Indian Post Payments Bank
Indian Post Payments Bank
Corporate Office, Speed Post Centre Building, Bhai Veer Sing Marg, New Delhi -110001
====================================================================================
RECRUITMENT OF CHIEF OPERATING OFFICER (COO), CHIEF COMPLIANCE OFFICER
(CCO), CHIEF FINANCE OFFICER (CFO), CHIEF HR OFFICER (CHRO)
India Post Payments Bank Limited (IPPB) has been setup under the Department of Post, Ministry of
Communications with 100% equity owned by Government of India having 650 branches all over India which
aims to utilize all of India's 1,55,015 post offices as access points and 3~Lakh Postmen and Gramin Dak Sewaks
(GDS) to provide doorstep banking services. IPPB is leading the next revolution of banking and financial
literacy and this new model will pave the way for India's largest banking network to reach each and every corner
of the nation.
In order to support our future growth and transformation challenges, we invite applications from qualified,
energetic and dynamic candidates through online application mode in different disciplines as per details given
below. Interested candidates who fulfil the eligibility criteria may apply online from 02.08.2025 to 22.08.2025
by visiting our website www.ippbonline.com. No other mode of application will be accepted.
1. Important Dates:
(i) Opening date for On-line Registration of Applications 02.08.2025: 10.00 AM
(ii) Last date of On-line Submission of Applications with Fee 22.08.2025: 11.59 PM
2.
Abbreviations used: TEGS: Top Executive Grade/ Scale, UR: Un-reserved, OBC (NCL): Other Backward
Classes (Non-Creamy Layer), EWS: Economically Weaker Section, SC: Scheduled Caste, ST: Scheduled
Tribe.
3. 2. Eligibility Criteria: The age and post qualification experience as on 01.07.2025 for the regular posts
specified at table 3 are prescribed as under:
4.
age Post Qualification Work
Scale Designation/ Post
as on 01.07.2025 Experience in Officer Cadre
TEGS-VI Deputy General Manager 35 to 55 Years 15 Years
TEGS –VII General Manager 38 to 55 Years 18 Years
The age and post qualification experience as on 01.07.2025 for the contractual posts specified at Point 3 (b)
are prescribed as under:
1|Page
3. Details of number of regular vacancies (tentative) including backlog reserved vacancies:
Note: The CFO vacancy is only one which will be either filled in Scale VI or VII position where most suitable candidate will be
found. The vacancies are tentative and may increase or decrease as per requirement of the Bank.
2|Page
Post Qualification Work
Experience (for the candidates
applying for Scale VII):
4. (b) Job description and minimum eligibility criteria for contractual vacancies:
Position Job Description Minimum Eligibility Criteria
1. To apprise the Board and senior management on Minimum Educational Qualification:
regulations, rules and standards and any further
Graduate in any discipline.
developments.
2. To provide clarification on any compliance related
Chief issues.
Compliance 3. To conduct assessment of the compliance risk (at
Officer least once a year) and to develop a risk-oriented Note:
activity plan for compliance assessment. The
activity plan should be submitted to the ACB for CA/CS/MBA Finance/Post Graduate degree
or equivalent is preferred.
3|Page
approval and be made available to the internal Certified Banking Compliance
audit. Professional by IIBF is preferred.
4. To report promptly to the Board / ACB / MD &
CEO about any major changes / observations
relating to the compliance risk. Post Qualification work experience:
5. To periodically report on compliance
Minimum 18 years of experience must be in
failures/breaches to the Board/ACB and circulating
the banking or financial services with at
to the concerned functional heads. least 5 years of experience shall be in the
6. To monitor and periodically test compliance by Audit / Finance / Compliance / Legal / Risk
performing sufficient and representative Management functions in senior
compliance testing. The results of the compliance management level.
testing should be placed to Board/ACB/MD &
CEO. Skills – The CCO shall have good
7. To examine sustenance of compliance as an integral understanding of industry and risk
part of compliance testing and annual compliance management, knowledge of regulations,
assessment exercise. legal framework and sensitivity to
8. To ensure compliance of Supervisory observations supervisors’ expectations
made by RBI and/or any other directions in both
letter and spirit in a time bound and sustainable
manner.
Primary Responsibilities: Minimum Educational Qualification:
Lead the operations of the Bank, including but not
limited to, customer onboarding, customer service & Graduate in any discipline.
grievance management, back office operations,
technology, human resources etc Post Qualification work experience:
• Frame operations governance framework, The candidate must have minimum
policies and processes to support business experience of 18 years in Banks/ Financial
goals and drive optimization & framework Institutions. Out of which minimum 10 years
• Strive towards excellence in customer service of experience in handling operations of a
& regulatory compliance, in line with leading/ Bank/ Financial Institution.
emerging trends.
• Alignment of Bank’s strategy and operations And
with key stakeholders – DoP and Government
of India. The candidate should have worked in a
• Oversee vendor relationship and compliance position not below three levels of MD &
with service level agreements/ contractual CEO of a Bank/ Financial Institution, for a
commitments. minimum period of two years, in the last five
Chief years.
Operating Skills & Competencies:
Officer
• Appropriate and relevant skills related to all
areas of operational risk management and
compliance
• Knowledge of banking, company, employment
and tax laws and regulations, banking
compliance regulations and accounting
principles
• Ability to monitor and assess achievements
against performance targets, quality standards
and service agreements that aligns with the
organization’s business plan
• Excellent oral and written communication
skills with advanced skills related to the
preparation and submission of regulatory,
statutory and risk/compliance reports
4|Page
• Put in place the operations framework, policies
and processes to support business goals.
• Ensure operations alignment with DoP, GoI
and 3rd party partner operations.
• Develop strong operational risk management
framework and processes to preserve the
safety, efficiency and operational resilience of
the bank.
• Establish a rapport with various stakeholders –
both internal and external
6. Selection Process:
a) Selection will be made on the basis of Interview. However, the Bank reserves the right to conduct
assessment, Group Discussion or Online Test in addition to interview. Merely satisfying the eligibility
norms do not entitle a candidate to be called for Interview/Group Discussion or Online Test.
b) IPPB reserves the right to call only the requisite number of candidates, as decided by the competent
authority at the Bank, for the Assessment/ Interview/ Group Discussion or Online Test after preliminary
screening/ short listing with reference to candidates’ qualification, experience, profile vis-a-vis job
requirements, etc.
c) Results of the candidates who have qualified for various stages of the recruitment process and the list of
candidates finally selected will be made available on the website.
5|Page
7. Application Fee / Intimation Charges (Non-Refundable)
i. Candidates should ensure their eligibility before paying the fees/applying online.
ii. Application once submitted will not be allowed to be withdrawn and fee once paid will NOT be refunded
under any circumstances nor can it be held in reserve for any other future selection process.
(a) Reservations and relaxations for SC/ ST/ OBC (Non-Creamy Layer) / PWD (Degree of Disability 40% or
above) candidates will be provided as per guidelines of Govt. of India for the purpose.
(b) Age relaxation for Ex-Servicemen category candidates is applicable as per Government of India guidelines.
(c) The upper age limit is relaxed by 5 years for SC/ST, 3 Years for OBC (Non-Creamy Layer) and 10 years
for PWD-UR, 13 years for PWD-OBC (Non-Creamy layer) and 15 years for PWD-SC/ST candidates.
(d) The age of candidates claiming relaxation under point 8 should not exceed 56 years as on 01.07.2025.
(e) The OBC candidates who belong to ‘Creamy Layer’ are not entitled for concession admissible to OBC
Category and such candidates have to indicate their category as unreserved.
11. Posting: The selected officers will be posted at Corporate Office, New Delhi. However, the Bank reserves the
right to post the officer anywhere in India. Candidates willing to serve anywhere in India should apply.
12. Application Guidelines: A candidate can apply for more than one post by filling separate applications for
each post. Candidates can apply online only from 02.08.2025 to 22.08.2025. No other mode of application
(other than online) will be accepted.
6|Page
i. Scan their photograph and signature ensuring that both the photograph and signature adhere to the required
specifications as mentioned in this advertisement at Annexure-I.
ii. Keep the necessary details/documents for Online Payment of the requisite application fee/ intimation charges
ready.
iii. Have a valid personal email ID which should be kept active till the completion of this recruitment process.
IPPB may send call letters for the Interview etc. through the registered e-mail ID. Under no circumstances, a
candidate should share with/mention e-mail ID to / of any other person. In case a candidate does not have a
valid personal e-mail ID, he/she should create his/her new e-mail ID before applying on-line and must maintain
that email account.
Candidates are advised to click here https://ippbonline.com/web/ippb/current- openings to open the online
Application Form.
i. To register their application candidates will be entering their basic information in the online application form.
After that a provisional registration number and password will be generated by the system and displayed on
the screen. Candidate should note down the provisional registration number and password. An Email & SMS
indicating the Provisional Registration Number and Password will also be sent.
ii. Candidates are required to upload their photograph and signature as per the specifications given in the
Annexure I of this form.
iii. Candidates are advised to carefully fill the online application themselves as no change in any of the data filled
in the online application will be possible / entertained.
iv. Prior to submission of the online application, candidates are advised to use the “SAVE AND NEXT” facility
to verify the details in the online application form and modify the same, if required. No change is permitted
after clicking on FINAL SUBMIT button. Visually Impaired candidates are responsible for carefully verifying
the details filled in the online application form and ensuring that the same are correct prior to submission, as
no change is possible after submission.
v. Prescribed Formats of SC, ST, OBC, PWD certificates as applicable to be submitted at the time of interview
can be found in Annexure - II, III & IV of this advertisement.
(a) To be disqualified from the selection process for which he / she is a candidate;
(b) To be debarred, either permanently or for a specified period, from any examination or recruitment
conducted by IPPB.
7|Page
15. General information
16. The management reserves the right to fill or not to fill or partially fill any of the above positions without
assigning any reasons whatsoever. IPPB also reserves the right to cancel / restrict / modify / alter the
recruitment process, if required.
17. Any modifications/ amendments /corrigendum in respect of the above advertisement shall be made available
only on IPPB’s official website. No further press advertisement will be published. Hence prospective
applicants are advised to visit IPPB’s website regularly for this purpose.
18. All correspondence/announcements with respect to above recruitment process shall be done through e-
mail/notices on the Bank’s website. Important information regarding recruitment will be available in IPPB
website and as such, candidates are advised to visit the same frequently. It is the responsibility of the candidate
to download/print the Admit Card/ Interview Call Letters. Bank will not be responsible for any loss of email
sent, due to invalid/ wrong Email ID provided by the candidate or due to any other reason. Candidate’s E-mail
Id and Mobile No. should be valid for at least one year.
19. For any queries related to online application candidates may write on the email id: careers@ippbonline.in.
20. Any dispute with regard to recruitment against this advertisement will be settled within the jurisdiction of
Delhi only.
Sd/-
Chief HR Officer
Speed Post Centre, Bhai Veer Singh Marg, New Delhi – 110 001
8|Page
Annexure -I
Candidates can apply online only from 02.08.2025 to 22.08.2025 and no other mode of application will be
accepted.
IMPORTANT POINTS TO BE NOTED BEFORE REGISTRATION
Before applying online, candidates should-
(i) scan there:
- photograph (4.5cm × 3.5cm)
- signature (with black ink)
- left thumb impression (on white paper with black or blue ink)
- a hand-written declaration (on a white paper with black ink) (text given below)
(ii) Signature in CAPITAL LETTERS will NOT be accepted.
(iii) The left thumb impression should be properly scanned and not smudged. (If a candidate is
not having left thumb, he/she may use his/ her right thumb for applying.)
(iv) The text for the hand-written declaration is as follows –
“I, _______ (Name of the candidate), hereby declare that all the information submitted by me
in the application form is correct, true and valid. I will present the supporting documents as and
when required.”
(v) The above-mentioned hand-written declaration has to be in the candidate’s hand writing and
in English only. If it is written and uploaded by anybody else or in any other language, the
application will be considered as invalid. (In the case of Visually Impaired candidates who
cannot write may get the text of declaration typed and put their left-hand thumb impression below
the typed declaration and upload the document as per specifications.)
(vi) Keep the recent Resume (in PDF Format) ready.
(vii) Keep the necessary details/documents ready to make Online Payment of the requisite
application fee/ intimation charges
(viii) Have a valid personal email ID and mobile no., which should be kept active till the completion
of this Recruitment Process. IPPB may send intimation about various steps/procedures
through the registered e-mail ID. In case a candidate does not have a valid personal e-mail
ID, he/she should create his/her new e-mail ID and mobile no. before applying on-line and
must maintain that email account and mobile number.
Bank Transaction charges for Online Payment of application fees/intimation charges will have to be borne by
the candidate.
A. Application Registration
9|Page
displayed on the screen. Candidate should note down the Provisional Registration Number and Password.
An Email & SMS indicating the Provisional Registration number and Password will also be sent.
3. In case the candidate is unable to complete the application form in one go, he / she can save the data already
entered by choosing "SAVE AND NEXT" tab. Prior to submission of the online application candidates are
advised to use the "SAVE AND NEXT" facility to verify the details in the online application form and modify
the same if required. Visually Impaired candidates should fill the application form carefully and verify/ get
the details verified to ensure that the same are correct prior to final submission.
4. Candidates are advised to carefully fill and verify the details filled in the online application themselves as no
change will be possible/ entertained after clicking the COMPLETE REGESTRATION BUTTON.
5. The Name of the candidate or his /her Father/ Husband etc. should be spelt correctly in the application as it
appears in the Certificates/ Mark sheets/Identity proof. Any change/alteration found may disqualify the
candidature.
6. Validate your details and Save your application by clicking the 'Validate your details' and 'Save & Next'
button.
7. Candidates can proceed to upload Photo & Signature as per the specifications given in the Guidelines for
Scanning and Upload of Photograph and Signature detailed under point "C".
8. Candidates can proceed to fill other details of the Application Form.
9. Click on the Preview Tab to preview and verify the entire application form before COMPLETE
REGESTRATION.
10. Modify details, if required, and click on 'COMPLETE REGESTRATION' ONLY after verifying and
ensuring that the photograph, signature uploaded and other details filled by you are correct.
11. Click on 'Payment' Tab and proceed for payment.
12. Click on 'Submit' button.
B. PAYMENT OF FEES
ONLINE MODE
1. The application form is integrated with the payment gateway and the payment process can be completed by
following the instructions.
2. The payment can be made by using Debit Cards (RuPay/Visa/MasterCard/Maestro), Credit Cards, Internet
Banking, IMPS, Cash Cards/ Mobile Wallets.
3. After submitting your payment information in the online application form, PLEASE WAIT FOR THE
INTIMATION FROM THE SERVER. DO NOT PRESS BACK OR REFRESH BUTTON IN ORDER TO
AVOID DOUBLE CHARGE
4. On successful completion of the transaction, an e-Receipt will be generated.
5. Non-generation of 'E-Receipt' indicates PAYMENT FAILURE. On failure of payment, Candidates are
advised to login again using their Provisional Registration Number and Password and repeat the process of
payment.
6. Candidates are required to take a printout of the e-Receipt and online Application Form containing fee
details. Please note that if the same cannot be generated, online transaction may not have been
successful.
7. For Credit Card users: All charges are listed in Indian Rupee. If you use a non-Indian credit card, your bank
will convert to your local currency based on prevailing exchange rates.
8. To ensure the security of your data, please close the browser window once your transaction is completed.
9. There is facility to print application form containing fee details after payment of fees.
Before applying online a candidate will be required to have a scanned (digital) image of his/her photograph,
signature, left thumb impression and the hand written declaration as per the specifications given below:
• Photograph Image: (4.5cm × 3.5cm)
10 | P a g e
o Photograph must be a recent passport style colour picture.
o Make sure that the picture is in colour, taken against a light-colored, preferably white, background.
o Look straight at the camera with a relaxed face.
o If the picture is taken on a sunny day, have the sun behind you, or place yourself in the shade, so that
you are not squinting and there are no harsh shadows.
o If you have to use flash, ensure there's no "red-eye".
o If you wear glasses make sure that there are no reflections and your eyes can be clearly seen.
o Caps, hats and dark glasses are not acceptable. Religious headwear is allowed but it must not cover
your face.
o Dimensions 200 x 230 pixels (preferred).
o Size of file should be between 20kb–50 kb.
o Ensure that the size of the scanned image is not more than 50kb. If the size of the file is more than 50
kb, then adjust the settings of the scanner such as the DPI resolution, no. of colours etc., during the
process of scanning.
• Photograph Capture:
In addition to the above photograph, candidates will also be required to capture and upload their live
photograph either by using webcam or mobile phone.
• On selecting “Capture Photo” option, candidates’ webcam will be activated allowing them to click
their picture, which will get auto uploaded in the application form.
• On selecting “Click here to Scan” option, candidates can use their mobile phone to scan the QR code,
which will redirect to a website, allowing to click photograph on their mobile phone. On selecting the
taken picture, photograph will get auto uploaded in the application form.
Do’s and Don’ts of Photo Capture
Dos:
• Ensure the photo is captured against a light coloured, preferably white background and
there is adequate light.
• Look straight at the webcam/ camera.
• Photograph should be of passport size.
Don’ts:
• Small size photograph not to be clicked/ uploaded.
• Coloured glasses or sunglasses/ Cap should not be worn.
• Shadow on face/ not facing the camera/ distorted face/ face covered with mask / blurred
image.
• Photo not taken in dark/ improper background
Signature, left thumb impression and hand-written declaration Image and Resume:
• The applicant has to sign on white paper with Black Ink pen.
o Dimensions 140 x 60 pixels (preferred).
o Size of file should be between 10kb – 20kb for signature and 20kb - 50kb for left thumb
impression.
o Ensure that the size of the scanned image is not more than 20kb.
• The applicant has to put his left thumb impression on a white paper with black or blue ink.
o File type: jpg / jpeg
o Dimensions: 240 x 240 pixels in 200 DPI (Preferred for required quality) i.e. 3 cm * 3 cm (Width
* Height)
o File Size: 20 KB – 50 KB
• The applicant has to write the declaration in English clearly on a white paper with black ink.
o File type: jpg / jpeg
o Dimensions: 800 x 400 pixels in 200 DPI (Preferred for required quality) i.e. 10 cm * 5 cm (Width
* Height)
11 | P a g e
o File Size: 50 KB – 100 KB
• The applicant should upload the recent Resume which includes all the relevant information.
o File type: PDF
o File Size: 20 KB – 500 KB
• The signature, left thumb impression, the hand-written declaration and the Resume should be of the
applicant and not by any other person.
• If the Applicant’s signature on the attendance sheet or Call letter, signed at the time of the examination,
does not match the signature uploaded, the applicant will be disqualified.
• Signature / Hand written declaration in CAPITAL LETTERS shall NOT be accepted.
12 | P a g e
(3) Candidate should also ensure that photo is uploaded at the place of photo and signature at the place of
signature. If photo in place of photo and signature in place of signature is not uploaded properly,
candidate will not be allowed to appear for the exam.
(4) Candidate must ensure that Photo to be uploaded is of required size and the face should be clearly visible.
(5) If the photo is not uploaded at the place of Photo Admission for Examination will be rejected/denied.
Candidate him/herself will be responsible for the same.
(6) Candidates should ensure that the signature uploaded is clearly visible
(7) After registering online candidates are advised to take a printout of their system generated online
application forms.
Note:
(1) In case the left thumb impression or the hand-written declaration is unclear / smudged the candidate’s,
application may be rejected.
(2) After uploading the left thumb impression / hand written declaration / Resume in the online application form
candidates should check that the images/files are clear and have been uploaded correctly. In case the left
thumb impression or the hand-written declaration is not prominently visible, the candidate may edit his/ her
application and re-upload his/ her thumb impression / hand written declaration, prior to submitting the form.
After registering online candidates are advised to take a printout of their system generated online application
forms.
13 | P a g e
Annexure -II - SC/ST Certificate Format
FORM OF CERTIFICATE TO BE PRODUCED BY A CANDIDATE BELONGING TO SCHEDULED
CASTE OR SCHEDULED TRIBE IN SUPPORT OF HIS / HER CLAIM
*[as amended by the Scheduled Castes and Scheduled Tribes lists Modification) Order,1956; the Bombay
Reorganisation Act, 1960; the Punjab Reorganisation Act 1966, the State of Himachal Pradesh Act, 1970, the
North-Eastern Areas (Reorganisation) Act, 1971, the Constitution (Scheduled Castes and Scheduled Tribes)
Order (Amendment) Act,1976, The State of Mizoram Act, 1986, the State of Arunachal Pradesh Act, 1986 and
the Goa, Daman and Diu (Reorganization) Act, 1987.],:
* The Constitution (Jammu and Kashmir) Scheduled Castes Order, 1956;
* The Constitution (Andaman and Nicobar Islands) Scheduled Tribes Order, 1959 as amended by the
Scheduled Castes and Scheduled Tribes Orders (Amendment) Act, 1976;
* The Constitution (Dadra and Nagar Haveli) Scheduled Castes Order, 1962;
* The Constitution (Dadra and Nagar Haveli) Scheduled Tribes Order, 1962;
* The Constitution (Pondicherry) Scheduled Castes Order 1964;
* The Constitution (Uttar Pradesh) Scheduled Tribes Order,1967;
* The Constitution (Goa, Daman and Diu) Scheduled Castes Order, 1968;
* The Constitution (Goa, Daman and Diu) Scheduled Tribes Order, 1968;
* The Constitution (Nagaland) Scheduled Tribes Order, 1970;
* The Constitution (Sikkim) Scheduled Castes Order, 1978;
* The Constitution (Sikkim) Scheduled Tribes Order, 1978;
* The Constitution (Jammu and Kashmir) Scheduled Tribes Order, 1989;
* The Constitution (Scheduled Castes) Orders (Amendment)Act, 1990;
* The Constitution (ST) Orders (Amendment) Ordinance, 1991;
* The Constitution (ST) Orders (Second Amendment) Act,1991;
* The Constitution (ST) Orders (Amendment) Ordinance, 1996;
* The Scheduled Caste and Scheduled Tribes Orders (Amendment) Act 2002;
* The Constitution (Scheduled Castes) Order (Amendment) Act, 2002;
* Order (Amendment) Act, 2002;
* The Constitution (Scheduled Caste) Order (Second Amendment) Act, 2002]
# 2. Applicable in the case of Scheduled Castes / Scheduled Tribes persons , who have migrated from one State
/ Union Territory Administration.
This certificate is issued on the basis of the Scheduled Castes / Scheduled Tribes* Certificate issued to Shri /
Smt / Kumari* _________________________________________Father /Mother* of Sri / Smt /
Kumari*____________________________________________________of village/
14 | P a g e
town*_________________ in District/Division*____________________of the State/Union
Territory*_________________________________ who belong to the______________________ Caste /
Tribe* which is recognized as a Scheduled Caste/Scheduled Tribe* in the State/Union Territory* issued by the
____________________________________[Name of the authority] vide their order No.
___________________________ dated _______________________.
3. Shri/Smt/Kumari*____________________________________________and/or* his/her* family ordinarily
reside(s) in village/town*__________________________ of ____________________ District / Division* of
the State / Union Territory* of _____________________.
Signature _____________________
Designation ___________________
Place: [With seal of Office]
Date : State/Union Territory:
Note: The term "Ordinarily resides" used here will have the same meaning as in Section 20 of the Representation
of the Peoples Act, 1950.
-------------------------------------------------------------------------------------------------------------------------------------
-
* Please delete the words which are not applicable.
# Delete the paragraph which is not applicable.
List of authorities empowered to issue Caste / Tribe Certificates:
1. District Magistrate / Additional District Magistrate / Collector / Deputy Commissioner / Additional Deputy
Commissioner / Deputy Collector/I Class Stipendiary Magistrate / Sub-Divisional Magistrate / Extra-Asst.
Commissioner / Taluka Magistrate / Executive Magistrate.
4. Sub-Divisional Officers of the area where the candidate and / or his family normally resides.
Note: The Certificate is subject to amendment/modification of Scheduled Castes and Scheduled Tribes lists
from time to time.
15 | P a g e
ANNEXURE III: OBC Certificate Format
This is also to certify that he/she does not belong to the persons /sections (Creamy Layer) mentioned in column
3 of the Schedule to the Government of India, Department of Personnel & Training OM No.36012/22/93-
Estt.[SCT], dated 8-9-1993 **.
Dated : District Magistrate
Deputy Commissioner etc.
Seal
* the authority issuing the certificate may have to mention the details of Resolution of Government of India, in
which the caste of the candidate is mentioned as OBC.
16 | P a g e
ANNEXURE IV: PWD Certificate Format
FORM-I
Disability Certificate
(In cases of amputation or complete permanent paralysis of limbs and in cases ofblindness)
(Prescribed proforma subject to amendment from time to time)
(NAME AND ADDRESS OF THE MEDICAL AUTHORITY ISSUING THE CERTIFICATE)
son/wife/daughter of Shri
Date
of Birth (DD /MM / YY) Age years, male/female
Registration No.
permanent resident of House
No. Ward/Village/Street
Post Office District
State , whose photograph is affixed
above, and amsatisfied that :
(A) he/she is a case of:
• locomotor disability
• blindness
(Please tick as applicable)
(B) The diagnosis in his/her case is
(A) He/ She has % (in figure) percent (in
words) permanent physical impairment/blindness in relation to his/her (part of
body) as per guidelines (to be specified)
2. The applicant has submitted the following documents as proof of residence:-
17 | P a g e
FORM - II
Disability Certificate
(In case of multiple disabilities) (Prescribed proforma subject to amendment from time to time)
(NAME AND ADDRESS OF THE MEDICAL AUTHORITY ISSUING THE CERTIFICATE)
Recent PP size
attested photograph
(showing face only)
of the person with
disability
In figures: percent
In words:
percent
18 | P a g e
2. This condition is progressive/non-progressive/likely to improve/not likely toimprove.
3. Reassessment of disability is :
Or
(ii) is recommended / after years months, and thereforethis
certificate shall be valid till (DD /
MM / YY)
Name and seal of Name and seal of Member Name and seal of
Member Chairperson
(Signature / thump impression of the person in whose favour the disability certificateis
issued)
19 | P a g e
FORM - III
Disability Certificate
(In cases other than those mentioned in Form I and II)
(Prescribed proforma subject to amendment from time to time)
(NAME AND ADDRESS OF THE MEDICAL AUTHORITY ISSUING THE CERTIFICATE)
Or
(ii)
is recommended / after years _ months, and therefore this
certificate shall be valid till (DD / MM / YY) .
@ - e.g. Left/Right/both arms/legs# -
e.g. Single eye / both eyes
£ - e.g. Left / Right / both ears
Countersigned
{Countersignature and seal of the CMO/Medical Superintendent/Head of Government Hospital,
in case the certificate is issued by a medical authority who is not a governmentservant (with
seal)}
(Signature / thump impression of the person in whose favour the disability certificate is issued)
21 | P a g e