Reminder-II

No.6/1/2018-CS-II(C)
Government of India
Ministry of Personnel, Public Grievances & Pensions
(Department of Personnel and Training)

$3^{\text {rd }}$ Floor, Lok Nayak Bhavan
Khan Market, New Delhi
Dated 24th May, 2018
To,
The candidates as in Annexure
Subject: Non submission of willingness and attestation form Stenographers Grade ‘C’ \& ‘D’ Examination, 2016.

Sir /Madam,
I am directed to refer to this Department’s OM of even number dated 28.02.2018 and subsequent reminder dated 04.04 .2018 which is available on the website of this Department at dopt.gov.in $\rightarrow$ About us $\rightarrow$ Central Secretariat $\rightarrow$ CSSS $\rightarrow$ Recruitment $\rightarrow$ Steno Grade D which was also sent on the address mentioned in the dossier and to say that the candidates, as mentioned in the annexure, have not yet submitted their willingness and attestation form.
2. As informed in the aforesaid OMs, all the successful candidates recommended to the grade of Stenographer Grade ‘D’ of CSSS are required to submit the following documents immediately:
(i) Willingness to join the post
(ii) Four sets of Attestation Form, all sets duly filled in ink.
[The candidates may take print out (back to back) of the Attestation Form attached and should carefully fill in the forms. No point in the form shall be left blank. The photograph pasted on all four sets should be signed by the candidate. Specific answers to each of the questions in point 15 of the form should be given by striking out ‘yes’ or ‘No’ as the case may be and not by tick mark $\sqrt{ }$. The Candidates should fill in the point 10 also even of it is same as in the points 2 or 3 of the form]
3. The candidate who in the point number 10 of the attestation form indicates his having resided in Delhi should additionally send the selfattested copies of the following documents and the soft copies of the same by email at chiarabrata.sarkar@nic.in \& sumit.k13@nic.in .

(a) One passport Size photograph in JPEG format (less than 20 kb )
(b) One copy of photo identity proof in JPEG format (less than 200 kb ) (any one of the following)
(i) PAN card
(ii) Driving License
(iii) Election ID
(iv) Aadhar Card
(C) One copy of residential proof in JPEG format (less than 200 kb ) (any one of the following)
(i) Passport
(ii) Electricity Bill
(iii) Telephone Bill (landline)
(iv) Ration Card
(v) Passbook
(vi) Utility Bill
(Vii) Rent Agreement
(viii) Others
4. Candidates should ensure that the requisite documents reach the undersigned at the address mentioned hereunder, latest by $11^{\text {th }}$ June, 2018 failing which your candidature will be processed for cancellation without any further notice.
“Department of Personnel & Training, CS-II Division
(Shri Chirabrata Sarkar, Under Secretary)
3rd Floor, Lok Nayak Bhawan,
Khan Market, New Delhi – 110003”

(Chirabrata Sarkar)
Under Secretary to the Government of India
Tele: 24623157
e-mail: chirabrata.sarkar@nic.in

.

“Affix signed Passport size (5 cms. X 7 cms. Apprise). copy of recent photograph

“WARNING

1. suppression of any factual information in the Attestation Form would be disqualification, and is likely to render the candidate unfit for employment under the government.

If detained, arrested prosecuted, bound down, fined, convicted, debarred, acquitted etc. subsequent to the completion and submission of this form, the details should be communicated immediately to the authorities to whom the Attestation Foam has been sent early, failing which it will be deemed to be a suppression of factual information

If, the fact that false information has been furnished or that there has been suppression of any factual information in the Attestation Form comes to notice at any time during the service of a person, his services would be liable to be terminated”.

| 7.(a) | Date of Birth | |
| — | — | — |
| (b) | Present age | |
| (c) | Age at Matriculation | |
| 8.(a) | Place of birth, district and state in which situated | |
| (b) | District and State to which you belong | |
| (c) | District and State to which your father originally belongs | |
| 9.(a) | Your Religion | |
| (b) | Are you a member of a scheduled Caste/Scheduled Tribe/Other Backward Class? Answer ‘Yes’/ ‘No’ | |
| 10: | Particulars of places (with periods of residences) where you have resided for more than one year at a time during the preceding five years. In case of stay abroad (including Pakistan), particulars of all places where you have resided for more than one year after attaining the age of 21 years, should be given. | |
| From | To | Residential Address in full i.e. Village
Thana & District or House No. Lane/Street/Road \& Town |

| 11. | Name
full
all
s
any | (in
&
if
) Nationality
by
birth
or by
domicile | Place
of
birth | Occupation
if
employed
give
designation
&
official
address | Present
postal
address
(if
dead
give
last
address | Permanent
Home
address |
| — | — | — | — | — | — | — |
| a) Father | | | | | | |
| b) Mother | | | | | | |
| c) Spouse | | | | | | |

1. Information to be furnished with regard to son(s) and/or daughters in case they are studying/living in a foreign country:

| Name | Nationality
by
birth
and/
or
by
domicile | Place of
birth | Country in
which
studying/living
with
full
address | Date from which
studying/living in the
country mentioned in
the previous column |
| — | — | — | — | — |
| | | | | |

1. Educational Qualification showing places of education with years in Schools and Colleges since 15th year of age:

| Name
address | School/College
with
full | Date
of
Entering | Date
of
Leaving | Examination
Passed |
| — | — | — | — | — |
| | | | | |

Signature

1. Are you holding or have any time held an appointment under Central or State Government or a Semi-Government or a Quasi Government body or an autonomous body or a public Sector Undertaking or a private firm or institution? If so, give full particulars with date of employment up-to-date

1. If the previous employment was under the Government of India/a State Government/undertaking owned or controlled by the Government of India or a State Government/and Autonomous Body/University/Local Body.

If you had left service on giving a month’s notice under Rule 5 of the Central Civil Services (Temporary Service) Rules 1965, or any similar corresponding rules, were any disciplinary proceedings framed against you, or had you been called upon to explain your conduct in any matter at the time you gave notice of termination of service, or at a subsequent dates(s), before your service actually terminated?

1. Have you ever been kept under detention? (a) (b) (c) Have you ever been beset under detention? (d) (e) Have you ever been prosecuted? (i.e has a charge sheet in a criminal case been filed against you in any court of law) (d) (e) Is any criminal case pending against you in any Court of Law at the time or filling up this Attestation form? (e) Have you ever been convicted by a court of Law for any Office? (f) Whether discharged/expelled/withdrawn from any training/institution under the Government or otherwise? (g) Have you ever been rusticated by any University or any other educational authority/institution? (Strike out ‘Yes’ or ‘No’ as the case may be) Yes / No Yes / No Yes / No

Signature

Note: (i) Please also see the ‘WARNING’ at the top of this Attestation Form (ii) Specific answers to each of the questions should be given by striking out ‘Yes’ or ‘No’ as the case may be

DECLARATION

I certify that the foregoing information is correct and complete to the best of my knowledge and belief.

I am fully aware that by providing false information or suppressing material information while filling this form, the authorities have full right to terminate my appointment letter and I am also liable for appropriate criminal/civil/legal action as a consequence.

I am not aware or any circumstances which might impair my fitness for employment under Government.

Date: Place: Signature of candidate

TO BE FILLED BY THE OFFICE

Name, Designation and full address of the authority forwarding the form: Under Secretary to the Government of India CS-II Division Department of Personnel & Training 3rd Floor, Lok Nayak Bhavan New Delhi-110003 (i) Post for which the candidate is being considered.

Stenographer Grade ‘D’ of Central Secretariat Stenographers’ Service (CSSS)