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FORM - I
(Rule – 17)
Government of Karnataka
Electrical Supervisory Certificate of Competency
Electrical Supervisor (General) Grade - 1

Certificate No. . . . . . . . . . . . . . . . Photo of the


Applicant
Date of Issue . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . .S/o or D/o. . . . . . . . . . . . . . .R/o. . . . . . . . . . . . . . .having satisfied the


Licensing Advisory and Examination Board that his/her qualifications entitle him/her for exemption
from taking the prescribed examination of supervisor is here by granted this certificate of Competency
Details of Examination passed:
Bangalore CHIEF ELECTRICAL INSPECTOR TO GOVT
AND EX-OFFICIO ADDL. SECRETARY
(ELECTRICAL LICENSING)
DEPARTMENT OF ENERGY
BANGALORE.

FORM - J
(Rule 17)
Government of Karnataka
Electrical Supervisory Certificate of Competency
Electrical supervisor (General) Grade - 2

Certificate No. . . . . . . . . . . . . . . . Photo of the


Applicant
Date of Issue . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . .S/o or D/o. . . . . . . . . . . . . . .R/o. . . . . . . . . . . . . . .having satisfied the


Licensing Advisory and Examination Board, by passing the prescribed Examination for Electrical
Supervisor (General) Grade II held at… . . . . . . . . . . . . . . .centre vide Register no. . . . . . . . . . . . .
hereby granted this certificate of competency
Bangalore
Dated
CHIEF ELECTRICAL INSPECTOR TO GOVT
AND EX-OFFICIO ADDL. SECRETARY
(ELECTRICAL LICENSING) DEPARTMENT
OF ENERGY BANGALORE.

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