Annexure-A

APPLICATION PROFORMA FOR THE POST OF

________________________________________ IN THE NATIONAL AUTHORITY,
MINISTRY OF ENVIRONMENT, FOREST AND CLIMATE CHANGE (ON
DEPUTATION)

1. Name & Designation:

2. Applied for the post of:
3. Date of Birth:
4. Date of retirement under Central/State Government rule:
5. Gender:
6. Educational Qualification:
7. Mobile No. and e-mail ID:
8. Service/Batch:
9. Details of employment in the chronological order. Enclose a separate sheet duly
authenticated by the Department, if space below is insufficient.
Department/
Scale of Pay and Nature of duties
Institution/ Post held From To
basic therein performed
Organization

10. Details of current employment:

11. Basic Pay, Pay Scale & Grade Pay:
12. Details of courses/training programmes attended, if any:
13. Details of publication, if any:
14. Language known:
15. Details of previous ex-cadre deputation, if any:
16. Additional information, if any, which you would like to mention in support of your
suitability for the post. Enclose a separate sheet, if need be:
17. Remarks

(Signature of candidate)
Address:

Date:

It is certified that particulars furnished are correct and no disciplinary case is either
pending or contemplated against the officer and no penalty, major or minor, was imposed on
the officer during the last 10 years and his integrity is beyond doubt.

Signature of the Head of Department

(with stamp)
 Annexure-1
VIGILANCE CLEARANCE CERTIFICATE

Certified that no Vigilance case of disciplinary proceedings or criminal proceedings is

either pending or contemplated against _________________________ who has applied for the
post of ______________________________________________ in the National
Compensatory Afforestation Fund Management and Planning Authority, Ministry of
Environment, Forests and Climate Change, New Delhi on deputation basis.

(Authorised Signatory)

Name and office Seal:

Date:
 Annexure-2
NO PENALTY CERTIFICATE

Certified that no minor/major penalty has been imposed during the last 10 years on
____________________________ who has applied for the post of
__________________________________ in the National Compensatory Afforestation Fund
Management and Planning Authority, Ministry of Environment, Forests and Climate Change,
New Delhi on deputation basis.

(Authorised Signatory)

Name and office Seal:

Date:
 Annexure-3
INTEGRITY CERTIFICATE

After scrutinizing Annual Confidential Report/ Annual Performance Appraisal Reports

of ____________________________ who has applied for the post of
__________________________________ in the National Compensatory Afforestation Fund
Management and Planning Authority, Ministry of Environment, Forests and Climate Change,
New Delhi on deputation basis, it is certified that his/her integrity is beyond doubt.

(Authorised Signatory)

Name and office Seal:

Date:

(Not below the rank of Deputy Secretary)