Ref. No.

: NIPER-R/2023-24/Recruitment/Non-Faculty/IV/ Date: 07th July, 2023

National Institute of Pharmaceutical Education and Research, Raebareli (NIPER-R) is “an Institute of National
Importance” set up by an Act of Parliament under the aegis of the Department of Pharmaceuticals, Ministry of
Chemicals & Fertilizers, Government of India, to impart higher education and undertake advanced research in the
field of Pharmaceutical Sciences and Technology.
Non-Faculty Positions:
NIPER-R desires to recruit Non-Faculty staff for the institute in various departments as detailed below. NIPER-R is
looking for candidates, who exhibit a high level of achievement, in their expertise. Online Applications are invited
from eligible Indian Nationals for Direct Recruitment for the Non-Faculty positions on a regular basis through open
competition.

Reservation
Pay Level Max. Age
Post Code Designation /Position Discipline
(7th CPC) UR OBC SC ST EWS (in Yrs.)

Non - Faculty Positions

Estate & Security
NT-001 Administration 10 1 0 0 0 0 45
Officer (ESO)

NT-002 Assistant Grade - I Administration 6 1 0 0 0 0 35

Junior Hindi
NT-003 Administration 6 1 0 0 0 0 35
Translator (JHT)
Junior Technical
NT-004 Technical 4 1 0 0 0 0 27
Assistant (JTA)
Date & time of commencement of Online Applications 07/07/2023 from 11:00 AM
Last date & time of Online Application & Payment of Fees 21/08/2023 up to 06:00 PM
Last date for receipt of a hard copy of the online applicationalong
with all enclosures 28/08/2023 up to 05:00 PM
For the online application form and other important details, please visit Institute’s Website:
http://niperraebareli.edu.in/

Abbreviations Used:
UR - Unreserved,
OBC - Other Backward Classes,
SC - Schedule Castes,
ST - Scheduled Tribes &
EWS - Economically Weaker Sections
Sd/-
Registrar

1
Advertisement No. NIPER-R/2023-24/ Recruitment/Non-Faculty /IV/ Date: 07th July, 2023

QUALIFICATION AND EXPERIENCE CRITERIA

Post Code / Number of

Designation Positions Period of
Essential and Desirable Qualifications
(Department) and /Reservation/ Probation
Pay Matrix Max age limit

Essential Qualification:
Bachelor’s degree in any discipline from a recognized
University/ Institute.

NT-001 Experience:
5 (Five) years of experience in Commissioned service in the
Estate & Security Army/Navy/ Air Force / Para Military Force or Police only
01 (One) not below the rank of captain or equivalent / Dy. SP of
Officer (ESO) Two Year
UR Police.
Pay level-10 45 Years
(as per 7th CPC) Desirable Qualification:

Preference will be given to the candidate with experience in

Supervision and Maintenance of the campus in National
Institutes.

Essential Qualification:
Bachelor’s degree in any discipline from a recognized
University/ Institute.
NT-002
Experience:
Assistant Grade-I 01 (One) 02 (Two) years of experience in
UR Establishment/Administrative in Central/State
Two Year
Level-6 Govt./Organizations / PSUs/University Research Institutions
35 Years
(as per 7th CPC) or Central / State autonomous and other recognized Institute
of repute.

Desirable Qualification:
Conversant with Central government rules and experience
in computer and data entry operations. Knowledge of usage
of computers.

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 QUALIFICATION AND EXPERIENCE CRITERIA

Post Code / Number of

Designation Positions Period of
Essential and Desirable Qualifications
(Department) and /Reservation/ Probation
Pay Matrix Max age limit

Essential Qualification:
Master’s degree from a recognized University in Hindi or
English with Hindi as a main subject at the degree level.
OR
Master’s degree from a recognized University in any subject
NT-003 with Hindi as a medium of Examination with English as a
compulsory subject at the degree level.
OR
Junior Hindi
01 (One) Bachelor’s degree with Hindi and English as the main
Translator (JHT) Two
UR subject with either of the two as a medium of Examination
Years
Level-6 35 Years and other as main subject plus a recognized diploma
(as per 7th CPC) Certificate Course of not less than one year in translation
from Hindi to English and vice Versa or two years’
experience of Translation work from Hindi to English and
vice versa in Central Government office. Including the
Government of India undertaking.

Desirable Qualification:
Proficiency in computer operation in Hindi.

NT-004
Essential Qualification:
Junior Technical
01 (One) Senior Secondary (10+2) with Science Subject.
Assistant (JTA) Two
UR
Desirable Qualification: Years
Level-4 27 Years
(as per 7th CPC) Knowledge of computer application

***************

3
 GENERAL INSTRUCTIONS, ESSENTIAL INFORMATION, AND CLARIFICATIONS

1. Eligibility, Age, Qualification & Experience:

a) Candidates of only Indian Nationality can apply for these posts.

b) Pay-levels mentioned are of the 7th Central Pay Commission.
c) The qualifications and experience of candidates must be relevant to the position applied for.

d) Age and experience requirements shall be reckoned as on the closing date of the advertisement.

Mere fulfillment of qualifications and experience does not entitle a candidate to be short-listed. The Institute
e) reserves the right to restrict the candidates to be called for the selection process to a reasonable number based
on relevant criteria, higher than the minimum prescribed.
The Institute reserves the right to act and take decisions as deemed fit, in all matters relating to
1) Eligibility;
2) Acceptance or rejection of the application;
f)
3) Incomplete or incorrect information (if any) furnished by the applicant;
4) Shortlisting and selection;
No request or correspondence of any kind in this regard would be entertained.
No vigilance or disciplinary case should have been contemplated, initiated, pending, or taken against the
candidate as of the date of submitting the applications. Such candidateswould be ineligible and hence should not
g)
apply. If such a development arises after the candidate submits the application, the Institute must be promptly
notified.
The candidates should not have faced any action by any law enforcement agency andshould not have been
h)
convicted by any Court of Law, either in India or abroad.
All the appointees including the in-service candidates shall be governed by the New Pension Scheme (NPS)
i)
introduced by Govt. of India.
Appointments under Direct Recruitment are regular in nature with a probation period as per the norms of the
j)
institute and the same shall be confirmed depending upon satisfactory performance of the incumbent.

The Institute reserves the right to:

1. Withdraw the advertisement either partly or wholly at any time without assigning any reason to this
effect.
k) 2. Fill or not to fill up some or all the posts advertised for any reasons whatsoever. Increase/decrease the
number of posts without giving any reason.
3. Any edition/deletion and changes in the matter of terms and conditions given in this recruitment
notification.

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 2. Vacancies and Positions:

a) The vacancies and positions are as given in the advertisement above.

The Institute reserves the right not to fill any, some, or all the advertised positions; or cancel the
advertisement in whole or in part, without assigning any reason and withoutincurring any liability. The
b) Institute also reserves the right to extend the closing date forreceipt of applications; restrict, enlarge,
modify, or alter the requirements or recruitmentprocess in whole or part, if such need arises, without
issuing any further notice or assigning any reason thereof.

c) Higher basic pay may be considered for deserving candidates i.e., of outstanding merit or exceptional
record of performance.

d) Appointments under Direct Recruitment are regular in nature with a probation period as per the norms of
the Institute, the same shall be confirmed depending upon satisfactory performance of the incumbent.

3. Reservations and Age Relaxation:

The reservations/relaxations policy for SC/ ST/ OBC/PwBD/EWS applicants will be as per the
a)
existing Govt. of India policy. The upper age limit of Ex-servicemen shall be relaxed as per the rule.
Reservations and concessions for SC, ST, OBC, and Persons with Benchmark Disabilities will
b) be as per existing Government of India norms as amended from time to time. Applicants applying for the
reserved posts should clearly state to which category they belong.
Applicants seeking reservation under SC/ST category are required to submit a certificate on the
c)
format prescribed by the Government of India, Department of Personnel & Training (Annexure-I).
Applicants seeking reservation under the OBC category are required to submit a certificate in the format
d) prescribed by the Government of India, Department of Personnel & Training.
(Annexure-II)
Applicants applying for the post(s) reserved for OBC, should submit a self-attested copy of a valid caste
certificate specifically mentioning Creamy Layer-exclusion in the format prescribed by Govt. of India,
issued by the competent authority, vide Column 3 of GOI Dept. of Personnel and Training O.M. No.
e) 36012/22/93-Estt. (SCT) dated 8.9.1993 and modified vide DoPT's O.M. No. 36033/3/2004- Estt.(Res)
dated 9.3.2004, subsequently revised vide O.M. No.36033/3/2004- Estt.(Res) dated 14.10.2008.
The Caste Certificate must be in the form as prescribed by the Govt. of India vide OMNo.36036/2/2013-
Estt (Res.) dated 30/05/2014.

A person with a Degree of Disability of 40% and above is eligible for applying for the PwBD. Proof to this
f) effect must be enclosed with the application as per Annexure - III-(a), III- (b), III-
(c) (Whichever is applicable) without which the application will be treated as 'General (unreserved)'.

g) The age relaxations are shown below:

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 Category Age Relaxation
OBC 3 Years against reserved posts only
SC/ST 5 Years against reserved posts only

PwBD with 40% minimum 15 years for SC/ST, 13Years for OBC, and 10 Years for others against all the
disability posts identified suitable for the relevant category of disability; subject to
maximum age not exceeding 56 Years on the last date for receipt of application

Ex-Servicemen As per the Government of India norms.

4. Disqualification:

The Institute shall verify the antecedents and documents submitted by applicants at any time, at the time of
a) appointment, or during the tenure of service. In case, it is found that the Applicants have submitted fake
documents, or the Applicants have undesirable clandestine antecedents/background and have suppressed
the material information, his/her services shall be liable to be terminated.

The character of a person for direct recruitment to the service must be such as to render him/her suitable in
b) all respect for appointment to the service. Persons dismissed by the Union Government or by a State
Government or by Local Authority or a Government Corporation owned or controlled by the Central
Government or State Government will be deemed to be ineligible for an appointment.

In case of any inadvertent mistake in the process of selection which may be detected at any stage even after
c) the issuance of the appointment letter, the Institute reserves the right to modify/withdraw/cancel any
communication made to the Applicants.

Canvassing in any form on behalf of or by any applicant will disqualify him/her from being considered for
d)
the post.

Candidates, who have obtained degrees or diplomas or certificates for various courses from any Institution
e) declared fake/derecognized by the UGC/AICTE/PCI shall not be eligible for being considered for
recruitment to the posts advertised. If this is detected at any stage during their service, their service will be
terminated forthwith.
A Candidate’s admission to the Written Test/Interview and subsequent process is strictly provisional. The
mere fact that the call letter has been issued to the candidate does not imply that his/her candidature has been
finally cleared by the NIPER-Raebareli. The NIPER- Raebareli would be free to reject any application, at
f) any stage of the process, cancel the candidature of the candidate in case it is detected at any stage that a
candidate does not fulfill the eligibility norms and/or that he/she has furnished any incorrect/false
information/Certificate/documents or has suppressed any material fact(s). If any of these shortcomings
is/are detected after an appointment in the NIPER- Raebareli, their services are liable to be summarily
terminated.

6
5. How to Apply and Other Terms and Conditions:

Interested candidates are invited to apply online using the prescribed link given on the Institute website
(www.niperraebareli.edu.in), alternatively, the candidates may also apply Online by clicking the Link >>
https://niperraebarelint.samarth.edu.in/ from 11:00 AM on 07.07.2023 to 6:00 PM on 21.08.2023.

The selection committee reserves the right to recommend higher initial pay and position to exceptionally
a)
qualified and deserving selected applicants.
b) No TA/DA and accommodation shall be provided for attending the Written Test & or Interview/Skill Test.
Call letters and other correspondence for attending the Written Test & or Interview/Skill Test etc., will be
c)
sent only to the eligible candidates by Email only and the list will be displayed on the Institute’s website.

After joining the service of the Institute, the persons will have to abide by the Rules, Regulations,
d) Ordinances, Statutes, and Acts of the Institute applicable from time to time. He/
She may be assigned any duty within or outside the Institute depending upon the exigency of the work.

No interim correspondence whatsoever will be entertained from Applicants regarding the conduct and result
e)
of the test(s) or Interviews and reasons for not being called for the test(s) or interview.
In case of any dispute/ambiguity that may occur in the process of selection, the decision of the Director,
NIPER-Raebareli in all matters relating to eligibility, acceptance or rejection of applications, mode of
f)
selection, conduct of examination/ interview will be final and no query or correspondence will be
entertained in this connection from any individual or his/her agency.
No person shall be recruited unless he/she is in good mental and physical health and free from any physical
defect that is likely to interfere with the efficient performance of his official duties. Candidates, who are
g)
finally approved for appointment to the institute, shall produce Medical Certificate from an authorized
Government Medical Officer at the time of joining the Institute.
Candidates are advised to visit the website: www.niperraebareli.edu.in regularly. Only Email
h)
communication will be sent.
In case any dispute arises on account of the interpretation of clauses in any version of this Advertisement
i) in a language other than English, the English version available on the NIPER-Raebareli Website shall
prevail.
Errors and omissions in the notification and selection process are subject to corrections as per
j) Rules and regulations. Moreover, the guidelines relating to recruitment rules shall be followed as per NIPER
Act, 1998, and as amended from time to time.

In the case of universities/institutes awarding CGPA/SGPA/OGPA grades etc., candidates are requested to
k)
convert the same into percentages based on the formula as per their university/institute guidelines.

7
 The Institute reserves the right to:
 Withdraw the advertisement either partly or wholly at any time without assigning any reason to this
effect.
 Fill or not fill up some or all the posts advertised for any reasons whatsoever.

l)  Increase/Decrease the number of posts without giving any reason.

 Any addition/deletion and changes in the matter of terms and conditions given in this notification of the
recruitment.
 Hold written test, Skill/Trade test, Presentation, and/or Interview for selection, whenever circumstances
so warrant.
 To frame the criteria rules by the committee while shortlisting.

Only the online applications with required uploaded enclosures will be accepted. Applicants should send
ONE hard copy of the application to reach before the date and time mentioned at 5 (t) along with all self-
attested testimonials, certificates, and all supporting documents wherever required without which the
application will not be considered. Applicants must produce original testimonials, certificates, and other
documents at the time of the interview if called.
The envelope should be super-scribed as :
Application for the Post of ‘ ’ vide advertisement no. Ref. No.: NIPER-R/2023-24/
Recruitment/Non-Faculty/IV Date: 07 July 2023
th

m)
Postal Address for sending the Application through Speed Post, Registered Post, or Courier:
Registrar,
National Institute of Pharmaceutical Education and Research (NIPER), Raebareli
New Transit Campus, Ahmadpur-Kamlapur (Near CRPF Base Camp and Bijnor Police Station),
Bijnaur-Sisendi Road, PO: Mati, Tehsil: Sarojini Nagar, Lucknow,
Uttar Pradesh, PIN -226002
Email: [email protected]
Website: www.niperraebareli.edu.in

The applicants serving in Govt./Semi-Govt./PSUs/Autonomous organizations must send their

application (in the prescribed format Annexure-IV) along with the relevant documents “Through Proper
Channel”.
In case the applicants are in service, and delay is expected in getting the endorsement of the employer
n) concerned on the original application, the applicants may submit an advance copy of the application along
with all enclosures directly (with or without the employer's endorsement on the advance copy), but their
candidature shall only be considered if the applications are received to this office through the proper
channel, within 07 days after the closing date for receipt of applications (Annexure-IV).
The applicants will have to submit a 'NO OBJECTION CERTIFICATE' along with Vigilance Clearance
Certificate in a sealed cover envelope from his/her employer at the time of the interview / written exam.

8
 Request for a change of mailing address or e-mail address during the process of recruitment will not be
o) entertained under any circumstances. The Institute will not be responsible for any loss of e-mail, loss of
any communication due to the wrong address provided by the candidates
Incomplete Hard copies of the application or those without relevant supporting documents (self-attested
p) copies of Date of birth/Degrees/Certificates/Mark sheets/Experience Certificates/documents, etc.) will be
rejected. Applicants shall have to produce original testimonials at the time of t h e Test/interview,
failing which they will not be allowed to appear in the Test/interview.
Procedure for the Payment of Recruitment Fee :
After successful Registration and before final submission of the application form, the candidates are
required to Pay the Recruitment Fee through the SBI Collect portal. The application will be valid only
after the payment of the required recruitment fee by the candidate and mentioning the transaction details
in the appropriate column of the application form.
The URL for Fee Payment is as under:-
https://www.onlinesbi.sbi/sbicollect/icollecthome.htm?corpID=4357359
OR
Candidates may also, directly pay the required Fee by visiting the SBI Collect Portal. The procedure for
payment of the Recruitment Fee directly through the SBI Collect Portal is mentioned as under:
Visit SBI Collect Website >> Click on ‘Recruitment’ >> Select State ‘Uttar Pradesh’ >> Select
q) ‘National Institute of Pharmaceutical Education and Research >> Enter Form/Registration Number
along with basic Applicant Details and Click on to Pay the required Fee.
For Payment of Recruitment Fee for the post of Estate & Security Officer (ESO), Select option
‘RECRUITMENT FEE FOR PAY LEVEL 10 AND ABOVE’
&
For all other positions, select option ‘RECRUITMENT FEE FOR PAY LEVEL 9 AND BELOW’
The fee of Rs. 1,000/- (Rupees One Thousand Only) for Pay Level – 10 and above Positions and Rs.
500/- (Rupees Five Hundred Only) for all other positions has to be paid through the link provided inside
the portal. Once the fee is submitted online, the candidates are requested to enter the reference number,
payment date, and amount in the NIPER Raebareli recruitment portal, without which, the final submission
will not be allowed. The fee once paid will not be refunded or adjusted under any circumstances.
No fee is required for the candidates belonging to SC/ST, PwD category.
The candidate, after submission of the Application and payment of the required Fee, are required to take the
print of the PDF application form and fee receipt generated by SBI Collect portal, sign, and send the same
along with all self-attested relevant supporting documents by Speed Post / Registered Post / Courier to:
r) Registrar,
National Institute of Pharmaceutical Education and Research (NIPER), Raebareli
New Transit Campus, Ahmadpur-Kamlapur (Near CRPF Base Camp and Bijnor Police Station),
PO: Mati, Tehsil - Sarojini Nagar, Lucknow, Uttar Pradesh, PIN: 226002
With super scribing the envelope as mentioned at 5 (m) above.
In case of any corrigendum/addendum pertaining to this advertisement, the same shall be
Published on the Institute’s website only. Accordingly, all applicants in their own interests
s) Are advised to regularly visit the Institute’s website www.niperraebareli.edu.in
Applicant are also advised to regularly check their registered email account for all future updates related
to recruitment.
9
 The application is to be submitted in four distinct steps, as below:
1) Registration (online)
2) Fee Submission (online through SBI Collect)
3) Application Submission (online)
4) Dispatch a physical copy of the online application with all other enclosures.
The deadline for the above-mentioned stages of application is as follows:
t)  Commencement of Online Registration 07.07.2023 from 11 am
 Last date of Online Application & Payment of Fees 21.08.2023 up to 6 pm
 Last date of receipt of hard copy of the online
application at NIPER-R along with all relevant 28.08.2023 up to 5 pm
enclosures.
The Institute will NOT be responsible for non-receipt of application (s) within the stipulated
u) period due to any postal delay/ loss of application/ document sent in transit. Applications received
after the last date and time will NOT be considered.
The Institute will communicate only with short-listed and selected candidates. It is explicitly made
v) clear that no correspondence, whatsoever, shall be entertained from applicants not shortlisted for
interview or not selected for appointment.
Applicants should read carefully the requisite minimum essential qualifications, age, eligibility,
experience criteria, etc., laid down in the advertisement and are advised to ensure before applying that
they possess essential qualifications and experience for the post. The Experience and Qualification
will be reckoned on the last date for submission of the application. No updating of qualifications and
w) experience will be entertained after the last date. The qualification and experience given in the Advt.
are minimum and Institute may prefer candidates with higher credentials and experience in the Govt.
system for similar positions. Therefore, mere fulfillment of minimum qualifications and experience
does not entitle any candidate to receive a call letter for an interview and the decision of the NIPER
Raebareli shall be final.
The maximum age limit and eligibility conditions shall be reckoned as on the date of the last date for
x)
receipt of applications.
Application once submitted cannot be altered/ resubmitted, under any circumstances. Further, no
request with respect to making changes in any data/particulars entered by the candidate in the Online
y) Application will be entertained once the application is submitted successfully. Therefore, please keep
all data/details ready before you start filling up the
Application Online.
The persons applying for more than one post must apply separately for each post (along with payment
z)
of prescribed fees for each post). An incomplete application in any respect will not be considered.
It is advised that the Applications to the Institute may be sent well in advance without waiting for the
aa) last date to avoid postal delay or any delay due to other unforeseen events or circumstances. The
Institute will not be responsible for any postal delay at any stage.

************************************************************************************************
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 ANNEXURE - I
FORMAT FOR SC/ST CERTIFICATE
A candidate who claims to belong to one of the Scheduled Caste or the Scheduled Tribes should submitin support of his
claim an attested/certified copy of a certificate in the form given below, from the District Officer or the sub-Divisional Officer
or any other officer as indicated below of the District in which his parents (or surviving parent) ordinarily reside who has
been designated by the State Government concerned as competent to issue such a certificate. If both his parents are dead, the
officer signing the certificate should be of the district in which the candidate himself ordinarily resides otherwise than for
the purpose of his own education. Wherever photograph is an integral part of the certificate, the Corporation would accept
only attested photo copies of such certificates and not any other attested or true copy.
(The format of the certificate to be produced by Scheduled Castes and Scheduled Tribes candidatesapplying for
appointment to posts under Government of India.)
This is to certify that Shri/ Shrimati/ Kumari* son / daughterof of
Village/Town/*
in District/Division *
of the State/Union Territory*
belongs to the Caste/Tribes which is recognized as a Scheduled Castes/Scheduled Tribes*
under:
@The Constitution (Scheduled Castes) order, 1950
@The Constitution (Scheduled Tribes) order,1950
@The Constitution (Scheduled Castes) Union Territories order,1951*
@The Constitution (Scheduled Tribes) Union Territories Order,1951*
[As amended by the Scheduled Castes and Scheduled Tribes Lists (Modification) order, 1956, the Bombay Reorganization
Act, 1960 & the Punjab Reorganization Act, 1966, the State of Himachal Pradesh Act 1970, the North-Eastern
Area(Reorganization) Act, 1971 and the Scheduled Castes and Scheduled Tribes Order(Amendment) Act, 1976.]
@The Constitution (Jammu &Kashmir) ScheduledCastesOrder,1956
@The Constitution (Andaman and Nicobar Islands) Scheduled Tribes Order, 1959 as amended by the Scheduled Castes
and Scheduled Tribes Order (Amendment Act), 1976
@The Constitution (Dadra and Nagar Haveli) Scheduled Castes Order 1962 @The
Constitution (Dadra and Nagar Haveli) Scheduled Tribes Order 1962@The Constitution
(Pondicherry) Scheduled Castes Order 1964
@The Constitution (Scheduled Tribes) (Uttar Pradesh) Order, 1967 @The
Constitution (Goa, Daman & Diu) Scheduled Castes Order, 1968@The Constitution
(Goa, Daman & Diu) Scheduled Tribes Order 1968 @The Constitution (Nagaland)
Scheduled Tribes Order, 1970
@The Constitution (Sikkim) Scheduled Castes Order 1978@The
Constitution (Sikkim) Scheduled Tribes Order 1978
@The Constitution (Jammu & Kashmir) Scheduled Tribes Order1989@The
Constitution (SC) orders (Amendment) Act, 1990
@The Constitution (ST) orders (Amendment) Ordinance 1991 @The
Constitution (ST) orders (Second Amendment) Act, 1991@The Constitution
(ST) orders (Amendment) Ordinance 1996
@The Scheduled Caste and Scheduled Tribes Orders (Amendment) Act, 2002@The
Constitution (Scheduled Caste) Orders (Amendment) Act, 2002
@The Constitution (Scheduled Caste and Scheduled Tribes) Orders (Amendment) Act, 2002
% 2. Applicable in the case of Scheduled Castes, Scheduled Tribes persons who have migrated fromone
State/Union Territory Administration to other.
This certificate is issued on the basis of the Scheduled Castes/ Scheduled Tribes certificate issued toShri/
Shrimati Father/Mother of Shri/ Shrimati/
Kumari*
Of village/town*_
in District/Division* of
the State/ Union Territory* who belong to the
Caste/Tribe* which is recognized as a Scheduled Caste/Scheduled Tribe inthe
State/Union Territory* issued by the dated .
%3.Shri/ Shrimati/ Kumari and/or* his/her family ordinarily reside(s)in village/town*
of District/Division* of the
State/Union Territory of .

Signature
**Designation
With a Seal of Office
State/Union Territory
Place:
Date:

* Please delete the words which are not applicable @ Please quote specific presidential order % Deletethe
paragraph which is not applicable.

NOTE: The term ordinarily reside(s) used here will have the same meaning as in section 20 of the
Representation of the People Act, 1950.

** List of authorities empowered to issue Caste/Tribe Certificates:

(i) District Magistrate / Additional District Magistrate / Collector / Deputy Commissioner /Additional Deputy
Commissioner / Dy. Collector/Ist Class Stipendiary Magistrate/Sub- Divisional Magistrate / Extra-
Assistant Commissioner / Taluka Magistrate / Executive Magistrate.
(ii) Chief Presidency Magistrate / Additional Chief Presidency Magistrate / Presidency
Magistrate.
(iii) Revenue Officers not below the rank of Tehsildar.
(iv) Sub-Divisional Officers of the area where the candidate and/or his family normally resides.

NOTE: ST candidates belonging to Tamil Nadu state should submit caste certificates ONLY FROMTHE
REVENUE DIVISIONAL OFFICER.
 ANNEXURE - II

FORMAT OF CERTIFICATE TO BE PRODUCED BY OTHER BACKWARD CLASSES

APPLYING FOR APPOINTMENT TO POSTS UNDER THE GOVERNMENT OF INDIA

This is to certify that son/daughter of

of village
District/Division In the
State belongs to the
Community which is recognized as a backward class under:

i) Resolution No. 12011/68/93-BCC dated the 10th September, 1993, published in the Gazetteof India
Extraordinary – Part I, Section I, No. 186 dated 13th September,1993.
ii) Resolution No. 12011/9/94-BCC, dated 19.10.1994 published in Gazette of Indiaextraordinary
Part I Section I No. 163, dated 20th October,1994.
iii) Resolution No. 12011/7/95-BCC dated the 24th May 1995 Published in the Gazette ofIndia
extraordinary Part-I Section I No. 88 dated 25th May,1995.
iv) Resolution No.12011/96/94-BCC dated 9th March,1996.
v) Resolution No. 12011/44/96-BCC, dated the 6th December, 1996, published in the Gazetteof India –
Extraordinary-part I, Section-I, No. 210, dated the 11th December,1996.
vi) Resolution No.12011/13/97-BCC dated 3rd December, 1997. vii) Resolution No.12011/99/94- BCC dated 11th
December, 1997. viii) Resolution No.12011/68/98-BCC dated 27th October, 1999.
vii) Resolution No.12011/88/98-BCC dated 6th December, 1999, published in the Gazette ofIndia, Extra
Ordinary Part-I, Section-I No.270, 6th December,1999.
viii) Resolution No.12011/36/99-BCC dated 4th April, 2000, published in the Gazette of India, ExtraOrdinary Part-I,
Section-I, No.71 dated 4thApril, 2000.
ix) Resolution No.12011/44/99-BCC dated 21.9.2000, published in the Gazette of India, ExtraOrdinary Part-I,
Section-I, No.210 dated21.9.2000.
x) Resolution No.12015/9/2000-BCC dated 6th September, 2001, published in the Gazette ofIndia, Extra
Ordinary Part-I, Section-1, No.246 dated 6th September,2001.
xi) Resolution No.12011/1/2001-BCC dated 19th June,2003, published in the Gazette of India,Extra Ordinary
Part-I, Section-1, No.151 dated 20th June,2003.
xii) Resolution No.12011/42002-BCC dated 13th January, 2004, published in the Gazette of India,Extra Ordinary
Part-I, Section-1, No.9 dated 13th January,2004.
xiii) Resolution No.12011/142004-BCC dated 12th March, 2007, published in the GazetteofIndia, Extra
Ordinary Part-I, Section-1, No.67 dated 12th March,2007.
Shri and/or his family ordinarily reside(s) inthe
District/Division of the State.

This is also to certify that he/she does not belong to the persons/sections (Creamy Layer) mentioned in column 3 of the
Schedule to the Government of India, Department of Personnel & Training OM No. 36012/22/93-Estt. (SCT) dated
08.09.1993 and modified vide Govt. of India Dept. of Personnel and Training OM No. 36033/3/2004-Estt(Res) dated
09.03.2004 & 14.10.2008.

Dated:
Seal: District Magistrate or Deputy Commissioner etc.
Note - I:

a) The term 'Ordinarily' used here will have the same meaning as in Section 20 of the
Representation of the People Act,1950.
b) The authorities competent to issue Caste Certificate are indicated below:-
i) DistrictMagistrate/AdditionalMagistrate/Collector/Dy.Commissioner/AdditionalDeputy
Commissioner/DeputyCollector/IstClassStipendaryMagistrate/Sub-DivisionalMagistrate
/ Taluka Magistrate / Executive Magistrate/Extra Assistant Commissioner (not below the rankof 1st
Class Stipendiary Magistrate).
ii) Chief Presidency Magistrate /Additional Chief Presidency Magistrate/ Presidency Magistrate.
iii) Revenue Officer not below the rank of Tehsildar
iv) Sub -Divisional Officer of the area where the candidate and/or his family resides.

Note - II:
The closing date for receipt of application will be treated as the date of reckoning for OBC status ofthe
candidate and also, for assuming that the candidate does not fall in the creamy layer.
 ANNEXURE - III-(a)

Form-V
CERTIFICATE OF DISABILITY
(In cases of amputation or complete permanent paralysis of limbs or dwarfism and
in case of blindness)
[See rule 18(1)]

(Name and Address of the Medical Authority issuing the Certificate)

Recent passport size

attested
photograph
(Showing face only)
of the person with
disability.

Certificate No. Date:

This is to certify that I have carefully examined Shri/Smt./Kum.

son/wife/daughter of Shri Date of Birth _(DD/MM/YYYY)_Age
years, male/female registration No._ permanent
resident of House No._ Ward/Village/Street Post Office
District State , whose photographis
affixed above, and am satisfied that:

(A) he/she is a case of:

□ Locomotor disability
□ Dwarfism
□ Blindness
(Please tick as applicable)
(B) the diagnosis in his/her case is .
(A) he/she has % (in figure) percent (in words) permanent
Locomotor disability/dwarfism/blindness in relation to his/her (part of body) asper
guidelines ( number and date of issue of the guidelines to be specified).
1. The applicant has submitted the following document as proof of residence:-

Nature of Document Date of Issue Details of authority issuing

certificate

(Signature and Seal of Authorized Signatory of

Notified Medical Authority)

impression of
the person in
whose favour
 ANNEXURE – III (b)
Form-VI
CERTIFICATE OF DISABILITY
(In cases of multiple
disabilities) [See rule 18(1)]

(Name and Address of the Medical Authority issuing the Certificate)

Recent passport size

attested
photograph
(Showing face only)
of the person with
disability.

Certificate No. Date:

This is to certify that we have carefully examined Shri/Smt./Kum.

son/wife/daughter of Shri Date of Birth _(DD/MM/YYYY)_Age
years, male/female registration No._ permanent
resident of House No._ Ward/Village/Street Post Office
District State , whose photographis
affixed above, and am satisfied that:
(A) he/she is a case of Multiple Disability. His/her extent of permanent physical impairment/disability has been evaluated
as per guidelines (............................................................................................................. number and date of issue
of the guidelines to be specified) for the disabilities ticked below, and is shown against therelevant disability in the
table below:
Sl. Affected Permanent physical
Disability part of Diagnosis impairment/mental disability(in
No. body %)
1 Locomotor disability @
2 Muscular Dystrophy
3 Leprosy cured
4 Dwarfism
5 Cerebral Palsy
6 Acid attack Victim
7 Low vision #
8 Blindness #
9 Deaf £
10 Hard of Hearing £
11 Speech and Language disability
12 Intellectual Disability
 13 Specific Learning Disability
14 Autism Spectrum Disorder
15 Mental illness
16 Chronic Neurological Conditions
17 Multiple sclerosis
18 Parkinson’s disease
19 Haemophilia
20 Thalassemia
21 Sickle Cell disease
(B) In the light of the above, his/her over all permanent physical impairment as per guidelines (
number and date of issue of the guidelines to be specified), is as follows:-
In figures:- percent.
In words:- percent.
2. This condition is progressive/non-progressive/likely to improve/not likely to improve.
3. Reassessment of disability is:
i) not necessary, or
ii) is recommended/after years months, and therefore this certificate shallbe
valid till _DD/MM/YYYY_.

@ e.g. Left/right/both arms/legs#

e.g. Single eye
£ e.g. Left/Right/both ears
4. The applicant has submitted the following document as proof of residence:-

Nature of Document Date of Issue Details of authority issuing

certificate

5. Signature and seal of the Medical Authority.

Name and Seal of Member Name and Seal of Member Name and Seal of the Chairperson

Signature/thumb
impression of the
person in whose
favour certificate
of disability is
 ANNEXURE – III (c)
Form-VII
CERTIFICATE OF DISABILITY
(In cases other than those mentioned in Forms V and VI) [See
rule 18(1)]
(Name and Address of the Medical Authority issuing the Certificate)

Recent passport size

attested
photograph
(Showing face only)
of the person with
disability.

CertificateNo. Date:

This is to certify that I have carefully examined Shri/ Smt./ Kum.

son/wife/daughter of Shri Date of Birth _(DD/MM/YYYY)_Age
years, male/female registration No._ permanent
resident of House No._ Ward/Village/Street Post Office
District State , whose photograph
is affixed above, and am satisfied that he/she is a case of
disability. His/her extent of percentage physical impairment/disability has been evaluated as per guidelines (… number and
date of issue of the guidelines to be specified) and is shown against the relevant disability in the table below:-

Sl. Affected Permanent physical

Disability part of Diagnosis Impairment/mental disability
No.
body (in %)
1 Locomotor disability @
2 Muscular Dystrophy
3 Leprosy cured
4 Cerebral Palsy
5 Acid attack Victim
6 Low vision #
7 Deaf €
8 Hard of Hearing €
9 Speech and Language disability
10 Intellectual Disability
11 Specific Learning Disability
12 Autism Spectrum Disorder
13 Mental illness
14 Chronic Neurological Conditions
 15 Multiple sclerosis
16 Parkinson’s disease
17 Haemophilia
18 Thalassemia
19 Sickle Cell disease
(Please strike out the disabilities which are not applicable)
2. The above condition is progressive/non-progressive/likely to improve/not likely to improve.

3. Reassessment of disability is:

i) not necessary, or
ii) is recommended/after years months, and therefore this certificate shallbe valid
till _DD/MM/YYYY_.

@ eg. Left/Right/both arms/legs#

eg. Single eye/both eyes
€ eg. Left/Right/both ears
4. The applicant has submitted the following document as proof of residence:-

Nature of Document Date of Issue Details of authority issuing

certificate

5. Signature and seal of the Medical Authority.

Name and Seal of Member Name and Seal of Member Name and Seal of the Chairperson

(Authorized Signatory of Notified Medical Authority)

(Name &Seal)
Countersigned
{Countersignature and seal of the
Chief Medical Officer/Medical Superintendent/Head of
Government Hospital, in case the Certificate is issued by
a medical authority whois not a Government servant
(with seal)}

Signature/thumb
impression of the
person in whose
favour certificate
of

Note: - In case this certificate is issued by a medical authority who is not a Government servant, itshall be
valid only if countersigned by the Chief Medical Officer of the District.
 Annexure – IV

Certificate to be furnished by the employer/Head of Office/forwarding authority, if in

service and applying through Proper Channel.

Employer’s Certificate/ Recommendation

Shri/Smt./Dr. is a Permanent/Temporary/Contractual
employee of the organization holding the post carries the pay scale of(Grade
Pay) and his/her application is forwarded for consideration and necessary
action.

Certified that the particulars furnished by are correct and he/she possesses
educational qualifications and experience mentioned in the advertisement.

Further certified that:

(i) No objection certificate, from the present employer.

(ii) There is no vigilance case pending/contemplated against him/her.
(iii) His/her integrity is beyond doubt.
(iv) No major/minor penalties have been imposed on him/her
during the last 10 years. Please enclose list of major/minor
penalties imposed during the last 10 years, if any.
(v) A cadre clearance certificate is appended herewith.

Please mark ( ) for which certificates are enclosed

Signature Name of the Officer:Designation:

Department: Office Seal:

Place Date:

(Signature of candidate)