This document is a standard Attestation Form to be filled out by candidates for employment under the government. It collects personal, educational, and professional details for verification purposes.
WARNING
The form begins with a stern warning regarding the furnishing of false information or suppression of any factual details. Such actions will lead to disqualification and can render the candidate unfit for government employment. Any subsequent legal issues (detention, arrest, conviction, etc.) after submitting the form must be immediately communicated to the authorities. Discovery of false information at any point during service can lead to termination.
Information to be Provided by the Candidate
Personal Details
- Photograph: Affix a signed passport size photograph (5cms x 7cms approx.).
- Name: Full name in block capitals, including any aliases.
- Addresses: Present and Home addresses in full.
- Origin: Address in Pakistan/Bangladesh and date of migration, if applicable.
- Identity Numbers: Aadhaar No. and PAN No.
- Nationality: To be specified.
- Age & Date of Birth: Date of Birth, Present Age, and Age at Matriculation.
- Birth & Domicile: Place of birth, District and State, and the District and State to which the candidate and their father originally belong.
- Religion & Category: Candidate's religion and whether they belong to SC/ST/OBC categories.
Residence & Family Details
- Residence History: Particulars of all places where the candidate has resided for more than one year during the preceding five years. For stays abroad, details of all places resided for more than one year after attaining 21 years of age.
- Family Information: Details for father, mother, and spouse, including name, nationality, place of birth, occupation, present postal address, and permanent home address.
- Children Abroad: Information about sons/daughters studying or living in a foreign country.
Education and Employment
- Educational Qualifications: Details of schools and colleges attended since the 15th year of age, including dates of entering and leaving, and examinations passed.
- Employment History: Details of any appointments held under Central/State Government, Semi-Government, Public Sector Undertakings, or private firms. This includes the period of employment, designation, emoluments, employer details, and reason for leaving.
Legal & Disciplinary History
Candidates must answer 'Yes' or 'No' to a series of questions regarding:
- Detention, arrest, or prosecution.
- Pending criminal cases.
- Conviction by a court of law.
- Discharge/expulsion from any training institution.
- Rustication by any educational authority.
- Debarment/disqualification by any Public Service Commission.
If the answer to any of the above is 'Yes', full particulars must be provided.
References & Declaration
- References: Names and full postal addresses of two responsible persons from the candidate's locality.
- Declaration: The candidate must sign a declaration certifying that the information provided is correct and complete to the best of their knowledge and belief.
FOR OFFICE USE ONLY
The final section is to be filled by the appointing authority, detailing the name, designation, address of the authority, and the post for which the candidate is being considered.