Ais-Upsc - Selection Forms Details
Ais-Upsc - Selection Forms Details
1. Vacancies: A copy of order of the Govt. of India clearly determining the vacancies for the
2. Seniority List: A complete and published seniority list of State Civil/Police/Forest Service
officers from amongst the promotions are to be made to the IAS/IPS/IFS indicating the date of birth, date of
confirmation, status of SC/ST, date of continuous appointment in the qualifying grade of SCS/SPS/SFS
etc.
3. Eligibility List: Eligibility list (year-wise eligibility lists where applicable) of officers required to
be considered by the Selection Committee as per Annexure 3.1 (SCS), 3.2 (SPS) & 3.3. (SFS). Bio Data in
respect of Non-SCS officers as per the format in Annexure 3.4. A consolidated statement of Non-SCS
officers proposed for consideration of the Selection Committee as per the format in Annedxure 3.4-A.
proceedings pending against the eligible officers indicating the brief facts and nature of charges as well as
the date of issue of charge-sheet to the officer concerned/date of filing the charge-sheet in the court of law
as per the format in Annexure 4.1. In case any of the DE/DP etc. has resulted in the imposition of penalty,
the details of such penalties may also be provided as per the format in Annexure 4.2.
5. Integrity Certificate: The integrity certificate certifying/ withholding the integrity of the
eligible officers duly signed by the Chief Secretary. The reasons for withholding the integrity of the eligible
officers may also be indicated alongwith brief details thereto as per the format in Annexure 5.
6. Adverse remarks/entries in ACRs: A statement of communication of adverse
remarks in the ACRs of the State Service officers and representations against such remarks as per DPAR
7. ACR dossiers: Complete ACR dossiers of the eligible officers together with a statement
giving the year-wise availability of ACRs to be furnished with the proposal. If some of the ACRs/Part ACRs
are not available, a certificate indicating the valid reasons as contained in Govt. of India (DOPT) OM dated
July, 1988 may be added in the respective ACR dossiers. A consolidated statement giving the status of
Non-availability of ACRs and the reasons thereof may also be furnished to the Commission as per the
format in Annexure 7.
8. Court directions: A statement of court cases and court orders (interim or final) having a
bearing on the Select List indicating the brief facts and the relevance of the court case to the Select List be
9. Composition of SCM At the time of meeting a certificate may also be furnished to the effect
that the officers of the State Govt. attending the SCM are exactly in accordance with the revised
composition of Selection Committee specified in the Regulations of the IAS/IPS/IFS promotion Regulation
and these officer are members of an All India Services as per Annexure 9.
10. No Relation Certificate: Before the start of the Selection Committee Meeting, the members of
the Selection Committee are required to sign a No Relation Certificate certifying that none of his/her close
relatives are being considered by the Selection Committee and that he is otherwise also not interested in
any particular candidate. The Members of the Selection Committee representing the State Government
may be informed of this requirement and a certificate to this effect may also be obtained from them in
12. In case of Non-SCS officers in addition to paras 1, 3 to 10 above, a certificate may also be
furnished to the effect that the Non-SCS officers recommended by the State Govt. are of outstanding merit
and ability, hold gazetted post in substantive capacity and have completed not less than 8 years of
continuous service under the State Govt. on the 1 st day of January of the year of the Select List in any post
which has been declared equivalent to the post of Deputy Collector in the State Civil Service as per the
format in Annexure 11. A copy of the order declaring the equivalence of Non-SCS posts under the State to
furnished.
Check list-I
Check-list for sending proposals for convening the Selection Committee Meetings for
promotion to IAS(SCS)/IPS/IFS
Name of State:
1. VACANCIES:
2. SENIORITY LIST:
3. ELIGIBILITY LIST:
5. STATUS OF PENALTIES:
6. INTEGRITY :
9. UCOURT DIRECTIONS:
10 IMPLEMENTATION OF RECOMMENDATIONS OF
. PREVIOUS SCM:
Whether copy(ies) of appointment order(s) of the immediately
preceding Select List(s) have been enclosed?
11 CERTIFICATE REGARDING COMPOSITION OF SELECTION
. COMMITTEE MEETING:
It is certified that the information furnished above is complete. In the event of any
incomplete information/deficiencies in the documents enclosed with the proposal are
found whether at the time of submission of proposal or subsequently, it is understood
that the Commission will not entertain the proposal and return the same to the State
Government.
( )
Name_________
Designation________
(to be signed by officer not below the rank of Secretary to the State Government)
Check list-II
Check-list for sending proposals for convening the Selection Committee Meeting for
appointment to IAS(Non-SCS)
Name of State:
Year of Select List to be prepared:
The proposal shall be treated as complete if the information furnished to the Commission in the
Annexures/documents, as per check-list, is complete in all respects with all columns duly filled
with requisite documents/ACRs sent alongwith the proposals. The page number of the
documents attached with the proposal may also be indicated.
Sl. Whether
No. Yes/No.
Please indicate
page no. at
which
document is
attached.
1. Vacancies
a No. of vacancies determined by Govt. of India
b. Whether a copy of the order of Govt. of India determining
the vacancies enclosed?
2. Eligibility list
a. Whether a consolidated statement of Non-SCS officers
proposed for consideration of the Selection Committee
furnished in Annexure 3.4-A?
5. ACR dossiers
a. Whether a statement of availability of ACRs of eligible
officers is furnished in revised Annexure-7?
b. Whether complete ACR dossiers of eligible officers have
been furnished?
8. No Relation Certificate
a. Whether the members of the Selection Committee
informed the requirement of signing a No Relation
Certificate in Annexure 10 before the SCM?
It is certified that the information furnished above is complete. In the event of any incomplete
information/deficiencies in the documents enclosed with the proposal are found whether at the
time of submission of proposal or subsequently, it is understood that the Commission will not
entertain the proposal and return the same to the State Government.
( )
Name_________
Designation________
(to be signed by officer not below the rank of Secretary to the State Government)
ANNEXURE 3.1 (SCS)
S. Name of Whether Date of Whether the officer Whether the officer is Date of Date of
No Officers SC/ST/ Birth is below 54 years available on 31st of appointment Confirmation in
OBC of age as on 1st of Dec of the year for in the State the State Civil
Jan of the year for which SL is to be Civil Service Service
which SL is to be prepared?
prepared?
1 2 3 4 5 6 7 8
Note :
1. If any officer is being excluded in the Eligibility List but his name figures in the Seniority List, the
reasons for his exclusion may be indicated.
2. Similarly, in case any officer is being included in the Eligibility List but his name does not figure in the
Seniority List, the reasons for his inclusion may also be indicated.
It is certified that the Eligibility List includes the name of only such officers who have not
attained the age of 54 years as on 1 st January of Select List year and were available in service as
on 31st December of Select List year;
Signature
Name...............................
Designation......................
ANNEXURE 3.2 (SPS)
S.No Name of Whether Date of Whether the officer Whether the officer Date of Date of Date
Officers SC/ST/ Birth is below 54 years of is available on appointment Confirmation offici
OBC age as on 1st of Jan 31st of Dec of the in the State in the State of
of the year for which year for which SL is Police Police Equi
SL is to be to be prepared? Service Service
prepared?
1 2 3 4 5 6 7 8
Note 1. If any officer is being excluded in the Eligibility List but his name figures in the Seniority List,
the reasons for his exclusion may be indicated.
2. Similarly, in case any officer is being included in the Eligibility List but his name does not
figure in the Seniority List, the reasons for his inclusion may also be indicated.
It is certified that the Eligibility List includes the name of only such officers who have not
attained the age of 54 years as on 1 st January of Select List year and were available in service as
on 31st December of Select List year;
Signature
Name...............................
Designation......................
S Name of Whether Date Whether the officer Whether the Date of Date of Date of
No Officers SC/ST/ of is below 54 years officer is appt in Confirmation in continuous
OBC Birth of age as on 1st of available on the the State officiation in
Jan of the year for st
31 of Dec of State Forest Service posts
which SL is to be the year for Forest included in
prepared? which SL is to Service the State
be prepared? Forest
Service
1 2 3 4 5 6 7 8 9
Note : 1. If any officer is being excluded in the Eligibility List but his name figures in the
Seniority List, the reasons for his exclusion may be indicated.
2. Similarly, in case any officer is being included in the Eligibility List but his name does not
figure in the Seniority List, the reasons for his inclusion may also be indicated.
B. CERTIFICATE TO BE SIGNED BY AN OFFICER NOT BELOW THE RANK OF SECRETARY
IN THE STATE GOVERNMENT
It is certified that the Eligibility List includes the name of only such officers who have not
attained the age of 54 years as on 1 st January of Select List year and were available in service as
on 31st December of Select List year;
Signature
Name...............................
Designation......................
Annexure 3.4 (Non-SCS)
1. Name of Officer :
2. Date of Birth :
3. Educational. Qualifications:
5. Date of Confirmation :
in Gezetted posts
S.No. Name of Whether Date of Post held Date from which Whether the
Officer SC/ST/OBC Birth (Declared continuously post held is
(S/Shri) equivalent to holding the post Gazetted
the post of Dy. (Declared and in
Collector in the equivalent to the substantive
State Civil post of Dy. capacity, if
Services) Collector in the so the date
State Civil of
Service) confirmation
in that post
ANNEXURE-4.1
S.No. Name of the Date of filing of Brief facts & Present Status
Officers charge sheet before Nature of
the Court Charges
Note : The Proceedings are deemed to be pending only if a charge sheet has already been
served upon the officer/filed in a Court of Law as laid down in the Promotion Regulations
[Explanation I under Proviso to Reg. 5(5)].
ANNEXURE 4.2
(A) DETAILS OF PENALTIES IMPOSED ON ELIGIBLE OFFICERS DURING THE LAST 10 YEARS
Dated :
INTEGRITY CERTIFICATE
The State Government certifies the integrity of following officers with reference
to the entries in his/their Annual Confidential Reports:-
S.No. Names
Dated:
INTEGRITY CERTIFICATE
The State Government withholds the integrity of following officer(s) for the
reasons indicated against each :-
(ii) Adverse entries in respect of the following eligible officers have been communicated
but no representations have been so far received from the officers concerned but the time limit
to represent is not yet over.
S.No. Name
Period
(iii) Representations against adverse entries in respect of the following officers have been
received within the stipulated time but the decision of the State Government is yet to be taken.
S.No. Name
Period
*Note: All India Service Manual Part-II Edition (GoI instructions-8-page 58) may be
referred.
ANNEXURE-7
(A)
Sl. Name of Officer Period of ACR Whether available?. Whether ACR is duly Whether the If
No. (preceding 5 reported/reviewed/accepted? ACR is valid as R
years) If yes, If no, whether per ACR Rules w
mark No Report of State Govt. tra
(Separate row (√) Certificate If yes If no, indicate If yes, If no, th
for each part (NRC) with mark (√) the deficiency mark indicate du
ACR) e.g. @
valid reasons with reasons (√) reasons of
added? e.g. not ra
2007-08, 2008- If If no, reviewed etc. St
09, 2009-10, yes, indicate th
2010-11, 2011- mark reasons If
12. (√) ye
m
(√
1. 2 3 4 5 6 7 8 9 10 1
2.
* The State Government is required to furnish the complete ACR dossier of the officer. The ACRs
for preceding five years may be duly flagged. If some ACRs are not written and NRC added,
preceding ACRs may be flagged and details furnished as above.
* The validity of the ACRs furnished to the Commission may be checked by the State Government
in terms of the ACR rules of the State Govt., if any. The validity of the UN Report/Special Report,
etc., if any, as per ACR Rules of State Government may be indicated clearly.
(To be signed by an officer not below the rank of Secretary in the State Government.
It is certified that all orders/Communications issued by the State Government in respect of ACRs of
eligible officers in pursuance of court directions or otherwise have been incorporated in the relevant
ACRs/placed in the relevant ACRs.
Signature
Name...............................
Designation......................
ANNEXURE-8
A STATEMENT SHOWING COURT CASES AND COURT ORDERS HAVING BEARING ON THE
SELECT LIST
S Name of Case Name of Date of Orders Directions Whether the Whether appeals Implication
No. Applicants No. Court including (in brief) order(s) has been have been filed on the
interim complied with? If and if so whether current
order(s) & yes, details stay orders have Select List
Compliance thereof. If not, been obtained?
Date reasons therefor.
ANNEXURE-9
Certificate (*)
It is certified that the officers of the State Govt. attending the SCM are exactly in
accordance with the composition of Selection Committee specified in the Regulation 3 of
IAS/IPS/IFS Promotion Regulations and these officers are members of an All India Service.
(Secretary)
NO RELATION CERTIFICATE
Certified that none of my close relatives are being considered by the Selection
Committee for promotion to IAS/IPS/IFS of __________ cadre and that I am otherwise not
1. Signature_______________________________
Name ( )
Designation
2. Signature_______________________________
Name ( )
Designation
3. Signature______________________________
Name ( )
Designation
4. Signature______________________________
Name ( )
Designation
5. Signature______________________________
Name ( )
Annexure- 11
Certified that all the officers recommended by the State Govt. are of outstanding merit and ability,
holding gazetted post in a substantive capacity and have completed not less than 8 years of
continuous service under the State Govt. on the first day of January of the Select List Year in a
post which has been declared equivalent to the post of Dy. Collector in the State Civil
Service.
( )
(*) Notes : 1. A copy of the order issued by the State Govt declaring the posts in the Non-State Civil
Service equivalent to the post of Dy Collector is to be invariably enclosed.
2. While declaring posts to be equivalent, the State Govt may kindly take into
consideration the clarifications issued by the GOI,DOP&T to Govt of Kerala on the matter
vide letter No. F.14015/30/2001-AIS(I) dated 30.05.2001 as extracted below :-
irrespective of the scale of pay of the post in the Non-SCS, being the same or above
the scale of post of the Deputy Collector, unless it is accompanied with a declaration of
the State Government as to its equivalence as of duties and importance to that of
Deputy Collector in the State Civil Service, such proposal will not be in conformity with
the relevant provisions in this regard.