Attestation Certificate and Identity Certificate for Indian Railway jobs

ATTESTATION FORM

Affix signed passport size 5cmx7cm approx copy of recent photograph where asked for

WARNING:   The furnishing of false information or suppression of any factual information in the Attestation Form would be a disqualification and is likely to render the candidate unfit for employment under the Government.

 

2.         If detained, arrested, prosecuted, bound down, fined, convicted, debarred, acquitted etc. subsequent to the completion and submission of this form, the details should be communicated immediately to the authorities to whom the attestation form has been sent early, failing which it will be deemed to be a suppression of factual information.

 

3.         If the fact that false information has been furnished or that there has been suppression of any factual information in the attestation form comes to notice at any time during the service of a person, his services would be liable to be terminated.”

 

1.

Name in full (in block capitals) with aliases, if any (Please indicate if your have added or dropped in any stage any part of your name or surname)

SURNAME

NAME

2.

Present Address in full (i.e. Village, Thana and District, or House Number, Lane/Street/Road and town)

 

 

3.

(a) Home Address in full (i.e. village Thana, and District, or House number, lane/street/road and town and name of District Headquarters.

(b) If originally a resident of Pakistan, the address in that Country and the date of migration to Indian Union.

 

 

(i)            Particulars of places (with periods of residences) where you have resided for more than one year at a time during the preceding five years.  In case of stay abroad (including Pakistan) particulars of all places where you have resided for more than one year after attaining the age of 21 years, should be given.

From

To

Residential address in full (i.e Village, Thana and Distt. Or house No.Lane/Street/Road and Town)

Name of the District Headquarters of the place mentioned in the preceding column.

 

 

 

 

 

 

 

 

 

 

 

 

 

5.        

 

Name

Nationality

(by birth and/or by domicile)

Place of birth

Occupation (if employed give designation and official address)

Present Postal address (if dead give last address)

Permanent Home Address.

(ii)           Father

 (Name in full   aliases, if any)

(iii)          Mother

(iii) Wife/Husband

(iv) Brother(s)

(v) Sister(s)

 

 

 

 

 

 

 

5(a) Information to be furnished with regard to son(s) and/or daughter(s) in case they are studying/living in a foreign country:

 

Name

Nationality (by birth and/or by domicile)

Place of birth

Country in which studying/living

with full address

Date from which studying/living in the country mentioned in previous column.

 

 

 

 

 

6. Nationality

 

7.    (a) Date of birth                                        (a)

       (b)   Present Age                                      (b)

       (c)   Age  at Matriculation                                    (c)

8.  (a)  Place of birth, District                           (a)

            and state in which situated

     (b)    District and State to                                        (b)                        

            which you belong

       (c)   District and State to                          

       Which your father originally belong                (c)

9.   (a)  Your religion                            :

      (b)  Are you a member of a Scheduled Caste/

            Scheduled Tribe? Answer ‘Yes or No’

 

(iv)         Educational qualifications showing places of education with years in Schools and Colleges since 15th year of age.

Name of School/ College with full address

Date of entering

Date of leaving

Examination passed

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(v)          (A) Are you holding or have any time held an appointment under the Central or State Government or a semi-Government or a quasi-Government body, or an autonomous body, or a public undertaking, or a private firm or institutions? If so, give full particulars with dates, of employment, up-to-date.

Period

Designation, emoluments and nature of employment

Full name and address of employer

Reasons for leaving previous service

From

To

 

 

 

 

 

 

 

 

 

 

                                               

11  (B) If the previous employment was under the Government of India, a State Govt./an undertaking owned or controlled by the Govt. of India or a State Govt./an autonomous body/University/Local body.  If you had left service on giving a month’s notice under rule 5 of the Central Civil Services (Temporary Service) Rules, 1965, or any similar corresponding rules were any disciplinary proceedings framed against you, or had you been called upon to explain your conduct in any matter at the time you gave notice of termination of service, or at a subsequent date, before your services were actually terminated?

 

12 (i)

(a)    Have you ever been arrested?                         

(b)    Have you ever been prosecuted?                                 

(c)    Have you ever been kept under detention?                  

(d)    Have you ever been bound down?                               

(e)    Have you ever been fined by a Court of Law ?                           

(f)     Have you ever been convicted by a Court of Law for any offence?

(g)    Have you ever been debarred from any examination Or rusticated by               any University or any other Educational authority/institution?

(h)   Have you ever been debarred/disqualified by any Public     Service

Commission /Staff Selection Commission for any of its examination/selection?

(i)    Is any case pending against you in any court of law                        

        at the time of filling up this Attestation Form?

(j)   Is any case pending against you in any University or any other                              educational authority/institution at the time of filling up this Attestation Form?           

(k)     whether discharged/expelled/withdrawn from any training  Institution under  

  the Government or otherwise?

      

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

 

Yes/No

 

Yes/No

 

Yes/No

 

 

Yes/No

 

12 [ii]       If the answer to any of the above mentioned questions is ‘Yes’ give full particulars of the case/arrest/detention/fine/conviction/Sentence/punishment etc. and/or the nature of the case pending in the Court/University/Educational Authority etc., at the time of filling up this form.

 

Note:   (i)    Please also see the ‘warning’ at the top of this Attestation Form.

 

(vi)         Specific answers to each of the questions should be given by striking out

       ‘Yes’ or ‘No’ as the case may be.

 

13.         Names of two responsible persons of            1.

            Your locality or two references to whom        2.

You are known.

 

I certify that the foregoing information is correct and complete to the best of my knowledge and belief.  I am not aware of any circumstances which might impair my fitness for employment under Government.

 

                                                            Signature of candidate:

                                                            Date:

                                                            Place;

 

IDENTITY CERTIFICATE

 

(Certificate to be signed by any one of the following)

 

      i.    Gazetted Officers of Central or State Government;

     ii.    Members of Parliament or State Legislature belonging to the constituency

    where the candidate or his parent/guardian is ordinarily resident;

    iii.    Sub-divisional Magistrates/Officers,

   iv.    Tehsildars or Naib/Deputy Tehsildars authorised to exercise magisterial powers,

    v.    Principal/Head-Masters of the recognised School/College/Institution where the candidate studied last;

   vi.    Block Development Officer;

  vii.    Panchayat Inspectors.

 

Certified that I have known Shri/Smt./Kumari _________________________ _______________son/daughter of Sri _______________ for the last __________ years ____________ months and that to the best of my knowledge and belief the particulars furnished by him/her are correct.

 

Date:   _________________                                      Signature: ______________

Place:   __________________                                   Designation or

                                                                                    Status and address: _______

TO BE FILLED IN BY THE OFFICE

 

(i)            Name, designation and full address of the appointing authority.

(ii)           Post for which the candidate is being considered.

 

Ref: Railway Board letter No. E(D&A) 82GS4-1 dated 21.4.1983

Comments

Member for

49 years 6 months

Guest (not verified)

Tue, 18/09/2012 - 21:56

dear sir/madam, for clerks ECRC, etc also should the candidate get sign from college Prinipal just as it is in the case for SE and JE joining? Thank you !

AJESH KUMAR G

Mon, 31/12/2012 - 12:05

Sir, I  been called for document verification for the post of Assistant Loco Pilot. I came to know that medical for this post is very tough. I have no problems with vision and body health, I am having 180 cms height and only 55 kg weight, It will disqualify me in medical???? The height Weight Chest co relation standard is a problem for this post???

ronitsahani

Tue, 23/04/2013 - 16:45

I have selected as a junior engineer through compensate ground.... My document verification has beend already done but again in this form in 9 (4) u have asked education after 15 years....sir please tell me y this has been asked. ..

prasun1811

Tue, 17/09/2013 - 18:13

Sir,

I have been selected for CEN 01/2012,CAT 42 ,JE (Electrical) post for RRB Bangalore division.

My document verification has been completed on 2nd april, 2013. That time they gave me the attestation form and told me to submit it when i'll get medical call.

After that till date I haven't got any call. Now few railway employees are telling me that if you don't submit the attestation form u'll not get medical call.

Is it true since they told me to submit it while getting the medical call??

Will I get a call to submit the attestation form or I can submit it anytime??

What should I do now please suggest me.

Mail id- [email protected]

ph- 9038681280

 

sanjeevthe1

Sun, 21/02/2016 - 18:09

Dear Sir/Madam,
I am selected in CEN-02/2014 for the post of JE WORKS and recommended for Metro Railway, as I approached Metro Railway head quarter they told me that at this time we do not have vacancy for JE WORKS, as we will have vacancy we will call you, we have joined one person for this post and appointment of 2nd person is in process, can any one tell me when i am expected to get appointment by Metro Railway