Official :: Vidyut Suraksha Nideshalay

LA / Form-12

Request letter to give the ability certificates of supervisors

Number .............................

District .............................

1- Name of applicant (in plain letter): ..........................................................................

2- Father's name ..........................................................................

3- Caste ..........................................................................

4- Full name of post..........................................................................

5- Date of birth .......................................................................... (which is given in the certificate)

6- Certificate permit

(A) Technical qualifications-

(1) Name of the Technical Institution ..........................................................................

(2) Degree or diploma or certificate received .........................................................................

(3) Duration of education ..........................................................................

(4) Duration of training ..........................................................................

(B) Technical qualifications:

(1) Name of the firm etc. ..........................................................................

(2) Training period..........................................................................

7- Details of previous and present service (certified copies of certificates of confirmation should be attached)

(1) Name of the service person ..........................................................................

(2) Date of commencement ..........................................................................

(3) Expiry date ..........................................................................

(4) Total service period ..........................................................................

I hereby declare that the details given above are correct: Treasury invoice of Rs. 225 / - (Number ............................ ...................................................... two certified photographs (one On the front and on the second page part) and two signatures are also certified and certified copies are attached in confirmation of the details given from column 4 to 7.

Date------------

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Signature of petitioner

In the presence of the following persons: -

(1)-----------------------------

(2)-----------------------------

It is necessary that this application is to be signed in the presence of a magistrate or a government gazetted officer or service adder, and all the details in it must be given in full swing. If this does not happen then the application form will be rejected.

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Essential: A person who is misrepresented or assisted in getting his certificate for himself or another person, will be prosecuted for criminal proceeding.

Instruction

1. By filling this application form, the Director, Electrical Security, Uttar Pradesh Government, Lucknow should be sent in a registered A / D envelope and along with the recently drawn drawings of the petitioner, two such photographs should be written by the name. The conditions have been certified from one front and one behind. Title: "0043- Electricity and Charges, 102- deposited under the Fees of Indian Electricity Rules", should be Treasury challan of Rupees 225 / - with the request letter.

2. With the request letter, the registration of two samples should be certified.

3. If there is any change in the address given in the prayer letter, then the information should be given immediately to this office otherwise there will be no liability for the office to delay the receipt of the letter or not to receive it.