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Railway Recruitment Cell, Chennai

Annexure - 'A'
FORMAT OF REPRESENTATION
(Only for PWbD Candidates of CEN No. 02/2018 who secured above relaxed qualifying mark )
Nature of Multiple Disability (any Document enclosed as
Postal Address,
Name of Registration Score obtained Zonal Railway one only to be ticked) proof of Disability Any other
Sl No Mobile No and Email Roll No
Applicant No in CBT already opted LD+VI+ (Certificate No., Date and remarks
id LD+VI LD+HI VI+HI
HI Issue authority)

Declaration:

I declare that particulars submitted above are correct and true and that no material information has been concealed. I also understand that merely submitting this representation in no way
entitles me for selection/recruitment against MD quota, which is subject to merit position, availability of suitable posts, number of unfilled vacancies, and other eligibility conditions.

Signature of the Applicant


Date :
Place :

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