Monday, 8 February 2016

DSC-2014 Model Check List For Certificate Verification for selection candidates


_________________________ DISTRICT – TET CUM TRT 2014
CHECK LIST FOR VERIFICATION OF CERTIFICATES
1 Name of the Candidate with full name ( in capital letters) :
2 Date of Birth (DD/MM/YYYY)
3 Hall Ticket No. :
4 Application on-line ID No
5 TET CUM TRT 2014 Marks
6 Rank in Merit list :
7 Address for correspondence

:
8 Category of Post (SGT /LP ) :
9 Medium :
10 Community ( Caste &Sub caste) :
11 Male/Female :
12 Qualifications: i) Academic :
ii) Professional :
iii) If any other :
13 STUDY PARTICULARS :
i)       IV & V classes :
ii)    VI to X class :
iii)  Whether the candidate belongs to Local/ Non-local :
14 Whether the candidate belongs to PHC . If yes mention particulars :
15 Whether the candidates belongs to Ex- Service Man to produce Pension payment order. :
16 Contact Phone No. :
DECLARATION
I,………………………………………………… do hereby solemnly and sincerely affirm and stated that above mentioned information is best of my knowledge, if any false information found in this regard I am whole responsible and abide rules and regulations in force.and opted the management of ……………………………..
Station:
Date:
SIGNATURE OF THE APPLICANT
I declare that the above mentioned information verified with Original Certificates of the applicant is found correct.
                     Signature of the Verification Officer                               (designation and address)

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