate 2s per instrucona) Deials of punishment awarded (f any) Major ‘Minor No. of chances so far availed fr ‘ppeering in the LOCE Educational qualifications (Atach certificate as per instructiens) CCerified that all the information as furnished by me inthis application are ttue and in case at any stage, any of them islare found incorrect or false, the ‘competent authority can reject my candidature without assigning any reasons thereot Further certied that | have not avalled three chances 8 fa in competing in {his examination and information furnished by me against courn 12 ls cocect. In cease al any stage, even after my appointment (am selested to the post) this information is found false or incorrect, my candidature may be relected/i may be reverted back to my substantive post, as the case may bs, by the competent authority, without assigning any reasons thereof and also competent authorty may take any appropriate isciptinary acon against me for furnishing of false and incorect information, Date:_* Place Signature ofthe candidafiled by the Unit Command 2 book Its certiod that = 1. ister date of bith is. 2. Helshe belongs to SC/ST category and has attached cory ofcetficte on the Prescribed proforma duty attested by a GO with the appleation form, 3, Helshe belongs to Hil area etc and has attached copy of cetficate on the brescnbed proforma duly aitested by a GO withthe application form: 4, Hefshe has completed 5 years’ service as on 01-08-2017 (appointed on of before 31.07.2012) 6. No criminal case is pending against himvher. 6. No DENVigllance or other any enquiry is pending or contemplated against him including sexual harassment. 7. Cortifed that the Departmentfice has no object in permitting Shri for applying to the post of in CISF. Its further certified that Shri thas ot Been awarded with any punishment (MajorMinr) ‘Gale and ‘is performance for the last 05 years of ‘service in this DepartmentOice has been above “AVERAGE” Date: ture of Place! Name Designation (Office Seal) ‘TO BE FILLED AT THE ZONAL HORS Accepted/Rejected (if rejected, give reasons therefore) Signature & Name of officer authorized to scrutiny the application é (Office Seal)APPENDIX B- CERTIFICATE (ANY WRONG CERTIFICATION WILL CAUSE CANCELLATION OF CANDIDATURE ‘AND DEPARTMENTAL ACTION) Leortity that ) No Criminal case is pending against me. b) NoD.E. Is pending against me. ©) have completed 5 years of service on 4) Only for SC/ST candidates “1 belong to Scheduled Caste/Scheduled Tribe and entered into service claiming the benefits on the basis of the certificate of this castertribe" ©) Forthe persons hailing from hill area : “1 belong to hill area and had entered into the service by ‘claiming the benefits on this basis". In case any statement from the above is found untrue, | am ble to abide by the actionidecision of the department. ‘Signature of the applicant: . (Name, CiSF No,, Reuftfize f-2/ APPENDIX 8.2 QUESTIONNAIRE FORM ar ae we a Rea ae We aga | fear sar? ‘YESINO | Have you ever beon convicted by any court of law or any other judicial institution? ea aed FT ce aH ee ae aya Is there any case pending against you In any court of lan? YESINO ‘wer are Perens wy SAY ewaane eat ag eae war aT ‘7a Frans a wet wr 87 YESNO Has any FIR been lodged and case is pending against you? Was any FIR ever lodged against you in the past? ayaa YESINO Den red frre EA whe ew af ae a ug a= 8a ct at Su don ate cuandan, few amr é ah | win on? @ If yes, case No. and sections under which FIR was lodged? a gfe eer wr os et we eM aA a a? b Name of Police Station where FIR was lodged? meer de wnfehe frat ar a sae guar are +e Rea wer at ? © Was the caso charge sheeted or returned in FR? maf a mete Pear ar ar sare # eT ‘iors eet? 4 If case was charge shooted, what was the ‘outcome in court? () 8 sor et Convicted fa) eres fre @——Acquitted f) wetar gat i) Compromisod (9) seer a ru (vy) Compounded @) ait sa qua weta at () any other. Please specifyoe ae a ae a ae wae Wa aT ayaa ref fra ar 2? YESINO Have you ever been dismissed/removed from any service |_| under the Central or State Govt? 0 war wieel wa Rar @ ates tara we wae? wa Have your service ever beon terminated while on probation YESINO (ae wear Ta Re ara aa WE a gar GT Ree aa pS wT H¥ the answer fo any one of the above is YES then please provide complete details. L ‘on a separate sheet | ‘sarrd /UNDERTA\ ound to be false or incorrect my candidature is liable to be cancelled apart from ‘any departmental or lagal proceedings that may be initiated against me. ares B STE ‘Signature ofthe candidate 05/Namo 14 Wen /CISF No, e/Rank ‘w09/Place ‘Rar wr am/Fathors Name Reais /Date vw/AddressSTIONN, 7] Have you ever been purished in course of any YesiNo Departmental Enquiry | Is there any Departmental Enquiry pending YesiNio ‘against you in any unit? 3. | According to best of your knowledge, is any YesiNio complaint of any kind pending against you? | Was any Dopartmental Enquiry ever conducted | YeaiNo against you in the past? | 8) yes, section under which DE was aorinor conducted? y_ Narre ofthe Unit where DE was conducted ©) WDE was conducted, what was the outcome? 7) Found Guily/exonerated by Disciplinary | Found Guity Authority Exonerated Ti) Exonerated by Appellate Authority Yesivo Tiy_ Exonerated By Revisioning Authorly, Yesmio Wy) Any other, please specify. UNDERTAKING 1___eciare thatthe above information is true to the bast of my knowledge and belief | understand that in case the information Is found tobe false or incorect my candidature i liable to be cancelled apart frm ‘any departmental or legal proceedings that may be inated against me, ‘Signature of the candidate Name Prace CCISF No, Dated: RankList of authorities empowered to issue Caste/Tribes Certificate 1. Distt Magistrate/Addiional District Magistate/Collector/Deputy ‘Commissioner/ Adiltional Deputy CommissionedDy, Collector!" Class ‘Stipendiary Magistrate/Sub Divisional Magistrate/Exta-Assitant (Commissioner/Taluka MagistraterExecutve Magistrate, 2. Chief Presidency Magistrate/Additonal Chef Presidency Mapistrate/Presidency Magistrate, 3. Revenue Officers not below the rank of Tehslda. '4. Sub-Divisional Officers ofthe area where the candidate andor his family ormally resides, Note: ST candidates belonging to Tamil Nedu State should eubmit caste ‘certificate ONLY FROM THE REVENUE DIVISION OFFICER.APPENDIX -¢ FORM OF CERTIFICATE TO BE PRODUCED BY A CANDIDATE BELONGING TO SCHEDULED Ci This is t6 cortty that Shri‘ShrimatiiKumarl sonidaughter of Shri ot villageTown, in. Distrctbivision of the ‘State!Union Territory, ‘belongs to the ‘castelTribe which is recognized as a Scheduled CastelScheduled Tribe under “The Constitution (Scheduled Caste) order, 1980, ‘The Constitution (Scheduled Tribes) order, 1950 “The Consttution (Scheduled Castes)(Urion Teritorios) order, 1051 “The ConsttutonScheduied Tribes) (Union Tertores) order, 1951 (jis amended by the Scheduled Castes and Scheduled Tribes (Modification ) order, 1956, the Bombay Reorganization Act, 1960, the Punjab Reorganization ‘Ack, 1968, the State of Hachal Pradesh Act, 1970, the North Easton Areas (Reocganization) Act 1971, and the Scheduled Caste and Scheduled Tribes Orders (Amendment) Act 1876 } ‘The Constitution (Jammu & Kashmir) Scheduled Castes order, 1958; “The Constitution (Andemen & Nicobar Islands) Scheduled Tribes Ordor, 1959 ‘as amended by the Scheduled Castes and Scheduled Tribes Grders (Amendment) Act, 1976 “The Constitution (Dadra and Nagar Havel) Scheduled Castes Order, 1962 “The Constitution (Dadra and Nagar Havell) Scheduled Tribes Order, 1962 “The Constitution (Pondicherry) Scheduled Castes Order, 1964 “The Constitution (Scheduied Tribes)(Uttar Pradesh) Order, 1967 “The Constiution (Goa, Daman and Diu) Scheduled Castes Order, 1968, “The Constitution (Goa, Daman and Diu) Scheculed Tribes Orce, 1968 “The Constitution (Nagaland) Scheduled Tribes Order, 1970 ‘The Constitution (Sikkim) Scheduled Caste Order, 1978 ‘The Constitution (Sikkim) Scheduled Tribes Order, 1878 ‘The Constitution (Scheduled Castes) Order (Amendment) Act 1900 ‘The Constitution (Scheduled Tribes) Order (Amendment) Ordinance, 1991 ‘The Constitution (Scheculed Tribes) Orders (Second amendment) Act, 1891 “The Constitution (Scheduled Tribes) Ordinance, 1986 °2, This certificate is Issued on the basis of the Scheduled CastolScheduled Tribes Cerificate Issued to Shri/Smt FatherMother “of | Shri/SmtKumari oF villagerTown In Districy Division ‘of the Sate. ‘who belongs to the CasterTribes which is recognized as a SCIST in the StatelJnion Teritory issued by the (ame of the prescribed Tssuing authority) wide th No. ‘dated, ‘ShifStyimatiiKumari an oie tay ‘ordinarily reside(s) in Vilage/Town DAarcION ena SST Teor of Signature Place Designation Date, (wih seal oF OFo=) “Please delete which are not applicable. NOTE : The terms ‘ordinarily’ reside(s) used here vill have the same meaning as in ‘Section 20 of the Representation of the People Act, 1950. (P. T. 0.)Appendix “D" # BE SUBMITTED BY TH ‘THOSE WHO INTEND TO AVAIL RELAXATION IN HEIGHT OR CHEST MEASUREMENT [SEE NOTE 2 BELOW PARA 2(C)] Corted that ShivKumar, SlotDio Shri _ permanent resent of ‘ilage. TehsiVTatuk District of Site 2. Its further certified that - “Residents of entre area mentioned above are considered as (Garhwal, Kumacuni, Dogras, Marathas, Sikkimies) for relaxation in height and chest measurement fr recruitment inthe para miltary forces ofthe Union of nea, ‘he belongs to Himachal Pradash& Jammu & Kashmi/North Eastern ‘States and is considered for relaxation in height and chest measurement for recutment inthe para miltary forces of Union of inda. ‘she belongs to Tribals/Adivasi communty and is Considered for felaxaion n height and chest measurement for recrutment In the para military forces ofthe Union of Inca Dated Sonature Place: Distct Magistrate/Sub Divisional MagistrateTebsidar *Delete whichever is not applicable.