कर्मचाी ाज् बीर्ा निगर् · 29 esic102599 1812010038 shradha...

6
कमचारी राय बीा निग EMPLOYEES’ STATE INSURANCE CORPORATION पदीप भवि, ुयालय, सी. आई. जी. ागम , िई ददली 110002 PANCHDEEP BHAWAN, HQRS. OFFICE, CIG MARG, NEW DELHI – 110 002. SCHEDULE OF INTERVIEW FOR RECRUITMENT TO THE POST OF IMO GR. II FOR HARYANA REGION The interviews of candidates shortlisted for recruitment to the post of Insurance Medical Officer (IMO) Grade – II (Allopathic) for Haryana Region are scheduled to be held from 6 th August, 2019 to 9 th August, 2019 at Faridabad (HR). The interview call letters are being dispatched to the candidates through speed post and email as per the list given below. In case candidates whose name appear in the list given below do not receive the interview call letter, he/she may report for the interview on the scheduled date, time and venue along with the documents as mentioned in the specimen interview letter. Date of Interview 6 th August, 2019 to 9 th August, 2019 (Date wise List Appended Below) Venue of Interview Regional Office, ESI Corporation, Panchdeep Bhawan, Sector – 16, Faridabad, Haryana – 121002. Reporting Time 09:30 AM LIST OF CANDIDATES FOR INTERVIEW TO THE POST OF INSURANCE MEDICAL OFFICER GR. II (ALLOPATHIC) FOR HARYANA REGION संया आवेदि संदभम संया रोल िंबर अयी का िा (डा.) ेणी सााकार की निथ Sl. No. Application Reference No. Roll Number Name of the Candidate (Dr.) Category Date of Interview 1 ESIC108399 1812010119 AANCHAL GUPTA General 06.08.2019 2 ESIC106422 2119010388 AJIT SINGH General 06.08.2019 3 ESIC108939 2120010145 ANJALI GUPTA General 06.08.2019 4 ESIC108440 2119010509 ANKIT VATS General 06.08.2019 5 ESIC107219 2221010034 ASMITA KAPOOR General 06.08.2019 6 ESIC112530 2118010667 BINDU RANI General 06.08.2019 7 ESIC109716 2322010069 DIKSHA General 06.08.2019 8 ESIC106449 2118010324 HARISH KUMAR General 06.08.2019 9 ESIC109359 2119010587 JASWANT General 06.08.2019 10 ESIC109103 1812010129 KAVINDER SINGH ROHILLA General 06.08.2019 11 ESIC112360 2716010249 KULDEEP General 06.08.2019 12 ESIC113648 1812010234 KULDEEP KUMAR General 06.08.2019 13 ESIC109356 2221010055 MADHURI GIRDHAR General 06.08.2019 14 ESIC112733 2322010092 MOHIT KUMAR General 06.08.2019 15 ESIC112580 2221010082 NEHA General 06.08.2019 16 ESIC110630 2221010064 NIKITA GOEL General 06.08.2019 17 ESIC112505 2221010081 PARUL GOEL General 06.08.2019 18 ESIC110263 2322010072 PRASHANT TYAGI General 06.08.2019 19 ESIC107745 2221010040 PREETIKA DHALL General 06.08.2019 20 ESIC100027 2118010021 RAHUL GABA General 06.08.2019 21 ESIC106074 2119010360 RAHUL GUPTA General 06.08.2019 22 ESIC100059 1813010001 RAMAN GUPTA General 06.08.2019 23 ESIC107430 1812010106 REEMA BANA General 06.08.2019 24 ESIC101722 2119010092 ROHIT General 06.08.2019 25 ESIC110243 2322010071 SACHIN General 06.08.2019 26 ESIC111110 2322010078 SAHIL General 06.08.2019 27 ESIC110503 2119010677 SANJAY KUMAR MISHRA General 06.08.2019 28 ESIC109746 1813010026 SATYADEEP General 07.08.2019

Upload: others

Post on 15-Jul-2020

3 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: कर्मचाी ाज् बीर्ा निगर् · 29 ESIC102599 1812010038 SHRADHA KHURANA General 07.08.2019 30 ESIC108668 2118010447 SONIA General 07.08.2019

कर्मचारी राज्य बीर्ा निगर् EMPLOYEES’ STATE INSURANCE CORPORATION

पञ्च्दीप भवि, र्ुख्यालय, सी. आई. जी. र्ागम, िई ददल्ली – 110002 PANCHDEEP BHAWAN, HQRS. OFFICE, CIG MARG, NEW DELHI – 110 002.

SCHEDULE OF INTERVIEW FOR RECRUITMENT TO THE POST OF IMO GR. II FOR

HARYANA REGION

The interviews of candidates shortlisted for recruitment to the post of Insurance Medical Officer (IMO) Grade – II

(Allopathic) for Haryana Region are scheduled to be held from 6th August, 2019 to 9th August, 2019 at Faridabad

(HR).

The interview call letters are being dispatched to the candidates through speed post and email as per the list given

below. In case candidates whose name appear in the list given below do not receive the interview call letter, he/she

may report for the interview on the scheduled date, time and venue along with the documents as mentioned in the

specimen interview letter.

Date of Interview 6th August, 2019 to 9th August, 2019 (Date wise List Appended Below)

Venue of Interview

Regional Office, ESI Corporation, Panchdeep Bhawan, Sector – 16, Faridabad, Haryana – 121002.

Reporting Time 09:30 AM

LIST OF CANDIDATES FOR INTERVIEW TO THE POST OF INSURANCE MEDICAL OFFICER GR. II (ALLOPATHIC) FOR

HARYANA REGION

क्रर् संख्या

आवेदि संदभम संख्या

रोल िंबर अभ्यर्थी का िार् (डा.) शे्रणी साक्षात्कार की

निथर्थ Sl. No.

Application Reference No.

Roll Number

Name of the Candidate (Dr.) Category Date of

Interview

1 ESIC108399 1812010119 AANCHAL GUPTA General 06.08.2019

2 ESIC106422 2119010388 AJIT SINGH General 06.08.2019

3 ESIC108939 2120010145 ANJALI GUPTA General 06.08.2019

4 ESIC108440 2119010509 ANKIT VATS General 06.08.2019

5 ESIC107219 2221010034 ASMITA KAPOOR General 06.08.2019

6 ESIC112530 2118010667 BINDU RANI General 06.08.2019

7 ESIC109716 2322010069 DIKSHA General 06.08.2019

8 ESIC106449 2118010324 HARISH KUMAR General 06.08.2019

9 ESIC109359 2119010587 JASWANT General 06.08.2019

10 ESIC109103 1812010129 KAVINDER SINGH ROHILLA General 06.08.2019

11 ESIC112360 2716010249 KULDEEP General 06.08.2019

12 ESIC113648 1812010234 KULDEEP KUMAR General 06.08.2019

13 ESIC109356 2221010055 MADHURI GIRDHAR General 06.08.2019

14 ESIC112733 2322010092 MOHIT KUMAR General 06.08.2019

15 ESIC112580 2221010082 NEHA General 06.08.2019

16 ESIC110630 2221010064 NIKITA GOEL General 06.08.2019

17 ESIC112505 2221010081 PARUL GOEL General 06.08.2019

18 ESIC110263 2322010072 PRASHANT TYAGI General 06.08.2019

19 ESIC107745 2221010040 PREETIKA DHALL General 06.08.2019

20 ESIC100027 2118010021 RAHUL GABA General 06.08.2019

21 ESIC106074 2119010360 RAHUL GUPTA General 06.08.2019

22 ESIC100059 1813010001 RAMAN GUPTA General 06.08.2019

23 ESIC107430 1812010106 REEMA BANA General 06.08.2019

24 ESIC101722 2119010092 ROHIT General 06.08.2019

25 ESIC110243 2322010071 SACHIN General 06.08.2019

26 ESIC111110 2322010078 SAHIL General 06.08.2019

27 ESIC110503 2119010677 SANJAY KUMAR MISHRA General 06.08.2019

28 ESIC109746 1813010026 SATYADEEP General 07.08.2019

Page 2: कर्मचाी ाज् बीर्ा निगर् · 29 ESIC102599 1812010038 SHRADHA KHURANA General 07.08.2019 30 ESIC108668 2118010447 SONIA General 07.08.2019

29 ESIC102599 1812010038 SHRADHA KHURANA General 07.08.2019

30 ESIC108668 2118010447 SONIA General 07.08.2019

31 ESIC103882 2118010198 SUMIT MALIK General 07.08.2019

32 ESIC113973 2119010894 VIKAS SHARMA General 07.08.2019

33 ESIC112020 1812010199 VISHAL CHOWDHARY General 07.08.2019

34 ESIC105600 2118010273 ANKITA PANWAR SC 07.08.2019

35 ESIC105567 2118010272 ANOOP KUMAR SC 07.08.2019

36 ESIC113779 2118010716 JITENDER SC 07.08.2019

37 ESIC110116 2119010651 JONI SC 07.08.2019

38 ESIC107963 2322010052 LALIT CHOPRA SC 07.08.2019

39 ESIC110440 2529010296 M ASHOK KUMAR SC 07.08.2019

40 ESIC104430 2119010253 MANISHA SC 07.08.2019

41 ESIC109728 1812010135 NEERAJ KUMAR RATHEE SC 07.08.2019

42 ESIC104173 2118010215 PANKAJ SC 07.08.2019

43 ESIC110066 2529010272 PRATHYUSHA MULY SC 07.08.2019

44 ESIC112813 2322010094 RAHUL SC 07.08.2019

45 ESIC100305 2322010004 RAVINDER SINGH SC 07.08.2019

46 ESIC102169 2322010013 RENU PANWAR SC 07.08.2019

47 ESIC107741 2118010394 SACHIN KUMAR SC 07.08.2019

48 ESIC105635 2120010080 SAHUL KUMARI SC 07.08.2019

49 ESIC102396 2322010015 SANJEEV KUMAR SC 07.08.2019

50 ESIC107973 2120010121 SHIV KUMAR SC 07.08.2019

51 ESIC114013 2322010108 SUBODH SC 07.08.2019

52 ESIC107346 2118010376 VIKRAM SINGH SC 07.08.2019

53 ESIC103744 1812010059 YADVINDER SINGH SC 07.08.2019

54 ESIC100326 2322010005 MESHRAM SAVITA RANGRAO ST 07.08.2019

55 ESIC109659 2322010068 AMIT KUMAR OBC 08.08.2019

56 ESIC106079 2119010362 ANITA SAINI OBC 08.08.2019

57 ESIC108608 2118010442 ANUJ KUMAR YADAV OBC 08.08.2019

58 ESIC110904 2322010076 APEKSHA OBC 08.08.2019

59 ESIC105947 2221010028 BHARAT BHUSHAN VERMA OBC 08.08.2019

60 ESIC109727 2120010162 BHIM SINGH OBC 08.08.2019

61 ESIC112163 2118010646 BHUPENDER SINGH OBC 08.08.2019

62 ESIC113598 1812010232 DEEPAK OBC 08.08.2019

63 ESIC109928 2119010633 DEEPAK KUMAR OBC 08.08.2019

64 ESIC113076 2119010831 DEVAPEE SINGH OBC 08.08.2019

65 ESIC110283 2322010074 DHEERAJ YADAV OBC 08.08.2019

66 ESIC103262 2118010163 DINESH GANGORIA OBC 08.08.2019

67 ESIC101854 2118010097 GAURAV KUMAR OBC 08.08.2019

68 ESIC111445 1812010177 GURPINDERBEER SINGH OBC 08.08.2019

69 ESIC104129 2322010024 HUNNY YADAV OBC 08.08.2019

70 ESIC104220 2322010027 IMRAN OBC 08.08.2019

71 ESIC111326 2716010230 INDER PAL YADAV OBC 08.08.2019

72 ESIC107977 2221010042 JYOTI YADAV OBC 08.08.2019

73 ESIC113590 1812010231 KARAN SINGH OBC 08.08.2019

74 ESIC112842 2529010396 KASTHURI UDAY KUMAR OBC 08.08.2019

75 ESIC110439 2529010295 KATTA MANASA OBC 08.08.2019

76 ESIC109352 2221010054 KULDEEP OBC 08.08.2019

77 ESIC107992 2118010410 MANISH YADAV OBC 08.08.2019

78 ESIC113676 2119010876 MAYANK OBC 08.08.2019

79 ESIC105422 2119010322 MOHD IMRAN OBC 08.08.2019

80 ESIC103834 2118010196 MONIKA SAINI OBC 08.08.2019

81 ESIC105049 2322010029 MONIKA YADAV OBC 08.08.2019

82 ESIC101852 2118010095 MUSTKIM OBC 08.08.2019

83 ESIC107592 2221010039 NAVEEN YADAV OBC 09.08.2019

84 ESIC102395 2118010117 NEHA JANGRA OBC 09.08.2019

85 ESIC100917 2118010056 NEHA YADAV OBC 09.08.2019

86 ESIC113463 2119010858 NIKITA YADAV OBC 09.08.2019

87 ESIC109249 2119010572 PARMOD JANGRA OBC 09.08.2019

88 ESIC110861 2322010075 RAJENDER KUMAR OBC 09.08.2019

89 ESIC107234 2221010035 RAVI KUMAR OBC 09.08.2019

Page 3: कर्मचाी ाज् बीर्ा निगर् · 29 ESIC102599 1812010038 SHRADHA KHURANA General 07.08.2019 30 ESIC108668 2118010447 SONIA General 07.08.2019

90 ESIC113324 2118010697 RAVIKANT YADAV OBC 09.08.2019

91 ESIC112971 2221010086 REEMA OBC 09.08.2019

92 ESIC102699 1812010042 RITESH DHARA OBC 09.08.2019

93 ESIC100327 2322010006 ROHIT KUMAR OBC 09.08.2019

94 ESIC104819 1812010072 ROOPAK SAINI OBC 09.08.2019

95 ESIC102698 1812010041 SAI JYOTI OBC 09.08.2019

96 ESIC112280 2118010652 SANGEETA VERMA OBC 09.08.2019

97 ESIC113152 2322010098 SANJAY YADAV OBC 09.08.2019

98 ESIC108046 2322010053 SARENU OBC 09.08.2019

99 ESIC106253 2322010043 SARIKA YADAV OBC 09.08.2019

100 ESIC113553 2119010865 SOURAV OBC 09.08.2019

101 ESIC111965 1812010197 SUDEEP OBC 09.08.2019

102 ESIC109417 2221010056 SUMIT KUMAR VAISHNAV OBC 09.08.2019

103 ESIC106656 2120010092 SUSHANT YADAV OBC 09.08.2019

104 ESIC113669 2917010065 TRIVENDRA OBC 09.08.2019

105 ESIC103821 2118010195 VIKAS SAINI OBC 09.08.2019

106 ESIC107347 2118010377 VIKAS SAINI OBC 09.08.2019

107 ESIC104720 2221010019 VINAY KUMAR OBC 09.08.2019

108 ESIC111593 1812010183 VISHAVJEET MEHRA OBC 09.08.2019

109 ESIC109355 2120010155 YOGESH YADAV OBC 09.08.2019

महत्वपूर्ण नोट/ Important Note:

1. साक्षात्कार के लिए चुने गए अभ्यलथणयो ों को साक्षात्कार के समय उपरोक्त पद के लिए अपनी पात्रता के समथणन में सभी दस्तावेज

प्रसु्तत करने हो ोंगे।

The candidates shortlisted for interview must bring all documents in support of their eligibility for the above

post at the time of interview.

2. साक्षात्कार के लिए चुने गये अभ्यलथणयो ों को यह सुलनलित करना चालहए लक वे सोंबोंलित शे्रर्ी/उप शे्रर्ी जैसा लक उपरोक्त पररर्ाम में

वलर्णत है से सोंबोंलित है।

Candidates short listed for interview must ensure that they belong the respective category/sub category as

mentioned in the result above.

3. उन अभ्यलथणयो ों को जो सरकारी सेवा में हैं (ईएसआईसी कमणचाररयो ों सलहत) साक्षात्कार के समय अनापत्ती प्रमार् पत्र (No Objection Cettificate) प्रसु्तत करना आवश्यक हैं ।

Those candidates who are in Govt. Service (including ESIC Employees) are required to produce No Object

Certificate (NOC) at the time of interview.

4. ओबीसी शे्रर्ी से सोंबोंलित अभ्यलथणयो ों को साक्षात्कार के समय भारत सरकार के लनिाणररत प्रोफामाण में नवीनतम ओबीसी प्रमार् पत्र

(जो नीचे अनुिग्नक – A पर सोंिग्न है) तथा घोषर्ा प्रपत्र (जो नीचे अनुिग्नक – B पर सोंिग्न है) के साथ प्रसु्तत करना आवश्यक है ।

Candidates belonging to OBC Category are required to submit latest OBC certificate in the prescribed proforma

of Govt. of India appended below at Annexure – A and along with Form of Declaration appended at Annexure –

B below at the time of interview.

5. सरकारी कमणचारी/ईएसआईसी कमणचारी के रूप में आयु छूट की माोंग करने वािे अभ्यलथणयो ों को साक्षात्कार के समय सेवा प्रमार्

पत्र प्रसु्तत करना होगा । सोंलवदा (Contract) आिार पर कायणरत अभ्यथी/तदथण आिार (Adhoc)/जूलनयर रेलसडेंट (JR) /सीलनयर

रेलसडेंट (SR) आलद कमणचारी लनयलमत नही ों होने के कारर् लनयमो ों के अनुसार आयु में छूट के लिए पात्र नही ों हैं ।

Candidates seeking age relaxation as Government Employee/ESIC Employee shall have to produce Service

Certificate at the time of interview. The candidates working on Contractual basis/Adhoc basis/Junior

Resident/Senior Resident etc., being not the Regular Employee are not eligible for relaxation in age as per

rules.

6. चूोंलक उपरोक्त पद के लिए आवेदन केवि ऑनिाइन मँगवाए गए थे और पद के लिए उनकी पात्रता के समथणन में दस्तावेजो ों के साथ-

साथ आवेदन की हाडण कॉपी भी अभ्यलथणयो ों से नही ों मँगवाई गयी थी, अत: साक्षात्कार के लिए चुने गए सभी अभ्यलथणयो ों की पात्रता

आयु, आवश्यक अहणता और आरक्षर् आलद के सोंबोंि में पूर्ण रूप से अनोंलतम है । Since the applications for the above post were called online only and hard copy of application along with

documents in support of their eligibility for the post was not called from the candidates, the candidature of all

the candidates short listed for interview is purely provisional subject of fulfilment of eligibility criteria with

regard to age, essential qualification and reservation etc.

Dated: 22nd July, 2019. उप – निदेशक (भिी)

DEPUTY DIRECTOR (RECTT.)

Page 4: कर्मचाी ाज् बीर्ा निगर् · 29 ESIC102599 1812010038 SHRADHA KHURANA General 07.08.2019 30 ESIC108668 2118010447 SONIA General 07.08.2019

SPECIMEN INTERVIEW LETTER FOR INFORMATION OF CANDIDATES

EMPLOYEES’ STATE INSURANCE CORPORATION

PANCHDEEP BHAWAN: C.I.G. MARG, NEW DELHI- 110 002.

F. No.:-A-12/16/1/2018-Exam.Col. III Dated:- _______________

To

Dr. ________________________

____________________________

____________________________

Subject: - Recruitment to the post of Insurance Medical Officer Grade – II (Allopathic) for Haryana Region.

Sir/Madam,

With reference to your application for the post mentioned above and result notice dated: 7th Feb., 2019 you

are requested to appear for the interview on the scheduled date and time as under: -

a Date of Interview

b Reporting Time 09:30 AM

c

Venue Address

Regional Office, ESI Corporation, Panchdeep Bhawan, Sector – 16, Faridabad, Haryana – 121002.

1. At the time of interview you are requested to must bring Print Copy of Online Application for the

above post and produce the originals of the following documents along with the attested

photocopies: -

a) Matriculation/School Leaving Certificate indicating date of birth. The candidate, who has not

submitted earlier the age proof mentioning date of birth, must produce it in original at the time of the

interview.

b) Degree/Post Graduate Diploma/Degree certificates, mark sheets of the examinations passed

along with the attempt certificate.

c) Certificate of completion of Compulsory Rotating Internship.

d) Certificate of Registration with the Medical Council of India/State Medical Council.

e) Certificates/documents in support of experience claimed, duly signed by Head of Institution (s)/ HOD

with rubber stamp, clearly indicating the period with date, month & year of employment and the nature

of work performed.

f) Employed candidates who have not already submitted “No Objection Certificate” from their

employer(s) or whose applications are not forwarded by the employer(s), are required to bring the

same at the time of the interview, failing which they may not be interviewed.

g) Candidates applying for the reserved vacancies are required to bring, in addition to the above,

SC/ST/OBC certificate (as the case may be) in the prescribed form.

h) Copies of publications/articles/research, if any.

i) The Medical qualifications possessed by the candidates should have the recognition of the Medical

Council of India/State Medical Council. The proof thereof may be attached.

2. No TA will be paid for attending the interview, nevertheless, out-station SC/ST candidates who are

unemployed and are not in receipt of any kind of stipend/emoluments etc., will be reimbursed actual

traveling expenses limited to 2nd Class Mail/Express Rail fare both ways by the shortest route subject

to production of the original tickets. SC/ST candidates who are not permitted to appear in the interview

on account of non-production of original certificates will not be entitled to such reimbursement.

3. Candidates are requested to bring this letter with them at the time of interview.

4. Please note that no request for change in the date, time and venue of interview will be entertained.

5. Your candidature is provisional subject to fulfilling of the eligibility criteria up to the satisfaction of the

appointing authority. The mere fact that you have been called for interview by the Corporation does

not in any way guarantee that you will be selected.

Yours faithfully,

DY. DIRECTOR (RECTT.)

Roll No.

Category

Page 5: कर्मचाी ाज् बीर्ा निगर् · 29 ESIC102599 1812010038 SHRADHA KHURANA General 07.08.2019 30 ESIC108668 2118010447 SONIA General 07.08.2019

Annexure ‘A’ (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 Shri/Smt./Kumari _______________________________ son/daughter of_________________________________ of village/town ________________________________ in District/Division _____________________ in the__________________________ State/Union Territory __________________________ belongs to the ________________ Community which is recognized as a backward class under the Government of India, Ministry of Social Justice and Empowerment’s Resolution

No.___________________________________________________________________dated_____________*. Shri/Smt./Kumari__________________________ and/or his/her family ordinarily reside(s) in the______________________________ District/Division of the ____________________________ State/Union Territory. 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**.

Date_______________ District Magistrate/ Deputy Commissioner etc.

Seal of Office

*- The Authority issuing the Certificate may have to mention the details of Resolution of Government of India, in which the Caste of candidate is mentioned as OBC.

**- As amended from time to time.

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 Certificate Certificates:

i. District Magistrate / Additional District Magistrate/ Collector/ Deputy Commissioner / Additional Deputy Commission/ Dy. Collector / 1st 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 applicant and or his family normally resides.

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:-

a. District Magistrate / Additional Magistrate / Collector / Dy. Commissioner / Additional Deputy Commissioner / Deputy Collector / Ist Class Stipendary Magistrate / Sub-Divisional Magistrate / Taluka

Magistrate / Executive Magistrate / Extra Assistant Commissioner (not below the rank of 1st Class Stipendiary

Magistrate).

b. Chief Presidency Magistrate /Additional Chief Presidency Magistrate/ Presidency Magistrate.

c. Revenue Officer not below the rank of Tehsildar

d. 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 of the

candidate and also, for assuming that the candidate does not fall in the creamy layer. Note-III The candidate should furnish the relevant OBC Certificate in the format prescribed for Central Government

jobs as per Annexure ‘A’ above issued by the competent authority on or before the Closing Date as stipulated

in this Notice.

Page 6: कर्मचाी ाज् बीर्ा निगर् · 29 ESIC102599 1812010038 SHRADHA KHURANA General 07.08.2019 30 ESIC108668 2118010447 SONIA General 07.08.2019

Annexure ‘B’

Form of declaration to be submitted by the OBC candidate (in addition to the

community

certificate)

I ………………. Son/daughter of Shri…………………….resident of village/town/city…………………. district………………….

state………………hereby declare that I belong to the………………..community which is

recognized as a backward class by the Government of India for the purpose of reservation in services as per orders contained

in Department of Personnel and Training Office Memorandum No 36102/22/93-Estt. (SCT) dated 8-91993. It is also declared

that I do not belong to persons/ sections/sections (Creamy Layer) mentioned in column 3 of the Schedule to the above

referred Office Memorandum dated 8-9-1993, O.M. No. 36033/3/2004-Estt. (Res.) dated

9th March, 200, O.M. No. 36033/3/2004-Estt. (Res.) dated 14th October, 2008 and OM No. 36033/1/2013-Estt.

(Res.), dated: 27th May, 2013.

Signature:………………………..

Full Name:………………………

Address