Annexure No.

–I
Experience Certificate / NOC

(To be submitted by all the applicants along with a copy of offer letter of the current employer)

Certificate No: Date:

Advertisement No: IISER Bpr/NT-01/17, dated 10/04/2017 and Post applied for :……………………

SN Item Description
1 Name of the
employee
2 Employee Code
3 Name of the
organisation
4 Type of organisation
_____________________________________________________________
{ (1) Central Govt. (2) State Govt. (3) Centrally funded Educational Institutes
(CEI) (4) Central Autonomous Body / PSU (5) State Autonomous Body / PSU
(6) Private University / Organisation (7) International Organization (8) Others
(please specify) }
5 Date of Birth
6 Type of
employment _________________________________________________________________
{(1)Regular (2) Contract (3) Ad-hoc (4) Temporary (5) Project (6) Outsourced Job
(7) Deputation (8) Others specify) }
7 Current and Previous positions held with pay scale, in the organization.

SN Positions Type of Full Pay Basic GP / DA Duration

held Employment Scale Pay Pay %
(Start-End) Level
From To
1
8 Current duties and
responsibilities
9 Type of Pension
Scheme and PRAN
No. if in NPS
10 Details of any
disciplinary
proceedings held
previously and
contemplated
presently, if any.
11 Notice period
required for
relieving the
candidate, if
selected.

Certified that the above information is verified from the personal service records of the employee and
the undersigned is competent to issue the NOC / Service Certificate.

Signature :
Name of the Authorized Signatory :
Designation :
Office Seal :