Inspr Certificate Verification by B2k03kwJ


									                                  GOVERNMENT OF INDIA
                                   MINISTRY OF FINANCE
                                 DEPARTMENT OF REVENUE
      Telephone No. : 044-28331093                          Email   :
      Fax No. : 044-28331151               Visit us at :

C.No.II/3/31/2010-CCA (Estt.)                                           Dated: 10/11/2010

        Sub:   CCA (Estt.) – Candidates qualified in the Graduate Level Examination,
               2008 conducted by the SSC to the posts of Inspector (Central Excise)
               in the Central Board of Excise and Customs – Call letter for Physical
               Endurance Test, Certificate verification and Medical examination – Reg.

       The following candidates have been recommended by the Staff Selection
Commission for appointment to the post of Inspector in Chennai Central Excise Zone
(Tamil Nadu & Puducherry) of Central Board of Excise & Customs, New Delhi on the
basis of results of Inspector (Central Excise & Income Tax) Examination, 2008.

 Sl.                                     Name                   Categ        Date on which
         Roll No.    No.
 No.                                  S/shri/smt.                ory       required to report

 1       6710028     242     DURBAPAL                            GEN
 2       6710229     301     JAGADEESH RAJA RAJAN R              GEN
 3       6710495     462     RAJESH S                            GEN
 4       1246522     484     RAJESH                              GEN
 5       6712187     703     MARIA ISABEL JUDITH                 OBC
 6       6830503     712     ANURADHA P                          OBC
 7       6710125     760     SURESH KUMAR G                      OBC
 8       6710516     870     VIJAYAN T V                         OBC
 9       6950868     876     SAKTHIKUMAR A                       OBC
 10      6710407     897     SATHYANARAYANAN G                   OBC
 11      2580298     927     SHRUTI SACHAN                       OBC           13.12.2010
 12      1651316     928     RAJNISH KUMAR                       OBC            10.00 A.M
 13      1482833     931     VIVEK RISHI                         OBC
 14      1243220     934     KRISHNA NANDAN KUMAR                OBC
 15      2710257     936     VINEET KUMAR                        OBC
 16      1780056     937     MONIKA VARMA                        OBC
 17      1705386     939     PURAN MAL                           OBC
 18      2010644     940     VED PRAKASH GUPTA                   OBC
 19      2410476     941     MOHAMMAD ATIQ                       OBC
 20      1240804     943     SAJJAN KUMAR                        OBC
21   3261886   944    RANAJIT DAS               OBC
22   2417508   945    RAJESH KUMAR YADAV        OBC
23   1219520   946    DINESH KUMAR              OBC
24   2416431   948    DHARMENDRA KUMAR SHARMA   OBC
25   3603852   949    JEETENDRA KUMAR SAHU      OBC
26   2563974   950    RAJAN CHAUDHARY           OBC
27   1580200   951    RAJ SINGH                 OBC
28   1217117   952    LALAN KUMAR RAHI          OBC
29   3708660   955    ADITYA BHUSHAN VIBHUTI    OBC
30   2411359   956    SUNEEL KUMAR              OBC    13.12.2010
31   1230969   958    NAVEEN KUMAR              OBC     10.00 A.M
32   2670744   959    SATISH KUMAR MAURYA       OBC
33   3700127   963    AKASH BHUSHAN             OBC
34   1242673   964    SURESH KUMAR              OBC
35   5014171   966    CHETAN PRASAD             OBC
36   5014035   967    SHIV PUJAN KUMAR          OBC
37   5310126   975    SANTOSH KUMAR RANA        OBC
38   1222666   976    SANJEEV KUMAR             OBC
39   2110653   981    DEEPAK KUMAR BHAGAT       OBC
                      SHYAM SUNDER PURI
40   2610561   983
                      GOSWAMI                   OBC
41   6210503   985    HARI SHANKAR KUMAR        OBC
42   3580507   988    JADUMANI NAIK             OBC
43   1712543   989    AMIT KUMAR                OBC
44   1212155   990    SAURAV ANAND              OBC
45   2290712   991    SUBHASH CHANDRA KUMAR     OBC
46   2644420   992    RAJESH KUMAR              OBC
47   2581938   993    MAHAVIR SINGH             OBC
48   1245410   996    PRIYANKA YADAV            OBC
49   2411280   997    AVADHESH KUMAR            OBC
50   2416170   1000   GULAB SINGH               OBC
51   1650195   1001
                      AJAY KUMAR SINGH           Ex
52   2418741   1002   KULDEEP JAISWAL           OBC
53   1215330   1004   VIKRAM KUMAR              OBC
54   2581084   1006   SHARAD YADAV              OBC
                                                        10.00 A.M
55   1211362   1007   SHIV KUMAR                OBC
56   1216069   1008   RANA RAJVEER KUMAR        OBC
57   2019712   1010   JAGAT NARAYAN             OBC
58   1221074   1011   ANIL KUMAR                OBC
59   3601787   1013   SUBASH CHANDRA MANIA      OBC
60   1780554   1014   JAYANT CHARAN             OBC
61   1212723   1018   SATENDRA VIR SINGH        OBC
62   1232311   1019   ROSHAN LAL                OBC
63   7020086   1022
                      NARAYANAMOORTHI P          PH
64   6710122   1042   ARUNKUMAR M                SC
65   6711219   1071   DHAYANESHWARAN A           SC
66   6712442   1099   BABY BINDU K               SC
67   6710595   1129   JANAKIRAMAN V              PH
68   6710358   1133   DEEPIKA LAZARUS            SC
69   3603502   1193   BANDITARANI BEHERA         SC
     70   4511857   1194   LASTLY WOOD KHARBULI              ST
     71   4210692   1195   ASHOK RAM                         SC
     72   7010142   1197   SURENDHAR A                       SC
     73   1724601   1198   ASHOK KUMAR VERMA                 SC           14.12.2010
     74   1214123   1200   VIVEK KUMAR                       SC            10.00 A.M
     75   2420022   1201   SUBODH PRASAD                     SC
     76   1222844   1202   RASHMI SINGAL                     SC
     77   2642567   1203   AVANINDRA KUMAR                   SC
     78   1750576   1210   VIJAY SINGH                       ST

2.     The candidates are directed to report to the undersigned at the above given
address on the date noted against each. While reporting, the candidates are required to
submit the duly filled in Attestation forms (enclosed) in the prescribed proforma in two
sets without fail along with original certificates in proof of (i) Date of Birth
(ii)Educational Qualification,(iii) Community Certificate (if applicable) (iv)PH/Ex-
Serviceman Certificate and any other relevant document. On satisfactorily completing
the verification process, the candidate will be required to undergo physical endurance
test which includes walking and cycling and thereafter they will be subjected to medical

3.     Also enclosed is the format of Identification and Character Certificate (from two
different gazetted officers) in three sets which are to be submitted duly certified at the
time of reporting in this Office.

4.    The candidates are also advised to come prepared to stay for 3 working
days for completion of the required formalities. It may be noted that the
candidates have to make their own arrangements for boarding and lodging
during the stay.

                                                    ( M. SENTHAMIL SELVAN )
                                                ADDITIONAL COMMISSIONER (P&V)
Encl: 1) Attestation Form (in duplicate)
      2) Identity Certificate.
      3) Character Certificate.
The Individuals
                                                (By R.PAD)
                                                          ATTESTATION FORM

                         1. The furnishing of false information or suppression
 Affix a signed             of any factual information in the Attestation Form
 Passport size              would be a disqualification and is likely to render
 (5cms X 7 cms              the candidate unfit for employment under the
 copy of recent          2. If detained, arrested, prosecuted, bound down,
 photograph here            fined, convicted, debarred, acquitted, etc.,
 without defacing           subsequent to the completion and submission of
                            this form, the details should be communicated
 the identity               immediately to the authorities to whom the
                            attestation form has been sent early, failing
                            which it will be deemed to be a suppression of
                            factual information.

                         3. If the fact that false information has been
                            furnished or there has been suppression of any
                            factual information in the attestation form comes
                            to notice at a time during the service of a
                            person, his/her services would be liable to be

1.    Name in full (IN BLOCK
      CAPITALS) with alias, if any.
      (Please indicate if you have
      added or dropped in any
      stage any part of your name
      or surname)
2.    Present address in full
      (i.e. Village / Thana /
      District or House No./
      Lane / Street / Road / Town
      and name of District Hqrs.)
3.    (a) Home address in full
      (i.e. Village / Thana /
      District or House No./
      Lane / Street / Road / Town
      and name of District Hqrs.)

      (b) If originally a resident of
      Pakistan, the address in
      that country and the date
      of migration to Indian Union
                                                 -: 2 :-

4.      Particulars of places (with period of residence) where you have resided for more than
one year at a time during the preceeding 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.

    Sl.        From          To        Residential address in full      Name of the Hqrs. of the
    No.                              (i.e. Village / Thana / District   places mentioned in the
                                     or Door No. / Lane / Street /         preceeding column
                                            Road and Town)

  Members            Name          Nationality      Place of   Occupation (if    Present postal
  of family      (with alias, if                      Birth     employed,         address and
                      any)                                        giving        permanent Home
                                                                designation         address
                                                                and Office
                       1               2                   3         4                  5


   Wife /

 Brother (s)

  Sister (s)

                                                -: 3 :-

5.     Information to be furnished with regard to son(s) and daughter(s) in case they are
studying / living in a foreign country.

Name                       Nationality  Place       of Country in which Date from which
                           (By birth or birth          studying/living with studying in the
                           Domicile)                   full address         country mentioned
                                                                            in previous column

6.     Nationality (by birth or Domicile)                 :

7.     (a) Date of birth                                  :

       (b) Present age                                    :

       (c) Age at Matriculation                           :

8.     (a) Place of Birth/District & State in             :
           which situated

       (b) District & State to which you                  :
           presently belong

       (c) District & State to which your                 :
           father originally belonged

9.     (a) Your religion                                  :

       (b) Are you a member of                            :   SC / ST / OBC
           (strike out whichever not applicable)

       (c) Name of the Caste                              :

       (d) Category of candidature                        :   PH / EX-SM / Dependents of
           (strike out whichever not applicable)              EX-SM killed in action

                                            -: 4 :-

10.   Educational qualification showing places of education with years in School(s)
      and Colleges(s) since 15th year of age.

Name of School/ College Date of entrance       Date        of Examination(s) passed
with full address                              leaving

11.   (a)    Are you holding or have any time held an 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-

     period          Designations,      Full name and address of      Reasons for leaving
 From       To      Emoluments and             the employer            previous service
                       nature of

      (b)    If the previous employment was under the Government of India / a State
             Government / an Undertaking owned by or controlled by the Government
             of India or a State Government / an autonomous body / University / local

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

                                                -: 5 :-

12.    (a)     Have you ever been arrested?                   :      Yes / No

       (b)     Have you ever been prosecuted?                 :      Yes / No

       (c)     Have you ever been kept under                  :      Yes / No

       (d)     Have you ever been bound down?                 :      Yes / No

       (e)     Have you ever been fined by a Court            :      Yes / No
               of Law?

       (f)     Have you ever been convicted by a              :      Yes / No
               Court of Law for any offence?

       (g)     Have you ever been debarred from any           :      Yes / No
               examination or restricted by any
               University or any other educational
               Authority / Institution?

       (h)     Have you ever been debarred /                  :      Yes / No
               disqualified by any Public Service
               Commission/Staff Selection Commission
               for any of its examinations / selections?

       (i)     Is any case pending against you in any         :      Yes / No
               University or any other Educational
               Authority / Institution at the time of
               filling up this Attestation Form?

       (j)     Is any case pending against you in             :      Yes / No
               any Court of law at the time of filling
               up this Attestation Form?

       (k)     Whether discharged/expelled/                   :      Yes / No
               withdrawn from any training institution
               under the Govt. or otherwise?

                If the answer to any of the above mentioned questions is “Yes”, give full
particulars of the case Viz. arrest/detention/fine/conviction/sentence/punishment, etc., and the
nature of the case pending in the Court/University/Educational authority, etc. at the time of filling
up of this form.

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

                                           -: 6 :-

13.    Name and addresses of two responsible persons of your locality or two references
       to whom you are known.







Date   :

Place :                                              Signature of the candidate
                                 IDENTITY CERTIFICATE

               Certified that I have known Shri / Smt./ Kum.___________________________
Son / Daughter of Shri ________________________ for the last ______________ years
________________ months and to the best of my knowledge and belief, the particulars
furnished by him/her are correct.

Date   :                                                   Signature:

Place :                                                    Designation / Status and
                                                           Address with seal


             1.     Gazetted Officers of Central or State Government.

             2.     Members of Parliament or State Legislature belonging to the
                    Constituency where the candidate or his parent /guardian is
                    Originally a resident

             3.     Sub-Divisional Magistrate / Officers

             4.     Tahsildars / Deputy Tahsildars authorized to exercise Magisterial

             5.     Principal / Head Master of the recognized School(s) / College(s) /
                    Institution where the candidate studied last

             6.     Block Development Officers

             7.     Post Masters

             8.     Panchayat Inspectors
                                 I. CHARACTER CERTIFICATE

                 Certified that I have known Shri / Smt. / Kum. ________________________
Son / Daughter of Shri __________________________________ for the last           __________
years ___________________ months and to the best of my knowledge and belief, he / she
bears reputable character and has no antecedents which render him / her unsuitable for
Government employment.

2.               Shri / Smt. Kum. _________________________________________ is not
related to me.

Date :                                             Signature     :
Place :                                            Designation   :
                                                   Seal          :

                                II. CHARACTER CERTIFICATE

                 Certified that I have known Shri / Smt. / Kum. _________________________
Son / Daughter of Shri __________________________________ for the last           __________
years ___________________ months and to the best of my knowledge and belief, he / she
bears reputable character and has no antecedents which render him / her unsuitable for
Government employment.

2.               Shri / Smt. Kum. _________________________________________ is not
related to me.

Date :                                             Signature     :
Place :                                            Designation   :
                                                   Seal          :

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