FORM ‘B’

(Government of Mysore)

First Class Boiler Attendant Certificate of Competency

(Granted under rule 44 of the Mysore Boiler Attendants’ Rules, 1962)

No. of 19 Shri
aged about years, at present residing at have
satisfied that Board of Examiners appointed under the Mysore Boilers Attendants’
Rules, 1962, of his competence to fulfill the duties of First Class Boiler Attendant is
granted under the said rules this Certificate of Competency as a First Class Boiler
Attendant authorizing him to have charge of a single boiler of any type or capacity,
or two or more boilers in a battery or separate, the total heating surface of which
does not exceed, 7,500 sq. ft. provided that such boiler shall be situated within a
radius of 75 feet in the same premises and belong to the same owner and that he
assisted by a Second Class Boiler Attendant or firemen.*

Dated at this day of 19

Secretary to the Board of Examiners.

Chairman to the Board of Examiners.

Descriptive Roll :-
1. Date and place of birth
2. Address
3. Nationality
Photo 4. Height without shoes
5. Marks of identification
6. Left thumb impression
7. Signature

* Here insert the number of firemen considered necessary by the Chief Inspector of
Boilers.