CERTIFICATE

Certified that I have known Dr. / Shri / Smt. / Ms. _____________________ S/O,
D/O Dr. / Shri / Smt. / Ms. _____________________ for the last ________ years
and _______ months and that to the best of my knowledge and belief. She/he
bears a good moral character and there is nothing to render him / her unsuitable for
Government Employment.

She / He is not related to me.

Place: _________________ Signature ____________________

Date: _________________ Designation___________________

Office_________________________

COUNTERSIGNED
(To be countersigned by District Magistrate or Sub-Divisional Magistrate or First
Class Magistrate)