Appointment to the grade of Stenographer Grade ‘D’ of Central Secretariat Stenographers’ Service

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This document details the appointment process for candidates who qualified in the Stenographers Grade ‘C’ & ‘D’ Examination, 2018, conducted by the Staff Selection Commission (SSC). It outlines the necessary documents to be submitted, including willingness forms, attestation forms, proof of residence, and medical examination requirements. It also includes a declaration form for candidates to affirm the accuracy of the information provided and warns against providing false information. The document specifies procedures for candidates residing in Delhi versus those outside Delhi, and provides details regarding medical examinations and potential reservation benefits. It emphasizes the importance of completing all formalities and the consequences of submitting false information.

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F.No.6/1/2021-CS.II(C)
Government of India
Ministry of Personnel, Public Grievances & Pensions
(Department of Personnel \& Training)
CS.II Division
$* * * * * * *$

3 $3^{\text {rd }}$ Floor, Lok Nayak Bhawan, Khan Market, New Delhi -110003. New Delhi, $11^{\text {th }}$ Feb., 2021.

To
The successful candidates of
Stenographers Grade ‘C’ \& ‘D’ Examination, 2018
recommended to the grade of Stenographers Grade ‘D’ of CSSS
(As per list annexed)
Subject: Appointment to the grade of Stenographer Grade ‘D’ of Central Secretariat Stenographers’ Service on the basis of Stenographers Grade ‘C’ \& ‘D’ Examination, 2018 conducted by Staff Selection Commission (SSC)- Completion of pre-appointment formalities thereof.

Dear Candidates,

Congratulations on your success in the Stenographers Grade ‘C’ \& ‘D’ Examination, 2018!

I am directed to say that you have been allocated Central Secretariat Stenographers’ Service by Staff Selection Commission on the basis of Stenographers Grade ‘C’ \& ‘D’ Examination, 2018. The allocation has been made on the basis of your rank in the merit list, eligibility, preference for services expressed by you and availability of vacancy.
2. Staff Selection Commission has nominated you for the appointment to the Stenographer Grade ‘D’ of Central Secretariat Stenographers’ Service on the basis of Stenographers Grade ‘C’ \& ‘D’ Examination, 2018 against the reported vacancies. Though utmost care has been taken while preparing the list of candidates, who fulfilled the eligible conditions, yet you are advised to cross check the particulars pertaining to yourself with the result declared by SSC.
3. All the successful candidates nominated for the Stenographer Grade ‘D’ of CSSS are required to submit the following documents:
(i) Willingness to join the post as per the given format
(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 (AnnexureII) and should carefully fill in the forms. No column in the Form should be left blank. The photograph pasted on all four sets should be self attested 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 details at point 10 even if it is same as in the points 2 or 3 of the form]


  1. The candidate who in the point number 10 of the attestation form indicates his/her residence in Delhi should additionally send duly filled-in Annexure-III along with the self-attested copies of the following documents and the soft copies of the same by email at bhagirathjha.68@gov.in/ranjan.ak13@nic.in indicating the subject as ‘Stenographers Grade ‘C’ & ‘D’ Examination, 2018 Rank ___________.

(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) Voter ID
(iv) Aadhar Card (v) Passport

(c) One copy of residential proof in JPEG format (less than 200 kb) (any one of the following)

(i) Passport (ii) Telephone/Electricity/PNG Bill (iii) Aadhar Card
(iv) Voter ID (v) Bank Passbook (vi) Rent Agreement
  1. All the candidates residing outside Delhi are required to appear before the Civil Surgeon/Principal Medical Officer/Chief Medical Officer of the District where the candidates are presently residing, for medical examination with a copy of this letter, to determine their fitness for the Government service. The candidates are required to give a statement and declaration regarding his/her health in the attached form in the presence of Medical Officer. The medical certificate of fitness should be in the prescribed format, a specimen of which is attached (Annexure-IV). The CMOs concerned are also requested to take up the Medical Examination of the candidates concerned on the strength of this letter and issue the Medical Certificate in original to the candidate, who will submit the same with the Attestation Form. In case any other authority letter is required by the Office of medical authority concerned, the undersigned may be contacted through mail at bhagirathjha.68@gov.in/ranjan.ak13@nic.in. (Candidates residing in Delhi will be informed about their medical examination in due course through DoP&T’s website).

1.1 However, if the candidate is already in Government service, instead of obtaining a fresh medical report, they may produce this letter to their controlling authority to enable them to forward an attested copy of their medical examination report obtained at the time of the appointment, to the undersigned. The candidates must ensure that the said medical examination report furnished to the previous employer should have been issued by Civil Surgeon/Chief Medical Officer or equivalent.
2. Further, candidates residing outside Delhi who wish to get their medical examination conducted in Delhi, may opt for the same in the willingness form. However, it may be noted that no TA/DA will be provided by the Department in such cases. Further, they have to undergo their Medical Examination on allotted date and time.
3. Candidates should ensure that the requisite documents as sought vide paras above, reach the undersigned at the address mentioned hereunder, latest by 5th March, 2021.

The Under Secretary CS.II CS.II Division, Department of Personnel & Training, 3rd Floor, Lok Nayak Bhawan, Khan Market, New Delhi-110003


  1. The eligibility of candidates who submit the requisite documents as above shall be determined for consideration for appointment. If found eligible, candidates will be offered appointment to the post of Stenographer Grade ‘D’ in Central Secretariat Stenographers’ Service subject to the verification of character and antecedents/claim for under any reserved category. The formal offer of appointment will be sent to you separately by the Cadre Controlling Authority (CCA) of the service, namely, D/o Personnel & Training. Along with the offer of appointment, the candidate will be intimated about the Mandatory Foundational Training for Stenographer Grade ‘D’ (Direct Recruit) organized by Institute of Secretariat Training and Management (ISTM) at Delhi.

  2. It may be noted that the above training is mandatory and has to be completed as a part of the successful completion of probation in service. Therefore, candidates are advised to be well prepared to attend the training on the scheduled date on nomination.

  3. It may also be noted that mere submission of willingness and other documents will not entitle any candidate to claim appointment to the post which will be subject to fulfillment of stipulated terms and conditions.

  4. The candidates must note that in case, at any stage, it is found that the candidate’s certificate is fake or candidate has furnished false information, he/she shall liable to be proceeded against, under the relevant rules, leading to such penalty as may be decided, which now extends to the termination of his/her appointment. Such action shall also be without prejudice to any other punitive action as may be attracted in such cases.

  5. Attention is also invited to this Department’s OM No. 11012/7/91-Estt.(A) dated 19.05.1993 as amended from time to time which already stipulates the action that can follow against furnishing of false information or submission of false information or submission of false certificates. The operative part of the said OM is reproduced below:-

“Wherever it is found that a candidate who was not qualified or eligible in terms of the recruitment rules etc. for initial recruitment in service or had furnished false information or produced a false certificate in order to secure appointment, he should not be retained in service. If, he is probationer or a temporary Government servant, he should be discharged or his services should be terminated. If he has become a permanent Government servant, an enquiry as prescribed in Rule 14 of CCS (CCA) Rules, 1965 may be held and if the charges are proved, the Government servant should be removed or dismissed from service. In no circumstances should any other penalty be imposed.”

  1. The aforementioned OM dated 19.05.1993 clearly brings out that persons who secure appointment on the basis of fake/false certificates should not be retained in service and should be dismissed/removed from service.

  2. The offer of appointment when made, will be provisional for the candidates who have claimed/availed the benefits of any type of reservation for posts and service in terms of the following instructions as may be relevant to them:-

(i) SC/ST Candidates: – The appointment will be provisional and is subject to due verification of SC/ST certificate by the DoP&T.


(iii) OBC Candidates:- This Department has issued OM No. 36012/22/93-Estt.(SCT) dated $8^{\text {th }}$ September, 1993, OM No. 36033/5/2004-Estt.(Res) dated $14^{\text {th }}$ October, 2008 and other extant instructions in this regard from time to time. In accordance with these instructions, only Non-Creamy Layer OBC candidates are entitled to get the benefits of reservation earmarked for Other Backward Classes (OBC). The appointment is, therefore, provisional to this extent and is subject to further verification of OBC certificate by the DoP&T.
(iii) PH Candidates:- The appointment will be provisional and subject to due verification of PH certificate by the DoP\&T.

Yours Faithfully,
Bhagirath Jha
(Bhagirath Jha) ${ }^{1}$
Under Secretary to the Government of India
Tel: 24654020
Email id: bhagirathjha.68@gov.in
NOTE: 1. Candidates may please note that further updates/information in regard to appointment to the post of Stenographer Grade ‘D’ on the basis of Stenographers Grade ‘C’ \& ‘D’ Examination, 2018 will be placed only on the website of DoP\&T (www.dopt.gov.inWhat’s new) and also www.dopt.gov.in – About us – Central Secretariat — Central Secretariat Stenographers’ Service – Recruitment (Steno Grade ‘D’) (Direct Recruitment). They are, therefore, advised to regularly visit the DoP\&T’s website for updates.
2. Candidates should indicate their (Stenographers Grade ‘C’ \& ‘D’ Examination, 2018) All India Rank in all their correspondence with this Department, including in the subject of email.


List of Selected Candidates

S.No. Roll No. Name Rank
1 2201032458 SHEKHA BHADANA 11
2 2201048755 PRINCE SONI 15
3 2201021047 KULDEEP 24
4 2201049061 SOMYA SATIJA 29
5 2201019357 RAVINDER KHATRI 30
6 2201043800 SACHIN NEGI 33
7 2201047579 AUJASVI GOSWAMI 34
8 2201062320 EKTA DHAWAN 35
9 4410004361 JAYITA DAS 36
10 2201064076 AASHIMA 38
11 2201066412 AALOK KUMAR 42
12 2201027253 KAMAL PAL 43
13 2405018498 VIVEK CHOPRA 50
14 2201045843 NAMAN RAWAT 55
15 2201040679 ANUKRITI MAHENDRA 57
16 7001700686 RAVI KUMAR 61
17 2201057311 DEEPANSH GUPTA 62
18 2201013534 NOSHEEN SIDDIQUI 64
19 2201044645 PRIYANKA 66
20 3206602326 RAVI BHARTI 67
21 2201032891 YOGESH BALYAN 71
22 2201044712 MONU PATHAK 74
23 2201013052 MRIDULA SAWHNEY 77
24 2201016731 CHARU 78
25 3001601368 KANCHAN CHAUHAN 80
26 2404001020 BHARAT SINGH RATHORE 86
27 3010602657 KAJAL GUPTA 87
28 3206601155 PINTU KUMAR 90
29 2201021716 MANOJ KUMAR 92
30 4410011626 MD RIZWAN KHAN 93
31 4410008285 RAJESH PRASAD 103
32 2409000135 GAURAV SHARMA 105
33 2201064163 TARUN SHARMA 109
34 2201036483 MANPREET KAUR 110
35 2201030037 NEERAJ SHARMA 111
36 2201056035 BRIJESH KUMAR 115
37 2201070462 VRINDA SHARMA 117
38 2201049228 GOVIND VASHISHTHA 118
39 2201024700 VIVEK KUMAR SHARMA 119
40 2201000610 PANKAJ PALIWAL 120
41 3009600363 ASHWANI SHUKLA 121
42 2201036953 ADITYA KUMAR RAI 124
43 3010014255 ARYAN SHUKLA 125
44 2201035095 DHRUV KAUSHIK 127

S.No. Roll No. Name Rank
45 2201045351 ALISHA GERA 128
46 2201033868 GARIMA KHANNA 129
47 2201067763 ANJALI KAUSHIK 133
48 4410009572 ARKA DAS 137
49 1601003898 RAVNEET KAUR 139
50 2201015711 MOHIT PUNDORA 140
51 6005002861 DISHANK GUPTA 142
52 2201040780 SAMEER SINGH 143
53 2201029583 KARAN SHARMA 144
54 3010602717 NEERAJ GANGWAR 145
55 2201009361 SHIVAM KUMAR 151
56 2201029448 AARTI RAWAT 152
57 3206602369 POOJA KUMARI 156
58 2201043934 VAISHALI PRUTHI 159
59 3010005546 VIJAY KUMAR GUPTA 161
60 1601000209 AJAY 162
61 2201069834 PAWAN KUMAR VERMA 163
62 3206601098 RINKI LATA 165
63 2201063392 ABHISHEK KUMAR MISHRA 166
64 4205009541 SMITA KUMARI 167
65 2201000944 AJAY KUMAR 168
66 4410006723 ABIR DAS 169
67 1601003522 RAVI SHARMA 172
68 2201034491 LAKSHAY ARORA 176
69 2201034556 SACHIN KUMAR SINGH 178
70 2201016080 RAHUL BHAI MANDAL 181
71 3206004332 MONIKA KUMARI 182
72 2201040740 RITU SOLANKI 183
73 2201028099 NIDHI BANSAL 184
74 2201020144 MUKESH KUMAR BISHT 186
75 2201057893 SHUBHAM VARUN 187
76 3206004867 KUMAR ABHISHEK RANJAN 188
77 2201064277 DEEKSHA ASIWAL 189
78 2201013788 BHAVUK GAHLOT 191
79 2201048259 PALLAVI 194
80 2201065581 VEDPAL 195
81 2201059726 GANESH CHANDER JOSHI 198
82 2405018405 HEMANT KUMAR 202
83 2201059218 AAKRITI ARORA 203
84 2201016610 ANKIT LAKRA 205
85 2201054933 HIMANI 207
86 2201002403 PAWAN KUMAR 208
87 2201019967 SHANTNU GOPAL SHARMA 209
88 2201053255 VINAY RAWAT 210
89 2404000653 VISHAL BHATIA 211

S.No. Roll No. Name Rank
90 2201021259 BHAVYA KAUSHIK 213
91 2201057741 GARIMA 214
92 4410009654 B LINA KUMARI 216
93 2201016516 MOHD SHAZEV 217
94 2201066549 SAUMYA BISHT 219
95 2405010033 GAURAV MISHRA 220
96 2404000009 TANUJ MUTREJA 223
97 2201050805 MANUJA RAWAT 224
98 2201012976 SAKSHI 225
99 3010601498 VANI BUDHOULIYA 226
100 2201045081 SHAHRUKH KHAN 227
101 2201043797 KAJAL MITTAL 228
102 2201028616 ANISHA SAHU 230
103 2003000305 MEDHA THAKUR 231
104 2201018136 JAGJINDER SINGH 232
105 2401002741 ASHOK SHARMA 233
106 2201052169 GAURAV VERMA 235
107 2201055350 SHAZAAD ZAKIR 237
108 3009004519 RAJAT SRIVASTAV 239
109 2201017047 NISHA JALAL 241
110 2201006917 VIDHI GOEL 246
111 2201004122 NIRDESH KUMAR 248
112 2201039712 CHETNA CHAUDHARY 249
113 4205001094 VINEET ANAND 250
114 2201065687 CHETAK 251
115 2201061437 HANUMAN JHA 252
116 2201013745 SANTOSH YADAV 254
117 2405015790 GANESH KUMAR SHARMA 255
118 2201060118 MOHIT KUMAR 256
119 2201028671 SHANAJ BEGUM 257
120 2201052143 PARDEEP KUMAR 258
121 6005002331 SHIVAM SHRIWAS 259
122 3009601346 HITANSHU SINGH 261
123 2201059777 ARPIT SINGH 262
124 2201070428 VAISHALI BALONI 263
125 2201005502 VISHAL CHAUHAN 267
126 2003002550 ANAMIKA SAINI 268
127 2201035972 KRITIKA SEHGAL 269
128 2201016427 RUPAL SHARMA 270
129 2201004154 ARVIND 271
130 2405011844 MAMTA 273
131 2201064682 PARSHANT ROJH 274
132 2201048952 APOORVA JAIN 277
133 2201036830 GEETA JOSHI 278
134 2201047076 ESHITA MONGA 280

S.No. Roll No. Name Rank
135 6005001251 SHEFALI GUPTA 284
136 2201045640 RACHNA CHAUHAN 286
137 2201043065 RAGHAV SHARMA 289
138 2201055043 PRASHAN 295
139 2201035720 SUSHANT SAHU 297
140 2201020445 SHIVAM SHRIVASTAV 303
141 2005000660 ANKIT YADAV 304
142 2201033287 PRERNA 310
143 2201010987 SHIV KUMAR MAJOKA 312
144 3011600633 VIVEK KUMAR GANGWAR 326
145 4205009584 SURENDER KUMAR 336
146 2201022243 AKHILESH YADAV 337
147 2201019689 MANVENDRA VERMA 339
148 2201059327 C DEEPA 347
149 4410001737 ANUSHKA 349
150 2201014531 KESHAV 362
151 2201006059 ANSHUL KUMAR 372
152 2201052234 AJAY SINGH 374
153 2201023914 PUNEET YADAV 376
154 2201058554 MANTHAN 381
155 2201020715 HARSHIT KUMAR 399
156 4410003899 NANDITA MITRA 404
157 2405011588 JYOTI KUMARI 426
158 2201020727 SAHIL 429
159 3206009322 NIKUNJ KUMAR 434
160 2201049827 KOMAL GUPTA 448
161 2201044611 ABHISHEK KUMAR 463
162 2201006627 MOHD JUNAID 465
163 3010602311 IRSHAD ALAM 466
164 6001101572 DEEPENDRA YADAV 468
165 2201033764 KAMINI 470
166 2404000695 GULSHAN YADAV 484
167 2201063776 NAVEEN DHIMAN 495
168 3206601944 KUNDAN KUMAR 511
169 2201029767 HIMANSHU BAGHEL 519
170 2201025686 GAURAV 537
171 3008000584 AJAY GUPTA 538
172 2201014579 VIKAS YADAV 539
173 2201022096 ROHIT KUMAR 541
174 2201063161 FAIRY 547
175 2201039081 YOGITA 548
176 2201052008 AMIT KUMAR 557
177 2201066227 VANDANA SINGH 570
178 3007601848 GAURAV MAURYA 597
179 2201051455 ROHAN THAKUR 610

S.No. Roll No. Name Rank
180 3207600423 MANISH KUMAR 613
181 3206606295 VISHAL KUMAR 614
182 2201004119 KOMAL SINGH 623
183 2201011104 VIRPAL 626
184 2201025263 SEEMA 627
185 2201036312 SHRUTI YADAV 629
186 2201035724 VIPIN 631
187 2201040019 AAFAQ AALAM ANSARI 633
188 2201017587 AFTAB MALIK 635
189 2201043958 ISHU SONKER 638
190 2201061495 S DHARINI 642
191 2201025015 ANAND YADAV 643
192 2201030126 LAKSHAY KASHYAP 645
193 2201021474 ATUL KUMAR 650
194 2201004046 ANKUSH KUMAR 653
195 2201019758 MOHIT KUMAR 654
196 2201061663 DEEPAK SUWANSIYA 655
197 2411001712 KRISHAN JAKHAR 656
198 2201061993 MUSKAN PAREWA 658
199 2201018834 SACHIN KUMAR 663
200 2201069386 NAZIM 664
201 2201040013 ANKUR YADAV 666
202 2201014437 HARSHITA YADAV 669
203 2201029824 RAJAT YADAV 670
204 2404001904 RAGUVEER SINGH 680
205 2201057171 RAHUL KUMAR 682
206 3010602573 VERSHA JAISWAL 683
207 3206603544 SAGAR KUMAR AARYAN 684
208 2201065048 ABHISHEK 688
209 2201063975 NISHANT 691
210 2411000175 INDRAJEET 694
211 2405016109 DEEPAK KUMAR MEENA 695
212 2201020319 AKSHAY KUMAR 697
213 2201047938 MANISH ARYA 704
214 2201025293 PRAVEEN KUMAR 719
215 2405006620 VINEET KUMAR DHOVI 720
216 2201030697 SAURABH 724
217 2201027577 URVASHI 725
218 2201035405 SHIVANI 726
219 2201008477 SUDHANSHU NANDAN 734
220 2201039931 MAHESH KUMAR 740
221 2201061260 RAHUL 744
222 6001001765 ANIL VERMA 748
223 2201068802 SURAJ KUMAR 761
224 2005000527 PARVESH KUMAR SINGH 776

S.No. Roll No. Name Rank
225 2201016803 SHARDA 780
226 2201069702 ASHISH VOAT 783
227 3010011146 RAHUL RAWAT 792
228 2201057850 MANOJ KUMAR 806
229 3010601284 DEEPAK ANAND GAUTAM 807
230 2201059075 SHIVANI GAHLAUT 808
231 2201058478 ISHANT 810
232 2201029459 RAKHI TANWAR 811
233 3010604021 VISHAKHA SINGH 813
234 2405000903 SHANKAR LAL MEENA 826
235 2405016092 VIJAY KUMAR MEENA 842
236 3205603178 KUMAR BHOLE SHANKAR 897
237 3013600458 DINESH KUMAR MURMU 903
238 2201034878 ROHIT PAUL MINJ 908
239 2405001429 HEMARAJ MEENA 909
240 2201012459 DEEPAK 912
241 2201015995 ADARSH RANA 913
242 4205011709 KHUSHBOO KACHHAP 917
243 2405006974 CHANDRA PRAKASH MEENA 920
244 2402002333 ANIL KUMAR JAIF 923
245 2405010692 VISHNU MEENA 926
246 2405007223 SACHIN KUMAR MEENA 927
247 2405000271 KHUSHBU MEENA 928
248 2201023843 AJAY KUMAR SAH 929
249 2405004114 NAVRATAN MEENA 931
250 1601000005 SANDEEP SINGH 943
251 2201068655 AKSHAY BAHL 963
252 2201025675 CHHOTE LAL 964
253 4205009539 RITU GUPTA 968
254 2002003811 AMIT KUMAR 973
255 2201069644 LOKESH KUMAR 974
256 2002003412 KAPIL KUMAR 975
257 2002003809 NEERAJ KUMAR 983
258 2404002549 SUMIT KUMAR 984
259 3206610962 HARI SHANKAR KUMAR 988
260 6001003594 SHALINI MISHRA 989

The Under Secretary (CS-II) CS-II Division Department of Personnel & Training $3^{\text {rd }}$ Floor, Lok Nayak Bhawan Khan Market, New Delhi-110003 Subject:- Appointment to the grade of Stenographer Grade ‘D’ of CSSS- Submission of documents by candidates of Stenographers Grade ‘C’ \& ‘D’ Examination, 2018, conducted by SSC-reg.

Sir, I am refer to letter No. 6/1/2021-CS-II(C) dated $11^{\text {th }}$ February, 2021 of Department of Personnel \& Training on the subject mentioned above and hereby convey my willingness to join the grade of Stenographers Grade ‘D’ of Central Secretariat Stenographers’ Service. 2. Three sets of Attestation Forms duly filled in my own handwriting, are also attached. 3. My details (in brief) are as under: i. Roll No. ii. Date of Birth iii. Email iv. Mobile No. v. Previous Employer (if any) (Name of Organization) vi Full Address of previous employment

Yours faithfully

Signature:

Name. $\qquad$ Rank (AIR). $\qquad$ Date:


Affix signed passport size ( $5 \mathrm{~cm} . \mathrm{X} 7 \mathrm{cms}$.
approx.) copy of recent photograph
“WARNING”
1. The furnishing of false information or suppression of any factual information in the Attestation Form would be a disqualification, and is likely to render the candidate unfit for employment under the government.
2. If detained, convicted, debarred etc. subsequent to the completion and submission of the form, the details should be communicated immediately to CS.II Divison, DoP&T, failing which it will be deemed to be a suppression of factual/material information.
3. If, the fact that false information has been furnished or that there has been suppression of any factual/material 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” in accordance with the extant rules.
1. (a) Name in full (in block capitals) with aliases, if any,
(b) Have you ever added or dropped in any stage any part of your name or surname: Yes/No
(If Yes, provide details)
2. Present address in full (i.e., Village, Thana, District, State and Pincode
or
House No., Lane/Street/Road \& Locality, City, State and Pincode)
3. (a) Permanent address in full (i.e., Village, Thana, District, State and Pincode
or
House No., Lane/Street/Road \& Locality, City, State and Pincode)
(b) If originally a resident of Pakistan/Bangladesh (erstwhile East Pakistan) the address in that country and the date of migration to Indian Union.
4. Aadhar Card No.
5. Permanent Account Number (PAN)
6. Nationality

  1. (a) Date of Birth
    (DD/MM/YYYY)
    (b) Present Age
    (at the time of filling the form)
    $\qquad$ Years $\qquad$ Months $\qquad$ Days
    (c) Age at the time of passing Matriculation
  2. (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
  3. (a) Religion
    (b) Whether belonging to Scheduled Caste / Scheduled Tribe/Other Backward Class (Creamy Layer) / Other Backward Class (NonCreamy Layer)/ Economically Weaker Section (EWS)?
  4. Particulars of places (with duration) where you have resided during the preceding five years (from the date of filling of this form).
    [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)]
    img-0.jpeg

  1. Name (in
    full & aliases
    if any)
    Nationality
    (by birth
    $\& /$ or by
    domicile)
    Place of
    Birth
    Occupation if
    employed – Give
    designation and
    Official Address
    Present Postal
    Address (If
    dead, give last
    address)
    Permanent
    Home
    Address
  2. Information to be furnished with regard to son(s) and/or daughter(s) in case they are studying/living in a foreign country.

Name Nationalit
y (by birth
$\& /$ / 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 $15^{\text {th }}$ year of age.
Name of School/College (with full address) Date of
Entering
Date of
Leaving
Examination
Passed

  1. (a) Are you holding or have any time held any appointment under the Central or State Government or a Semi-Government or a Quasi-Government body, or an autonomous body, or a public undertaking, or a private firm or institution? If so, give full particulars with dates, of employment, up-to-date.
Period Designation,
Emoluments and
Nature of
Employment
Full name and address of employer Reasons for leaving previous service
From To
  1. (b) If the previous employment was under the Govt. of India, a State Govt. / an undertaking owned or controlled by the Govt. of India or a State Govt. / an autonomous body / University / Local body.

If you had left service on giving a month’s notice under 5 of the central civil services (temporary service) rules, 1965, or any similar corresponding rules were any disciplinary proceedings initiated 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 date, before your services were actually terminated? 15. (i) (a) Have you ever been kept under detention? (b) Have you ever been arrested? (c) Have you ever been prosecuted? (d) Is any criminal case pending against you in any Court of Law at the time of filling up this Attestation form and charge-sheet in that case has been filed or not? (e) Have you ever been convicted by a court of law for any offence? (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? (h) Have you ever been debarred / disqualified by any Public service commission from appearing at its examination / selection?


(ii) If the answer to any of the above mentioned questions is ‘Yes’, give full particulars of the case / arrest / detention / fine / conviction / sentence / punishment etc. and / or the nature of the case pending in the Court / University / Educational Authority etc., at the time of filling up this attestation form:

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 writing ‘Yes’ or ‘No’ as the case may be.

16. Name, Address and
Aadhar No. of two
responsible persons of
your locality or two
references to whom you
are known:
1)
2)

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 and I am also liable for appropriate criminal/civil/legal action as a consequence.

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

Date:
Place:
Signature of Candidate

TO BE FILLED BY THE OFFICE

(i) 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,
$3^{\text {rd }}$ Floor, Lok Nayak Bhavan,
New Delhi-110003
(ii) Post for which the candidate is being considered:

Stenographer Grade ‘D’, ‘Group-C’, Non-Gazetted of Central Secretariat Stenographers’ Service.


Candidate’s Details for Delhi Police Verification

1 Name of the Candidate
(a) Alias name, if any
2 Father’s Name
3 Mother’s Name
4 Marital Status
(a) If married, name of the spouse
5 Blood Group
6 Place of Birth
7 Candidate’s Date of Birth
8 Gender
9 Candidate’s Contact No.
10 Candidate’s email id
11 Nationality
12 Religion
13 Category
14 Present Address
15 Permanent Address
16 Address Duration (Delhi) From (Month & Year)
17 Add more than one address (Delhi) here- From (Month \& Year)
18 Police Station
19 District

Signature with Date

Rank No./Year of Exam.


FORM OF MEDICAL CERTIFICATE

I hereby certify that I have examined $\mathrm{Sh} / \mathrm{Smt} / \mathrm{Km}$.
a candidate for employment in the Central Secretariat Service in the Government of India and cannot discover that he/she has any disease (communicable or otherwise), constitutional weakness or bodily infirmity, except $\qquad$ .

I do not consider this a disqualification for employment in Central Secretariat Service in the Government of India.

The age of Shri/Smt./Kum. $\qquad$ according to his/her own statement is $\qquad$ years, and by appearance is about $\qquad$ years.
(Signature/thumb impression of the candidate)

Date $\qquad$
(To be signed in the presence of the examining Medical Officer)
img-1.jpeg

Signature of Medical Officer
Name $\qquad$
Address $\qquad$
Official Seal
(Seal should be spread over form and the photograph)

Note: The officer making this certificate should be a Civil Surgeon or a District Medical Officer of equivalent status of a Government Hospital


CANDIDATE’S STATEMENT AND DECLARATION

(The candidate must make the following statement and must sign the declaration below it before the medical officer. Attention is specially invited to the WARNING in the ‘Note’ at the bottom of page 2.)

  1. Name in full
    (in BLOCK letters)
  2. Age and place of birth
  3. Have you ever had
    (a)small-pox, intermittent fever and other fever, enlargement suppuration of glands, spitting of blood, fainting attacks, rheumatism or appendicitis? OR
    (b) any other disease or accident requiring confinement to bed and medical or surgical treatment?
  4. When were you last vaccinated?
  5. Have you or any of your relatives been afflicted by consumption, scrofula, gout, asthma, fits, epilepsy or insanity?
  6. Have you suffered from any form of nervousness due to overwork or any other cause?
  7. Have you been examined and declared fit for Govt. Service by a medical officer/ Medical Board within the last three years?
  8. Furnish the following particulars:
Father’s age, if
living, & state of
health
Father’s age at the
time of death and
cause of death
No. of brothers
living, their ages and
state of health
No. of brothers
who have died,
their ages at death
and cause of death

Mother’s age, if living, &
state of health
Mother’s age at the
time of death and
cause of death
No. of sisters
living, their ages
and state of health
No. of sisters who
have died, their
ages at death and
cause of death

DECLARATION

I declare that all the above answers are true and correct to the best of my knowledge and belief. I also solemnly affirm that I have not received any disability certificate/ pension on account of any disease or other condition.

Candidate’s signature
Date: $\qquad$
Signed in my presence.

Signature of Medical Officer

Name: $\qquad$
\& Designation: $\qquad$

Note: The candidate will be held responsible for the accuracy of the above statement. By wilfully suppressing any information he will incur the risk of losing the appointment and, if appointed, of forfeiting all claims to superannuation allowance or gratuity.