Bro-pAT{CURRICVLUM V.rTA4 PryRFORMA

I . Name and Address ( in Block Letters)

1. Date of Birth (in Christian era)
   
   
2. I) Date ofentry into service
   
   

ii) Date ofretirement under Central/ State Govemment Rules

1. EducationalQualifications
   
   
2. Whether Educational and other qualifications required for the post are satisfied. (If any qualification has been treated as equivalent to the one prescribed in the Rules, state the authority for the same)
   
   

Qualification/ ^{Experience required as Qualifications/ experience possessed by the mentioned in the advertisement / officer vacancy circular}

Essential Essential

A) Qualification A) Qualification B) Experience B) Experience

Desirable Desirable

^A) Qualification A) Qualification B) Experience B) Experience

5.1 Note: This column needs to be amplified to indicate Essential and Desirable _{Qualifications} as mentioned in the RRs by the Administrative Ministry/ Department / Office at the time of issue of Circular and issue of Advertisement in the Employment News.

1. ^{in the case of Degree and Post Graduate Qualification Elective / main subjects and subsidiary subjects may be indicated by the candidate.}
   
   
2. Please state clearly whether in the light of entries made by you above, you meet the
   
   

^requisite Essential Qualifications and work experience of the post.

6.1 ^Note: Borrowing Department are to provide their specilic comments/ uietnicolrfr.-irrg ttre

^relevant Essential Qualification/ Work experience possessed by the Candidate ( as indicated in the Bio-data) with reference to the post applied.

^{7. Details of Employment, in chronological order, enclose a separate sheet duly .utlrerrticated ny your signature, if the space below is insufficient.}

Office /	Post held on	From	To	*Pay Band	Nature of
Institution	regular basis			and Grade	Duties (in
				PaylPay Scale	Detait)
				ofthe post	highlighting
				held on	experience
				regular basis	required for
					the post
					annlied for

^*Important: Pay-band and Grade Pay granted under ACP/Ir4ACP are personal to the officer ^and therefore, should not be mentioned. Only Pay band and Grade ^{Payl Pay scale of the post held on regular basis to be mentioned. Details of ACP/ MACP with present Pay Band and Grade Pay where}

_such benefits have been drawn by the Candidate may be indicated as below;

Office/ Institution Pay, Pay Band and ^{From To} Grade Pay drawn under ACP/ MACP Scheme

8. Nature of present employment i.e. Ad-hoc or Temporary or Quasi-

is. olease statea) The date of initial b) Period of appointment c) Name of the ^parent appointment on deputatior/ contract office/ organization to

_{9J l{ote:} In case of Officers already on deputation, the applications of such _officers should be forwarded by the parent cadre / Department along with Cadre

9 (c) & (d) above must be given in all

ffiolumn

_cases where a person is holding a post on deputation outside the cadre /

a lien in his parent cadre / organizati t0lf any post tretd on Deputation in the past by the applicant, date of retum from the last deputation and other details.

11. Additional details about present employment:

_Please state whether working under ( indicate the name of your employer against the relevant column) a) Central Government

b) State Govemment c) Autonomous organization d) Govemment Undertaking

e) Universities 0 Others

same Department and are in the

ffithe

feeder grade or feeder to feeder e the date from which the

_{revision iook} place _and also indicate the pre-revised scale

14. Total emoluments

d) Name of the post and Pay ofthe

post held in

substantive capacity in the parent

1. In case the applicant belongs to an organization which is not following the Central _Govemment Pay-scales, the latest salary slip issued by the organization showing the following details may be
   
   
2. A Additional Information, ifany, relevant to the
   
   

enclosed.
Basic Pay with Scale of Pay and	Deamess Payl interim relief / other Allowances etc. (with	Total Emoluments
rate of increment	break-up details)

post you applied for in support of your suitability for the post. (This among other things may provide information with regard to (i) 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

insuflicient)

16. B Achievement: The candidates are requested to indicate information with regard to;

(i)

Research publications and reports and special projects

(ii)

Awards/Scholarships/Offi cial Appreciation

(iii) Affiliation with the professional bodies/ institutionVsocieties and;

(iv)

Patents registered in own name or achieved for the organization

(v)

Any research / innovative measure involving official recognition (vi) any other information.

(Note: Enclose a separate sheet if the space is

insufficient)

17. Please state whether you are applying for deputation (ISTC/ Absorption/ Re-employment Basis#.

# ^(Officers under Central/ State Govemments ar onlv eligible for "Absorption". Candidates of non'-Govemment Organizations are eligible only for Short Term Conlract)

_{# (The Option of 'STC' /} ,Absorption,/

Reemployment' are available only if the vacancy _circular specially mentioned recruitment by ^..STC,, or "Absorption" or " Re-employment,' _).

18. Whether belongs to SC/ ST

^{I have carefully gone through the vacancy circular/ advertisement and I am well _{aware that the}information fumished in _{the curricurum vitae dury supported by the documents in respect of}}

^Essential Qualification / work Experience submitted by _{me wilr also be assessed by the Setection}

^{committee at the time of selection for the post. The information/ details provided by me are _correct}

^{and true to the best ofmy knowledge} and no materiar fact having a bearing on _{my serection has been}suppressed / withheld.

(Signature of _{the candidate)} Address

Date

Certification by the Employer/Cadre Controlling Authority

The informatior/ details provided in the above application by the applicant are true and correct as per the facts available on records. He/ she possesses educational qualifications and experience mentioned in the vacancy circular, ifselected, he/ she will be relieved immediately.

2.	Also certified thaq
i)	There is no vigilance or disciplinary case pending/ contemplated against Shri/ Smt.
ii)	His/ her integrity is certified.
iiD	His/ her CR Dossier in original is enclosed/ photocopies ofthe ACRs for the last 5 years duly attested by an officer of the rank of Under Secretary of the Gort. of India or above are enclosed.
iv)	No Major/ Minor penalty has been imposed on him/ her during the last l0 years Q1 A list of major/ minor penalties imposed on him/ her during the last l0 years is enclosed (as the case may be).

Countersigned (Employer / Cadre Controlling Authority with Seal)