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Non Judicial Stamp Paper: Rs.10 Rs.10

This document contains details provided by Muna Pradhan for enrolling in the Indian Army. It includes his personal information like name, father's name, caste, religion, current and permanent addresses. It also mentions any past court cases or FIRs against him. The document states that he understands a police verification will be conducted and certifies that he is eligible to attend the recruitment rally. It provides details of any past nativity/domicile certificates held and recruitment rallies attended. Muna signs to confirm all documents submitted are correct and acknowledges penalties for furnishing wrong information.

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Muna
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2K views3 pages

Non Judicial Stamp Paper: Rs.10 Rs.10

This document contains details provided by Muna Pradhan for enrolling in the Indian Army. It includes his personal information like name, father's name, caste, religion, current and permanent addresses. It also mentions any past court cases or FIRs against him. The document states that he understands a police verification will be conducted and certifies that he is eligible to attend the recruitment rally. It provides details of any past nativity/domicile certificates held and recruitment rallies attended. Muna signs to confirm all documents submitted are correct and acknowledges penalties for furnishing wrong information.

Uploaded by

Muna
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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NON JUDICIAL STAMP PAPER

Rs.10 Rs.10
1. I, Name MUNA PRADHAN son of CHARAN PRADHAN while
applying for enrolment in Army Solemnly affirm & state the
Paste your
following my respect :-
photograph
(a) I belong to the following caste/Religion :- and self attest
Caste _______ Sub Caste _______ Religion Hindu the same
(b) My Residential Addresses are as under :-

(i) Permanent Home Address

Father Name CHARAN PRADHAN House No

Vill/Mohalla Pendurapalli Tehsil Banapur

District KHORDHA State ODISHA

(ii) Postal Address

Father Name CHARAN PRADHAN House No

Vill/Mohalla Pendurapalli Tehsil Banapur

District KHORDHA State ODISHA

(ii) I fully understand that if enrolled, a detailed verification of my character and antecedents will be carried
out by police and civil administration from my permanent address submitted above and also places where I
have resided in the last five years.

(iii) My places of residence in the last five years are as stated under :-

Residential address in full i.e., House Number,


Lane/Street/Road, Village/Town/Mohalla, Thana, Post Office,
S/No. From To Tehsil and District
(a)
(b)
(c)
(c) I am Unmarried.
(d)I hereby certify that I am not involved in any civil/criminal case
OR

I was involved in following cases but was acquitted :-

(i) ______________________

(ii) ______________________

OR

Following court cases / FIR are pending against me :-

(i) ______________________

(ii) ______________________
(e) Consent Certificate. I am below 18 years and my parents give their consent, for attending the Army
Recruitment Rally. (if applicable)

Signature of Father _______________

(f) I am authorized to attend UHQ rally because I am son/ brother of No ____________ Name
_____________ Regt ___________________.
(g) I hereby certify that I, son of No ______________ Name _________________ Regt ______________
am eligible for claiming bonus marks as none of my brothers have been enrolled in Army earlier/ I am not
eligible to claim bonus marks (Cut whichever is not applicable).
2. I am aware that there is only one recruitment rally conducted in a recruiting year (01 April to 31 March)
for every district and therefore I am entitled to attend only once every recruiting year from my home town
district based on my nativity/domicile certificate. I fully understand that if I attend another recruitment rally in
the same recruiting year, based on a different district Nativity/ Domicile certificate, my candidature will be
cancelled and if enrolled, I will be dismissed from service.
3. I am attending this recruitment rally based on the Nativity / Domicile certificate issued by _________
(mention the state government), details of which are as stated below :-

S/No. Cert No Date of Issue Validity Issuing authority

(a)
4. Details of nativity/domicile certificate held by me in past (if any) are as stated below :-

Present status
S/No. District Issued by Issuing date
(Valid/Expired)

(a)

(b)

(c)

5. I hereby certify that till date I have attended the following Army Recruitment Rallies :-

Nativity/
Army Month Category
Recruitment Domicile
S/No. Recruitment and Applied
Rally Venue Certificate
Office Year For
Address used

(a)

(b)

(c)
6. I give an undertaking that all documents submitted by me are correct. All documents issued by govt org
/ offices have been signed by authorized designated and govt officials. If any document at any stage is
found fake or wrong info is furnished by me, I am aware that I will be dismissed from service and FIR will be
lodged against me .

Signature of Notary Signature of Candidate

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