10:25:50 9 O00 Yen 4 16)

1 99.4613854
2 3rrRferrt (ufte) 94.5798978
3 98.5908171
4 90.3745338
99.0697384
5 91.6844194
7 98.3083025

8 86.3579347
9 93.4982089
10 HTyfat nft (ufk) 67.9460802
11 94.2277943
12 89.5431509
13 82.8745296
14 72.5085037
15 93.4982089
16 47.9743703
17 85.9290775

3ejosana3
SECRETARY
BIHAR STAFF SELECTION COMMISSION,
 NDEMNITYY CERTIEICAE

(Certiheate tn be signed by any one of the otng)

dastd Ollos dCtae Bt Gonet;
ut Ma
odas

et t

hhas here he c
MtrBoa Depnant Ollors
Pchayat pc

Mtsoghr of SM
yan
telet he sartcuasted by hinhar d

eatur

A oEFLLED IY THE OPTC

Name, dgalon a n M d d e g o

e amb
de beng condeee
 RAILWAY RECRUITMENT BOARD, E RALWAY
IATTESTATION FORM

tmtWsing

passpat sSToap) edinnedatythe toson teaoo has baa aty talng ich t e
copy of t ghtgragh wha Snad to beaseon f adtomaton
utetto
attt etata tae tomaton has ber

Paase nd youhae
add or dpped in anytage ny pat o younme oruna)
te o ye
Pee addesa i e . age Thannt
Dant ar unb LaneShRoat and T

eafand un antanerDutt adga

n i h l a t a n d oursgeassed in he pecatg osuna

 Formate of AFFIDAVIT

"l, Shri/Smt./Kumari
son/daughter of Shri/Late
years resident of
aged

(give complete residential address) have been allowed to join Railway service for the post of
pending detailed verification for character and

antecedents. Ihave submitted a character certificate from principal of the educational institute,
last attended/Gazetted officer (delete whichever is not applicable) for simple verification of my
character and antecedents. Ihereby certify that I have no adverse report with the Police
authorities anywhere in India or abroad and have no criminal case/pending against me nor I have
been convicted in any criminal case in the past.

civil
In case any adverse report about my character and antecedents is later given by the
authorities, the administration of the Eastern Railway will be well within their rights to terminate
forthwith."
my service/cancel my candidature for the post of

month 20.
Signed this day of

Signature and name of the candidate

Full Address:

7/9
 CHARACTER CERTIFICATE
candidate studied last.)
of Institution where the
(70 be obtained from the Head
Certificd that I have known Sri/Smt.
for the last.....years..
Son / daughter of ...
that to the best of my knowledge and belief he bears reputable character and has no
months and
antecedents which render him/her unsuitable for Government employment.

islis not related to me.

2. Sri/Smt.

Place... Signature

Date. Designation

(To be attested by stipendiary 1 class Executive Magistrate, District Magistrate

or Sub-Divisional Magistrate/S.D.0)

ATTEST ED

Place.. Signature

Date...... Designation...
* (Attesting Authority)

" OFFICE SEAL

OFFICE SEAL
" N.B. The signatory must sign on his own stamp (Designation). His
should also be aflixcd.