Appx ‘A’

From,
_____________
_____________
_____________

To,
The Secretary
Kendriya Sainik Board
Ministry of Defence
West Block-4, Wing-VII
RK Puram, New Delhi-66

WILLINGNESS/UNWILLINGNESS CERTIFICATE
(TO BE SUBMITTED AT KSB DURING COUNSELING ONLY)

Sir,

1. I, ______________________________________________________ son/daughter of
______________________________________________________ (Father’s No, rank & Name)
NEET Roll No _____________ address ________________________________________
have been offered following MBBS/BDS seats through KSB Sectt presently available under
Central Pool Quota as on _____________ (Date) :

(a) _______________
(b) _______________
(c) _______________

2. I am willing ____________ to join the MBBS or BDS ____________ seat at any college
located under Central Pool Quota.

3. I am unwilling _______________ to join the MBBS or BDS ______________ seats

offered to me as on ______________ (date) under Central Pool Quota and hence authorized
KSB Sectt to utilize the same seat offered to me to next candidate in merit.

4. I will not change my option hereafter.

Thanking you,
Left Thump
Date : impression of the (Candidate Signature)
Place : candidate

Date : Left Thump (Parents’/Guardian Signature)

impression of the
Place :
Parent/guardian

Note:

(i) Please strike out the option which is not applicable. This certificate should be sent by fax/
e-mail and by post also. (Fax No. 011-26192362, E-mail:- jdadmcordksb@gmail.com).

(ii) Any candidates whom seat is offered but he/she has not given willingness/unwillingness
certificate by specific date mentioned by KSB Sectt, his/her candidature will be cancelled and
his/her seat will be passed to the next candidate in merit.
 Appx ‘B’

From,
_____________
_____________
_____________

To,
The Secretary
Kendriya Sainik Board
Ministry of Defence
West Block-4, Wing-VII
RK Puram, New Delhi-66

UNWILLINGNESS CERTIFICATE TO ATTEND THE

MBBS/BDS SEAT ALLOTMENT PROCESS

Sir,

1. I, ______________________________________________________ son/daughter of
______________________________________________________ (Father’s No, rank & Name)
NEET Roll No _____________ address ________________________________________
have been offered MBBS/BDS seats through KSB Sectt under Central Pool Quota.

2. I am unwilling to join the MBBS or BDS seats allotment process offered to me under
Central Pool Quota and hence authorized KSB Sectt to utilize the same seat offered to me to
next candidate in merit.

4. I will not change my option hereafter.

Thanking you,
Left Thump
impression of the
Date : candidate (Candidate Signature)
Place :

Left Thump
impression of the
Date : (Parents’/ Guardian Signature)
Parent/ guardian
Place :

Note:

(i) Please strike out the option which is not applicable. This certificate should be sent by fax/
e-mail and by post also. (Fax No. 011-26192362, E-mail:- jdadmcordksb@gmail.com).

(ii) Any candidates whom seat is offered but he/she has not given willingness/unwillingness
certificate by specific date mentioned by KSB Sectt, his/her candidature will be cancelled and
his/her seat will be passed to the next candidate in merit.