Attestation Form

WARNING

Candidates are warned against the furnishing of false information or the suppression of any factual information in the Attestation Form. Doing so will lead to disqualification and may render the candidate unfit for government employment. Any subsequent detention, arrest, prosecution, conviction, etc., after submitting the form must be immediately communicated to the authorities. If false information or suppression of facts is discovered at any time during service, the person's services will be liable for termination.

Required Information

Candidates are required to provide the following details:

1. Personal Details:

   • Name in full (in block capitals) with any aliases.
   • Present full address with PIN.
   • Home address in full with PIN.
   • Details if originally a resident of Pakistan/Bangladesh, including the address in that country and date of migration.
   • Aadhaar Number.
   • PAN Number.
   • Nationality.
   • Date of Birth, Present Age, and Age at Matriculation.

2. Domicile and Background:

   • Place of birth (District and State).
   • District and State to which you belong.
   • District and State to which your father originally belonged.
   • Religion.
   • Membership of Scheduled Caste/Scheduled Tribe/Other Backward Classes (Yes/No).

3. Residence History:

   • Particulars of places where you have resided for more than one year at a time during the preceding five years. For stays abroad (including Pakistan) after the age of 21, all such places must be listed.

4. Family Information:

   • Details of Father, Mother, and Spouse including: Name, Nationality, Place of Birth, Occupation, Present Postal Address, and Permanent Home Address.

5. Children's Information:

   • Information regarding son(s) and/or daughter(s) studying/living in a foreign country, including their Name, Nationality, Place of Birth, and address/duration of stay abroad.

6. Educational Qualifications:

   • Details of education in Schools and Colleges since the 15th year of age, including the name of the institution, dates of entering and leaving, and examinations passed.

7. Employment History:

   • Details of any past or present appointments under Central/State Government, Semi-Government, Quasi-Government, autonomous bodies, Public Sector Undertakings, or private firms.
   • If previously employed under a government body, details regarding the circumstances of leaving the service are required.

8. Declarations on Legal/Disciplinary Matters (Yes/No):

   • Have you ever been kept under detention?
   • Have you ever been arrested?
   • Have you ever been prosecuted?
   • Is any criminal case pending against you?
   • Have you ever been convicted by a court of law?
   • Have you ever been discharged/expelled/withdrawn from any training/institution?
   • Have you ever been rusticated by a University or other educational authority?
   • Have you ever been debarred/disqualified by any Public Service Commission/Staff Selection Commission?
   • If the answer to any of the above is 'Yes', full particulars must be provided.

9. References:

   • Names and full postal addresses of two responsible persons from your locality or two references who know you.

Declaration

The candidate must certify that all information provided is correct and complete. The candidate acknowledges that providing false information or suppressing material information can lead to termination of appointment and is liable for criminal/civil/legal action.

For Office Use Only

• Name, Designation, and full address of the appointing authority.
• Post for which the candidate is being considered.