vuqizek.ku&i=

inuke % fujh{kd] dsUnzh; mRikn 'kqYd ¼1½ vuqizek.ku QkeZ esa dksbZ xyr lwpuk nsuk vFkok fdlh

egRoiw.kZ rF; dks Nqikuk v;ksX;rk le>h tk;sxh rFkk ;g vH;FkhZ dks ljdkjh lsok ds fy, v;ksX; djkj dj ldrh gSA ¼2½ D;k dHkh dkjkokl esa j[ks x,] U;k;ky; }kjk nks"kh fl) ik, x, vFkok fooZftr ?kksf"kr gq, gks rks mldk foLr`r fooj.k] bl QkeZ dks iw.kZ djus ds rFkk izLrqr djus ds i'pkr ml izkf/kdkjh ftlus ;g vuqizek.ku QkeZ Hkstk gS] mls 'kh?kz lwfpr dj nsuk pkfg,A lwpuk u nsus ij ;g le>k tk;sxk fd egRoiw.kZ rF; fNik;k x;k gSA

;fn fdlh O;fDr ds lsokdky ds nkSjku fdlh Hkh le; bl ckr dk irk py tkrk gS fd mlus vuqizek.ku QkeZ esa xyr lwpuk nh gS vFkok fdlh egRoiw.kZ rF; dks fNik;k gS rks mldh lsok,as lekIr dh tk ldsxhA uksV % uhps fn, x, izR;sd dkWye esa okafNr lwpuk iw.kZ :i ls fy[ksa] dksbZ Hkh dkWye

[kkyh vFkok ¼&½ yxkdj u NksM+saA ¼1½ iwjk uke ¼lkQ v{kjksa esa½

¼;fn vkius dHkh fdlh le; vius uke vFkok dqyuke esa dksbZ va’k tksM+k gks vFkok mlesa ls gVk;k gks rks mldk mYys[k djsa½

%

¼2½ orZeku iwjk irk ¼ftleas xk¡o] Fkkuk] ftyk] edku la[;k] xyh] lM+d] 'kgj rFkk ftyk eq[;ky; dk uke fn;k tk;s½

%

¼3½¼v½ LFkkbZ ?kj dk iwjk irk ¼ftleas xk¡o] Fkkuk] ftyk] edku la[;k] xyh] lM+d] 'kgj rFkk ftyk eq[;ky; dk uke fn;k tk;s½

%

¼3½¼c½ ;fn ewy :i ls ikfdLrku ds fuoklh gSa rks ml ns'k esa mudk irk rFkk Hkkjr esa izotu dh frfFk

%

¼4½ jk"Vªh;rk % ------------------------------------------------------------------------------------- ¼5½ ¼v½ tUefrfFk % ------------------------------------------------------------------------------------

¼c½ fnukad 01-01-2014 dks vk;q % ----------------- o"kZ ---------------- ekg ----------------- fnu

Lo;a dk gLrk{kfjr QksVks ¼ikliksVZ lkbZt½ ;gk¡ fpidk;saA

¼jktif=r vf/kdkjh ls izekf.kr gks½

¼6½ xr ik¡Wap o"kksZa esa tgk¡ vkius ,d o"kZ ls vf/kd fuokl fd;k gS] ogk¡ fuokl dh vof/k crkrs gq, LFkkuksa dk fooj.k nsaA ;fn fons’k ¼ikfdLrku lfgr½ esa jgsa gksa] mu lc LFkkuksa dk fooj.k fn;k tkuk pkfg;s tgkW¡ vkius 21 o"kZ dh mez ds i'pkr ,d o"kZ ls vf/kd dh vof/k ds fy;s fuokl fd;k gksA

fnukad ls fnukad rd fuokl dk iwjk irk ¼vFkkZr xk¡o] Fkkuk] ftyk] edku la[;k] xyh] lM+d] 'kgj vkfn½

fiNys dkWye esa fn, x, LFkku ds ftyk eq[;ky;

dk uke

¼7½ ikfjokfjd fooj.k % uke jk"Vªh;rk

tUe ls@ vf/kokl }kjk

dk;Z djus dk LFkku

O;olk; ¼;fn lsok esa gSa rks dk;kZy; dk irk o inuke nhft,½

orZeku Mkd dk irk ¼;fn e`r gS rks vkf[kjh irk½

¼1½ ¼2½ ¼3½ ¼4½ ¼5½ ¼1½ firk dk uke

¼miuke lfgr½

¼2½ ekrk ¼3½ iRuh@ifr ¼4½ HkkbZ

¼5½ cgusa

¼8½ ;fn iq= vkSj iqf=;k¡ fons’k esa i<+ jgs gksa@jg jgsa gksa rks ml laca/k esa Hkh lwpuk izLrqr dh tk;sa % uke jk"Vªh;rk

¼tUe ls@ vf/kokl ls½

tUe LFkku iwjs irs lfgr ml ns'k dk uke tgk¡ i<+ jgs gSa@jg jgsa

gSaA

frfFk ftleas fiNys dkWye esa mYysf[kr ns'k esa jg@i<+ jgs gSa

¼9½ ¼v½ tUe LFkku % ftyk rFkk jkT; ftlesa fLFkr gS %

¼c½ ftyk rFkk jkT; dk uke ftlds vki fuoklh gSa

¼l½ ml ftys rFkk jkT; dk uke % ftlesa vkids firk ewy :i ls lEc) gS

¼10½ ¼v½ /kEkZ % ---------------------------------------------------------------------------------------------------- ¼c½ D;k vki vuqlwfpr tkfr@vuqlwfpr tutkfr@ vks-ch-lh- ds lnL; gSa \

mRrj gkWa ;k uk esa nsa ;fn mRrj gkWa esa gS rks mldk uke crk;sa % gkWa@ugha -----------------------------------------------------

¼11½ 'kS{kf.kd ;ksX;rk % 15 o"kZ dh mez ds i'pkr Ldwyksa@dkWystksa esa tgkWa f’k{kk izkIr dh gS muds uke rFkk f’k{k.k o"kZ %

Ldwy dkWyst dk uke izos'k dh

frfFk NksM+us dh frfFk

mRrh.kZ dh xbZ ijh{kk

vadksa dk izfr’kr

¼12½ D;k vki fdlh dsUnzh; vFkok jkT; ljdkj vFkok v)Z ljdkjh vFkok ljdkjh o`r

fudk; vFkok fdlh Lok;Rr fudk; vFkok ifCyd v.MjVsfdax ¼lkoZtfud laxBu½ vFkok futh QeZ ;k laxBu esa fdlh in ij gSa] vFkok iwoZ esa ,sls in ij fu;qDr gq, Fks ;fn gkW rks fu;kstu dk v|ru frfFk;ksa lfgr iwjk fooj.k nhft, A

vof/k inuke] ifjyfC/k;kWa rFkk

fu;kstu dh izd`fr fu;kstu dk iwjk uke o irk

fiNyh ukSdjh NksM+us ds dkj.k

ls rd

¼13½ D;k fiNyk jkstxkj Hkkjr ljdkj@jkT; ljdkj@ljdkj }kjk fu;af=r vFkok

futh v.MjVsfdax@Lok;Rr fudk;@fo’ofo|ky;@LFkkuh; fudk; ds v/khu Fkk \ ;fn lfoZl NksM+h gS rks D;k vkius dsUnzh; flfoy lfoZl ¼vLFkkbZ lsok;sa½ fu;e 1965 ds fu;e 5 ds v/khu ,d ekg dk uksfVl fn;k Fkk vFkok blh rjg ds fu;eksa ds v/khu vkids fo:) fdlh izdkj dh vuq’kklukRed dk;Zokgh dh xbZ Fkh] vFkok lsok ls R;kxi= dk uksfVl nsrs le; vFkok okLrfod :i ls vkidh lsok;sa lekIr djus ds iwoZ vuqorhZ frfFk ij D;k vkidks fdlh Hkh ekeys esa vius vkpj.k dks Li"V djus ds fy, cqyk;k x;k Fkk \

¼14½ fuEufyf[kr izR;sd iz’u dk lqfuf’pr mRrj gkWa vFkok ugha tSlk Hkh ekeyk gks] dks

iz’u ds lkeus mYys[k djsaA ¼d½ D;k vki dHkh fxj¶rkj fd, x, gSa \ ¼[k½ D;k vkids fo:) dHkh vfHk;kstu pyk gS \ ¼x½ D;k vki dHkh utjcan fd, x, gSa \ ¼?k½ D;k vki ij dHkh U;k;ky; }kjk n.M yxk;k x;k \ ¼M-½ D;k vki dHkh u’ks esa /kqr ik, x, \ ¼p½ D;k vki dHkh fdlh U;k;ky; }kjk vijk/k ds fy, ¼fl)nks"kh½ Bgjk;s x;s \ ¼N½ D;k vkidks la?k yksd lsok vk;ksx }kjk dHkh mudh ijh{kkvksa@p;uksa esa lfEefyr

gksus ls vioftZr vFkok v;ksX; ?kksf"kr fd;k x;k \

¼t½ D;k vkidks fdlh ijh{kk esa csBus ls jksdk x;k vFkok fdlh fo’ofo|ky;@laLFkk }kjk fu"dkflr ¼jsLVhdsV½ fd;k x;k \

¼>½ bl vuqizek.ku QkeZ ds Hkjrs le; D;k fdlh U;k;ky; esa vkids fo:) dksbZ ekeyk cdk;k iM+k gS \

¼¥½ bl vuqizek.ku QkeZ ds Hkjrs le; D;k fdlh fo’ofo|ky; esa vFkok fdlh vU; 'kS{kf.kd izkf/kdkjh ds le{k vkids fo:) dksbZ ekeyk cdk;k iM+k gS \

;fn mijksDr iz’uksa dk mRrj gkWa esa gks rks ekeys ds fxj¶rkjh ds fo:) gksus ds@tqekZuk fd, tkus ds@dqdhZ gksus ds@n.Mkns’k fd, tkus ds@nf.Mr gksus vkfn ds iwjs fooj.k nsa vkSj@vFkok U;k;ky; esa@fo’ofo|ky; esa@’kS{kf.kd izkf/kdkjh ds le{k cdk;k iM+s ekeyksa dh izo`fr dk Hkh iw.kZ mYys[k djsaA

uksV % d`i;k bl vuqizek.ku QkeZ ds Åij nh xbZ psrkouh dks Hkh ns[ksaA ¼15½ vius bykds ds nks ftEesnkj O;fDr;ksa ds uke tks vkidks tkurs gksa % 1- ----------------------------------------------------------- 2- ----------------------------------------------------------- irk % irk % eSa izekf.kr djrk gwWa fd esjh tkudkjh vkSj fo’okl ds vuqlkj mi;qZDr lwpuk lgh vkSj iwjh gSA eq>s ,slh fdlh vkSj ckr dk Kku ugh gS tks ljdkj ds vUrxZr esjh fu;qfDr dh mi;qDrrk dks nwf"kr dj ldsaA vH;FkhZ ds gLrk{kj ----------------------------------------------- frfFk % LFkku %

¼izek.k&i= fuEufyf[kr esa ls fdlh ,d ds }kjk gLrk{kfjr fd;k tkos½ 1- dsUnz vFkok jkT; ljdkj ds jktif=r vf/kdkjhA 2- ml fo/kkulHkk {ks= ds izkFkhZ vFkok mlds ekrk&firk@laj{kd lkekU;r% jg

jgk@jgsa gksa ds fo/kkulHkk lnL; vFkok laln lnL;A 3- mi e.Myh; eftLVªsV@vf/kdkjhA 4- rglhynkj vFkok uk;c rglhynkj ftUgsa eftLVªsV dh 'kfDr;ksa ds iz;ksx ds fy,

izkf/kd`r fd;k x;k gksaA 5- tgkWa vH;FkhZ igys Nk= jg pqdk gks ,sls ekU;rk izkIr

fo|ky;@egkfo|ky;@laLFkk ds fizalhiy@iz/kkuk/;kidA 6- [k.M fodkl vf/kdkjhA 7- iksLV ekLVjA 8- iapk;r fujh{kdA izekf.kr fd;k tkrk gS fd eSa Jh@Jhefr@dqekjh -------------------------------------------------- iq=@iq=h@iRuh Jh -------------------------------------------------- dks fiNys -------------- o"kZ ------------- ekg ls tkurk gwWa rFkk muds }kjk fn, x, fooj.k esjh tkudkjh vkSj fo’okl ds vuqlkj lgh gSA LFkku % gLrk{kj % irk % ------------------------------------------------------------- ¼uke o eqgj lfgr½ ------------------------------------------------------------- frfFk %

CERTIFICATE OF CHARACTER

Certified that I have known Shri ______________________________

S/o Shri _________________________________ for the last __________

years _________ months and that to the best of my knowledge and belief

he bears reputable character and has not antecedents which render him

unsuitable for Government Employment.

2. Shri ___________________________ is not related to me.

Place :________________ *Signature __________________

Date : _______________ Name & Designation __________

(* By a Gazetted Officer)

ATTESTED

Place :________________ **Signature : ________________

Date : _______________ Name & Designation :_______________

(Attesting Authority)

**(To be attested by Stipendiary I Class Executive Magistrate/ District

Magistrate or Sub Divisional Magistrate).