deputation/absorption basis.

1. Name and Address (in block letters) :
   
   
2. Date of Birth (in Christian era)
   
   
3. Date of retirement under Central Govt.
   
   
4. Whether belongs to SC/ST/OBC : Rules
   
   
5. Educational and other technical qualifications possessed. :
   
   
6. Whether Education and other qualifications required for the post are satisfied. (If any other qualification has been treated as equivalent to the one prescribed in the rules, state the authority for the same).
   
   
7. Please state clearly whether in the light of entries made by you above, you meet the requirement of the post.
   
   
8. Details of Employment, in chronological order( Enclose a separate sheet, duly authenticated by your signature, if the space below in insufficient).
   
   
9. Nature of present employmenti.e. Ad-hoc : Or Temporary or Quasi-Permanent or Permanent:
   
   
10. Experienceininvestigation ofcriminal cases Enquiry, vigilance or intelligence investigation work :
    
    
    1. In case the present employment is held : On deputation/contract basis, please state
       
       
    2. a) The date of initial appointment b) Period of appointment on deputation/contract. c) Name of the parent office/organization to which you belong.
    1. Additional details about present employment Please state whether working under:
       
       
       1. Central Government
          
          
       2. State Government
          
          
       3. Autonomous Organization
          
          
       4. Government Undertaking
          
          
       5. University
          
          
       6. Others
          
          
11. Please state whether you are working in the same Department and are in the feeder grade or feeder to feeder grade.
    
    
12. AreyouinRevised Scale of Pay?ifyesgive the datefrom Which the revision took place and also indicate the Pre-revised scale/Pay Band with Grade Pay.
    
    
13. Total emoluments per month now drawn. :
    
    
14. Additional information, if any, which you would like to Mention in support of your suitability for the post . () this among other things may provide information with regard to (1) additional academic qualifications ( ii) Professional training and (iii) work experience over and above prescribed in the Vacancy Circular/Advertisement) (Note:Enclose a separate sheet, if the space is insufficient)
    
    
15. Whether the post held in parent Deptt. Is ( Gazetted GroupA orGazetted Group B or Non-Gazetted)
    
    
16. Whether willing to serve in any Branch of the CBI through-out the country if not, indicate choice or at least 3 places in order for preference.
    
    
17. Complete Postal Address with contact number of the Controlling Authority with whom correspondence could be made.
    
    

Ihave carefully gone through the vacancy circular/advertisement and I am well aware that the Curriculum Vitae duly supported by documents submitted by me will also be assessed by the selection committee at the tie of selection for the post. Certified that the information furnished above are true to my knowledge and belief and noting has been concealed there from.

Signature-----------------Designation____________

Complete Postal Address( with contact number

CERTIFICATE BY THE SPONSORING AUTHORITY

1. Certified that the information furnished by the applicant has been checked and is in accordance with the official records.
   
   
2. It is certified that no disciplinary/vigilance case is pending or contemplated against the applicant and he is clear from the vigilance angle.
   
   
3. His integrity is certified.
   
   
4. It is certified that no major or minor penalties have been imposed on the officer during the last ten years.
   
   
5. In the event of the selection of the officer, he will be relieved to join the new assignment.
   
   

Dated :

Place : Signature Name & Designation (Official Seal)