CH NO (PH-I): DECLARATION FORM CH NO (PH-II):

1. ROLL NO 2. Batch No:

4. NAME (as in 10th pass certificate)
3. DATE OF BIRTH
(BLOCK CAPITAL LETTERS)
(DD/MM/YYYY)
D D M M Y Y Y Y

5. Qualifying Exam : Graduation / Post Graduation 8. Are you a habitual wearer of Glasses /
Appearing / Appeared / Passed Spectacles or Contact Lens?
(PUT TICK)
6. Total percentage of marks scored…………………. %
7. Current Backlog : YES/NO YES / NO
BODY TATTOO : YES/NO SAINIKSCHOOL:
ARMED FORCES/ GOVT/ PSU EMP : YES/NO MILSCH: WRITE NAME OF SCHOOL,
(IF YES,NOC) : YES/NO RIMC: IF STUDIED ELSE N/A

DIRECT PH-II : YES/NO AFPI/ SPI:

Certificates pertaining to relevant Health Mandatory on arrival
advisories issued by Government
(viz COVID-19 certificate etc)
Next of Kin (Name) Relation: Contact No:
FOR S/OUT & REPEATERS ONLY
9. Have you appeared earlier in SSB for ARMY/ NAVY / AIR FORCE /COAST GUARD? YES NO
If yes, give following details (Note: write overleaf if space is inadequate):
Sl No Type of Entry viz NDA/CG/ No. of days
Previous Batch Place & Date UES/TES/10+2TES/SEC/MET stayed at
& Chest No. (Mandatory) (Mandatory) SSB/AFSB

1
2
3
4
5
6
7
8
9
10
11

10. Have you appeared for INSB/PAB/CPSS Test earlier? YES / NO If yes, give following details:

Batch No. Chest No. AFSB Centre Date CPSS/PAB Result (Put tick)
PASS FAIL

11. I hereby declare that the statement made in this form is true to the best of my knowledge and belief.
In case of any incorrect information, my candidature is liable to be cancelled. I also understand that the
decision of the IAF on eligibility condition would be final. I have no relatives or known person working in
this Selection Board.

Date: Sign of candidate: Mob No.:

 JOURNEY PARTICULARS

AFCAT No:……….…….……... Batch No: ………………………….. Name ……………………………….

Mobile No: …………………………………. Alternate Mobile No: ……………………………………..
Email ID: ……………………………………………………………..

Address of candidate (Present address) …………………………………………………………….

………………………………….…………………………………………………………………………………

Nearest Railway Station to your home town …………………………………………………..………

AMOUNT ADMISSIBLE
FARE DETAILS (JOURNEY DETAILS) TICKET AMOUNT (FOR OFFICIAL USE AT
AFSB ONLY)
ONWARD PNR NO:
JOURNEY TICKET NO:
RETURN
SAME AS ABOVE
JOURNEY
TOTAL

ACCOUNT DETAILS

ACCOUNT NUMBER
NAME OF THE A/C
(Hard copy of NAME OF BANK AND
HOLDER
cancelled cheque / BRANCH
(If giving some other
copy of front page of IFSC CODE (Must be a nationalised
account, relation of
passbook must be bank or set up under
the person to be
provided for RBI regulations)
mentioned)
verification purpose)

NOTE: Candidates having account in recently merged banks must provide the updated IFSC code.
Please attach the following documents with this form:
1. Hard copy of ticket travelled (Bus/ Train / Air)
(If it is Waitlist, confirmed berth no. should be mentioned on ticket)
{If travelled by air, (a) boarding pass and (b) hard copy of the ticket must be attached}
Price on ticket must be available.
2. Cancelled cheque or photocopy of the first page of your bank passbook
Certified that I have/have not appeared for the same type of entry/course in any of the
Selection Boards previously and I am entitled / not entitled for TA/DA. I declare that the statements
made in this form are true to the best of my knowledge and belief.

Place: Signature of Candidate

Date:
FOR OFFICE PURPOSE ONLY

FOR PRICING:

Chest No. Ph I:………… Chest No. Ph II :………...

 FORM OF INDEMNITY BOND

To,

The President of India

In Consideration of the Union of India having called me / my ward (Name)

……………………………………………………… (a minor of whom I am the legal/natural guardian) to
appear before Selection Board for conducting selection tests for grant of Commission in the
Army/Navy/Air Force, I undertake and agree that neither I nor my heirs nor my executors nor
administrators will make any claim against the Union of India or against any officer or airmen of the IAF
or against any person in the service of Union of India in respect of any loss or injury to me /my ward
including injury resulting in my/his/her death which I/he/she may suffer as a result of or in connection with
any of the tests given to me/him/her at the service selection board and I understand and agree that no
compensation will be paid by the Union of India or by an officer or airmen of the IAF or any person in the
service of the Union of India in respect of any such loss of injury or death and I further agree so as to bind
myself, my heirs, my executors and administrators to indemnify the Union of India, any officer or airman
of the IAF and any person in the service of the Union of India against any claim which may be made by
any third party against the Union of India, or any officer or airman of the IAF or any person in the service
of the Union of India, arising out of any act or default on the part of myself/minor or in connection with
such tests before services selection board.

Dated ……day of......................2023 (Date must be the date on which the document is signed)

Signature of Witness: Signature of

Candidate / Natural / Legal Guardian

Name: Name:

Address:_____________________ Address:_______________________

____________________________ ______________________________

____________________________ ______________________________

NOTE:1. Delete portions which are not applicable. To be signed by self if age is above 18 years.

2. Candidates must also note that they will not be admitted to the Services Selection Board
interview without this Certificate.

3. Signature of witness is mandatory. Witness must be a person above 18 years of age,

known to you
 TO WHOM IT MAY CONCERN
BONAFIDE/CONVERSION CERTIFICATE
(FOR CANDIDATES APPEARING IN FINAL YEAR/SEMSTER ONLY)
(The Bonafide issued under college letter head must consists of all of the following details)

1. This is to certify that ………………………………….. (Name of the student) is a Bonafide student

of ………………………………………………………………….... (college/institute).
He is currently studying/appeared in …………… (Semester/Year) of …………………………. (Name
of the course).
2. The student has no current backlogs.
3. His / her result will be declared by ……………………… (MM/YY) OR His / her exams would be
completed by ………………….. (DD/MM/YYYY).
4. His / her percentage of marks till …………… (Sem/Yr) is …………….. (in case of CGPA/SGPA,
equivalent percentage to be stated)
5. CGPA/SGPA to Percentage Conversion formula # for the above-mentioned course:

……………………………………………………………………

Affix College/University seal Signature of Principal/

Director/Registrar with Official
stamp
Date:

Note:
# In case no conversion formula exists, it should be clearly mentioned. Please strike out
Columns which are not applicable.

* Date of declaration of result / completion of examination must be clearly mentioned (the last
date of submission is provided in official notification). Candidates carrying this certificate without
clear mention of the date of declaration of result will be routed back without testing.

Institutes must ensure that all the fields above are mandatorily filled. If issued under letter head, the
entire contents of this form must be endorsed without fail.
 CHEST NO PH-I: (TO BE LEFT BLANK) CHEST NO PH-
II:
COURSE CUM PERCENTAGE CERTIFICATE
(TO BE SUBMITTED ON ARRIVAL AT AFSBs)

Name :…………………………………… ………. AFCAT No……………………………

(BLOCK LETTERS) (AS IN CALL LETTER)
GRADUATION (QUALIFYING)
Name of Degree : Stream/Branch :
Name of University:
Original Degree Certificate No: dated:
Provisional Degree Certificate No: dated:

YEAR/ SEMESTER MAX MARKS / SGPA OBTAINED MARKS / SGPA PERCENTAGE

Ist Year/ Semester
IInd Year/ Semester
IIIrd Year/ Semester
IVth Year/ Semester
Vth Year/ Semester
VIth Year/ Semester
VIIth Year/ Semester
VIIIth Year/ Semester
TOTAL

Total Percentage of Marks * ………………. %upto …………………….. Year/Semester

POST GRADUATION
(ONLY FOR CANDIDATES APPLIED ON THE BASIS OF PG FOR EDN BRANCHES)
Name of Degree : Stream/Branch:
Name of University:
Original Degree Certificate No: dated:
Provisional Degree Certificate No: dated:
YEAR/ SEMESTER MAX MARKS / SGPA OBT MARKS / SGPA PERCENTAGE
st
I Year/ Semester
IInd Year/ Semester
IIIrd Year/ Semester
IVth Year/ Semester
TOTAL

UNDERTAKING

I, …………………………. son/daughter of …………………………. Batch No-…………….………………

do hereby certify that I meet all the eligibility criteria for SSB. I am aware that in case of any discrepancy,
my candidature is liable to be cancelled at any stage.

Date:
Place : ……………………….
(Sign of candidate)
*Note: For candidates with CGPA, the same needs to be converted into percentage as per
directions of your University. Proof of conversion as issued by university/college be attached
with this form
 SELF CERTIFICATION CERTIFICATE (ONE FOR EACH TATTOO)
BY CANDIDATES FROM TRIBAL COMMUNITIES WITH PERMANENT BODY TATTOO(S)
(TO BE FILLED IN DUPLICATE)
1. I, …………………………….. (Name of Candidate), Son/ Daughter of …………………………
(Name of Father/ Mother/ Guardian as applicable) ………………….. (Date of Birth) hereby give an
undertaking that I belong to ……………………… Tribe from …………….. area of
.................................................................................................................................................................................. st
ate
and *I do not have any permanent body tattoo on my body/ *I have............. No. of permanent
body
tattoo (s) inked on my body as follows (one for each tattoo) (*strike out whichever is not applicable).:-

Photograph of Tattoo Details of Tattoo

(Post card size to be pasted here duly signed by the candidate with name. Size of Tattoo
Please do not use staple pins/ clips) (in Cms): ……..

Language (If applicable):

…..…………….

Significance of Tattoo (If

Post Card size Photograph 14 cm X 9 cm (Length and breadth) applicable):
……………………….

Location of Tattoo

…………………………..

2. I am enclosing Certificate (s) as per Appendix ‘B’, in original, for permanent body tattoo (s) on
my body, duly signed as per instructions.
3. I hereby declare that besides the tattoo(s) as referred in Para 1 of Appendix A above, I will not
have any other permanent body tattoo (s) in future if I am selected to undergo pre- commissioning
training.
4. The above information given by me is true and correct to the best of my knowledge and belief.
5. I understand and am aware that misrepresentation of any facts/ concealment of any information
regarding permanent body tattoo(s) will lead to cancellation of my candidature at any stage from
commencement of the selection process for which I shall be solely responsible.

( ) ( )
Signature of Parent Signature of Candidate
Name_______________ Name________________
Date:________________ Date:_________________
If below 18 years If above 18 Years

Note: (i) This form should be signed by parent (father / mother / legal guardian) if the candidate is below 18
years of age.
(ii)The candidate must be in possession of this form at the time of arrival at this Board for SSB.
 CERTIFICATE (ONE CERTIFICATE FOR EACH TATTOO) FOR PERMANENT
BODY TATTOO IN RESPECT OF CANDIDATES FROM TRIBAL COMMUNITIES
(TO BE FILLED IN DUPLICATE)

1. This is to certify that …………………………..…………… (Name of Candidate) whose date of

birth is..……………… son/ daughter of …………………………………. (Name of Father/ Mother/
Guardian as applicable) and belongs to ……………………… (Name of the Tribe) Community of
…………………… (Name of the District) in the state of …………………………. (Name of the State).

2. It is certified that the permanent body tattoo(s) inked on the following parts of the body
of…………………………………….….. (Name of the Candidate) is/ are as per existing customs and
traditions of …………………………………………Tribe and is prevalent as on date:-

(a)

(b)

3. Post card size photograph of each of the tattoo as given in Paragraph 2 of Appendix ‘B’ above
is certified to be true and correct and annexed herewith for future reference/ record hereafter:-
Photograph of Tattoo Details of Tattoo

(Post card size to be pasted here duly signed by the candidate with name. Size of Tattoo
Please do not use staple pins/ clips) (in Cms): ……..

Language (If applicable):

…..…………….

Significance of Tattoo (If

Post Card size Photograph 14 cm X 9 cm (Length and breadth)
applicable):
……………………….

Location of Tattoo

…………………………..

Note - Separate photograph of each tattoo with details and description will be separately furnished and
each page will be duly attested by the Authority.

Date: (Signature with Name, Designation and Stamp of) DC/ DM or

SDM of the District/ Tehsil)
OR
(Signature with Name, Designation if any and Address of
Place: Chairman/ Secretary or Senior Member of the Tribe to which
the candidate belongs to with their stamp).
 SELF CERTIFICATION CERTIFICATE (ONE FOR EACH TATTOO)
UNDERTAKING BY CANDIDATES (OTHER THAN THOSE FROM TRIBAL COMMUNITIES)
WITH PERMANENT BODY TATTOO(S)
(TO BE FILLED IN DUPLICATE)
I, …………………………….. (Name of Candidate), Son/ Daughter of ………………………………..…
(Name of Father/ Mother/ Guardian as applicable) ………………….. (Date of Birth) hereby give an
undertaking that I do not have any permanent body tattoo on my body/ *I have .............. No. of
permanent body tattoo(s) as per the details and shown in the photograph(s) at Paragraph 2 below(*strike out
whichever is not applicable).

Photograph of Tattoo Details of Tattoo

(Post card size to be pasted here duly signed by the candidate with name. Size of Tattoo-(in Cms)
Please do not use staple pins/ clips)
Language - (If
applicable)

Significance of Tattoo
(If applicable)
Post Card size Photograph 14 cm X 9 cm (Length and breadth)
Location of Tattoo

………………………..

2. I hereby declare that besides the tattoo(s) as declared by me in Paragraph 1 of Appendix D

above, I will not have any other permanent body tattoo(s) in future if I am selected to undergo pre-
commissioning training. The above information given by me is true and correct to the best of my
knowledge and belief.
3. I understand and am well aware that misrepresentation of any facts/ concealment of any
information regarding permanent body tattoo(s) will lead to cancellation of my candidature at any stage
from commencement of the selection process for which I shall be solely responsible.

( ) ( )
Signature of Parent Signature of Candidate
Name_______________ Name________________
Date:________________ Date:_________________
If below 18 years If above 18 Years

Note: (i) This form should be signed by parent (father / mother / legal guardian) if the candidate is below 18
years of age.
(ii)The candidate must be in possession of this form at the time of arrival at this Board for SSB.

Note: Separate photograph of each tattoo with details and description will be separately furnished and each page
will be duly signed by the Candidate. President 5 AFSB or Commandant of a Pre- Commission Training Academy,
are empowered to reject a candidate for non-permissible permanent body tattoo(s).
 DETAILS OF GAZETTED OFFICERS
(IN BLOCK CAPITAL LETTERS)

GAZETTED OFFICER / TRUST WORTHY PERSON-1

NAME
DESIGNATION
POSTAL ADDRESS
FLAT NO
VILLAGE / STREET
POST OFFICE / POLICE STATION
DISTRICT
STATE
PIN CODE
MOBILE NO

GAZETTED OFFICER / TRUST WORTHY PERSON -2

NAME
DESIGNATION
POSTAL ADDRESS
FLAT NO
VILLAGE / STREET
POST OFFICE / POLICE STATION
DISTRICT
STATE
PIN CODE
MOBILE NO
 (Each form should be printed in separate A-4 size single paper)
INSTRUCTIONS FOR FILLING DECLARATION FORM

1. Write the No. and place of the AFSB to which you are required to report on top of each form.

2. Ch No (PH-I) & CH NO (PH-II) – Leave blank

3. Next of Kin (NOK) details: NOK must be your parents or legal guardian, if parents are not
alive.

4. Direct Ph-II: If you are reporting directly for Phase-II testing, tick yes. Otherwise, tick No.

5. Body tattoo: If you have any tattoo on any part of your body, tick yes. Otherwise, tick No.

6. Armed Forces/Govt /PSU: If you are serving in any of these, tick yes. Otherwise tick No. If
serving in any of these, bring NOC from your employer (mandatory).

7. Sainik School/Military School/RIMC/AFPI/SPI: If you have studied in any of these institutes,

tick yes and specify the name of institute. Otherwise leave blank.

8. AFCAT NO: Write AFCAT Roll number as in your call up letter.

9. Batch No: already filled. Recheck that you have applied for same. If not hen contact us.

10. Date of Birth: Write your DOB (format DD/MM/YYYY) as per 10 th passing certificate.

11. Name: Write your name asin10thpassingcertificate.

12. Qualifying Exam: Tick on graduation/Post graduation and if you are yet to complete, tick
appearing and strike out the rest. Give details of your total marks (aggregate percentage) secured.

13. Are you a habitual wearer of Glasses/ Spectacles or contact lens?: If you are wearing
any kind of spectacles or contact lenses, tick yes. Otherwise, tick no.

14. FOR S/OUT & REPEATERS ONLY: Those candidates who are coming for SSB for the first
time, be it in Air Force, Army, Navy or Coast Guard, are to leave the table blank. For those who
have been to any SSB centre for testing before are required to fill the data. Mandatory columns
should not be left blank. In result column, if you are screened out on Day 1 of testing write S/Out. If
you are not recommended on the day of conference, write Not Rec and if you are a recommended
candidate, write Rec. You are also required to write number of days stayed at Selection Board for
that particular attempt.

15. If you have appeared for CPSS/PAB test before, tick yes/no. If yes, please furnish details.

16. Sign the declaration form and also mention your contact number. Date mentioned should
be your date of reporting at AFSB. This form will be submitted to the staff on your arrival. You are
therefore advised to bring the form duly filled before your arrival at this Board.
INSTRUCTIONS FOR FILLING JOURNEY PARTICULARS
1. Write AFCAT Roll number as in call up letter (10digitnumber).

2. Write your name as in 10th passing certificate.

3. Address mentioned must be same as in AFCAT Call Letter/Application Form.

4. Write nearest railway station to the above-mentioned address.

5. Write fare and ticket/PNR number of your travel tickets. Make sure to attach the hard copies of the
ticket& Boarding Pass, proof of account details before submitting this form.

6. Sign the form. Date mentioned should be your date of reporting at AFSB. This form
will be submitted to the staff on your arrival. You are therefore advised to bring the form duly filled
along with hard copy of tickets before your arrival at this Board.

INSTRUCTIONS FOR FILLING INDEMNITY BOND

The Indemnity Bond should be signed by the individual who has attained the age of 18 years
at the time of SSB testing. Signature of witness is also mandatory and the person signing as witness
should be older than 18 years and must be known to the candidate personally.

INSTRUCTIONS FOR FILLING COURSE CUM PERCENTAGE CERTIFICATE

Candidates must ensure that all applicable fields in the form is filled. Breakdown of semester /
year wise marks is to be endorsed in respective columns. If graded with CGPA, the same needs to be
converted to percentage as per the formula issued by university/institute and is to be clearly mentioned.

INSTRUCTIONS FOR FILLING BONAFIDE CERTIFICATE

Due care needs to be taken while getting Bonafide Certificate issued by your institute. If
issued under letter head, all the contents of this forms needs to be mandatorily endorsed without
which you will be routed back without testing.

INSTRUCTIONS FOR FILLING BODY TATTOO CERTIFICATE

The forms need to be carried by those candidates who have permanent body tattoo
permissible according to existing rules and regulations. Candidate need to choose the form which
is appropriate to his community and all fields must be duly filled and signed prior to reporting.

DETAILS OF GAZETTED OFFICER / TRUSTWORTHY PERSONS

Gazetted officers are those who are working in Central / State Gotv. holding gazette ranks.
Trustworthy persons can be any of the following:

(a) Member of Parliament / State Legislatures

(b) Principal / Headmaster of your College / School
(c) Development Officer
(d) Postmaster
(e) Panchayat’s or Person’s holding of trust in local bodies / Institutions of Public.