Attestation Form Police Verification In Marathi Language 5e5z2o

nrl1r (qs-/r)-1?-?oo1. ( q, o o.o o o )-.qlrrr * E r?- iq.-'" ".-1-o.,,. z sEt ?i. f tr4tq-t s, ii t yz/r r,s11",1i1 " " ".1 fi14 teqrrrd. l q.S., C. A. D., No. 1062, dated 5-2-1962.1

q-*

s

E:.

, Rq') q. d'.

(Tarft

)

Gen. 29? m.,.. (Revjsed)

flIw?mrr qgF'[ A?T&STATIO ir{ ['t]F.]t

q'-4T q;H]{{ rfi4rqE+^ sldt ryfffil 5'J*ri l'+er qBfffiirffill6 :r 11* '1= }
gn.Rr

1. {r c{Tr Hlt +(qrqm-qifq-

{rr< teqrq {, gl-{q11 qqli].{a; fqae'is, il-dlry." o {(qIff fltEi .r-Ro or, r.,I."l(qt'| tqr,.:q o}+t?r 3rrqlrrrst FS olr{i ;qi-qrme vrert+r a]Ilr wafhar {tE rrn,nflesi=crsii,'ml*urrr owfre arqqr'rq {ar{o' ciEi. st T(qns mq< i"'eir.r, {qgtiq-&fffi{ r' f6fi rqe iodr +r1 .rk t;mom ntu 3 If-dctained,,convicted, debarred. cfc. subseqxrat t. ibe comri:tion a.LJ )ubuissiou of this f,.rm,tbe detalls sbculd be communicated, immediately, to the I\tahsraihtra lu'i:c Service Cc,mnri:.rr.cn or the suthority to whom th, attestation form has 6".n s"nt earlir, as tho crse ;a-v tt filir* 1"-ii6 i" *ij be deemed to be suppression of factual information, i. qt 6l-EIFn I ffit, l, sr qw^li {r qlmriq - qiqir.i q}ei rrr tBft 5,f+o, an{ f5a1 +rgrEffif:6v+;^ rr1ft{f isl{ iq'-} erii .,-i tq al+titan trarq-apr.pi fh'a:-- *rr, 1i ir=ir k*r +.rit €t*qTt q.iq aiir. 3. !f lhe fact that false i1i61s3ri61r has been fr:inisu,, - or:hai rbcre ba: bcen oflry [actua.l "uppressic:l j..ri.. cia information in the artcstario.r form, comcs to n(.',c .'?ny rime.during il-,"' r,"l:.on, rri, ,

setyice would be iiabl,: to be tetnrira1,r.1-

Y. ql- si+q tqrfto (qirfl qr;:s 11 arau r 1q-a, .,,r, ntqsr{Ti ' itq" qq.r "n-ii.,:, lei;"i fiEsq-+ It H-fi'r1n +ki Baczn{ ,lrr:."r-ci}' 1o mi i, d "i6,.-is .ils{i6tr .t-c-,{t st-{s'rtr;.i cr
+ft..

'{'

&h:1c furnishing infcrmatjcu reglrdiag colur.u Ii,,. ll ol tir Attejtaiioo [1r ;rr]. canJ,rJa,. r.tn,t wrjto ',ir" "Yes" cr "No"IIf the cot,,n n iir"i., ii;n[ o; ,,'ai* ii u:: i.,iai,"t*. \iresration '.;;j,.; Forrn will be retumed to Liitr.

*iil-i

qt 1.

t.

spt aia (aa+ aarra), dtr + e.sw,g ifis.E {+tul.-{* Eij Tqr Sqqr q'rtdia F+at qlraqrf,ra qirqargr qri .na-E, in*-,r,a hqr tqrt rr{ E{T6'fl q{.qrq, (crqr lriEr +rrqr). Name in full (i block capjrals) Eith aliascs. if auv rplease indiclte you have. added or dropped at any stage, iny piri uf your narre

il

or surname), E4Iqr

qoi- l-tir (.qor.ia afilur crfl).

qrli/tffi

Prese_nt addrcss

rrrc, arti c

fwql h,

q-r

rrio, m6/

in full (L e. vi[age, Tfianaland District or Horse

Number, Lane/Street/Road and fown).

(q) RT r.

(a)

(Eortit .rra, arni q fsqr Fqsq-r qr ,6.qirF, wfvr a-6 ). 'r+dl*n,tlrsr Homc Address in full (i, e. Village. Thana aucl District or HX,or q-ifl

House Number, Lane/Street/Road and Town).

(a) wf*wrarfta Ta (Q
(b)

BT(€fls, rrrT tnrfia ftn €ft1q rr fqniF. Iforjginally e resident ofPakisraa, the address in that courtrv and rhe dare of DrigratioD lo the inrlian Un;on. - -. i,i ,

{iq{rqrd

r.q-oim hrql

g;ftq Surtl*ruc

+1;i Name

r.

wtfeirrt lwrwrt ttr Namp of the District llena

rn,its Rirrm tirrqran iee6

Quarter of the place mentioiol in the preceding column

fr

qi?-si'h*(e{}

g.

|:Lrher's--(a) Ncme in ful si.h alisse6, if any' :..

uEQ Efe,

ril)

iaj '

e:.

Lf iii ::ldtes"l.

selzice give deaig&auon and

..r

rniiFA. l:r+raqrl {j.r

E 1-,ri s.rr Nasc of Schoo|Colleges with fuil adrtress

1". (c) 10.

(a)

"**'^-":-:*4--.

**otnt

r$r$

f*t"-n

Date rrf lea..,irg

Exnraifi*ti*m

gql .r'Efi ?t6fr +id qsre a-< acfta erqt_ If you havo afly tir e employs.d, give de;aile*

of wrrk

,..;!L:firqi?

ilqiifls i it s+'+ iq: dt*qr qrlr Full aCdresr: of ,r:he offior. firu or institutioa

r0.

(b)

*E* ulsqr{t

?sTntt

esoi

sr(6

itruil r.rasons r-or

Itre pte ..'.

({)

Paesqat

E-{

anq +tt c(.lre Ffi{r c{{ri sqtq -Designatiou or posr hekl or descriotion

r".

q-*qrr

'-.

lervirg Ho s 8elYlct ...--.._-]-'4-

-:

I

l"

(1.)

r,c :,oa evsr lxi4n arrsslcd, prosccut{q tept under Lr:fr.ii:r), or b,,u:1,.1 c own/find /convicted bry a court of law ir;i ai:v ollenco or detrarredfdisqualitie.d by aav Fublic $ervice C,,rs: ii,,.ion fron: appearing et ils essmitrtlj&ts/srlcctioas r,i' Jrr.r:l;d fror,l i..kix!g ar:r eramiirati.ia6./rrt5Licaied by any 'll'il

{ :,vr:' . r..r .u-v othcr cduco.rionai euti

11.

I

r\ .. :f i.

:r

i

r-,

ir

o

ril y,Jnsfituti6n?

rT{ta?I +iidtiiq{t i{:{;FEI,{, fTgrei5Fr

FfCr

'' ,r,, ;.;.'-1 .' ,1:7 1;1.iJ !1.

.l

,L) :. r. ril\r r:.n{,ing i:!.}ilst .*-ou i,l ffly ct}urt of ias, 1, i .,:.i.': ar lt.J ,rrj:r r (rlt}cationsi s.uthofity/TsstinofJoD ol '' ';" c c' lit"l,j up rhix atfcs{lrilofr fosrn? .

..t: , .1' ,1r:i'tif.l y{ ,!?nfl :rlttqi +.-{ qas!, qr:s, Lfifitrdt, Bs, <}sii{A, 6r , i;,; [ s,(l{ " '. . {to {1w, . ' :fa;1,1r4 nTri: r'#tq'F Xr;'+81'0i i i{itt ilrtr?dl {6Ffif ry.iFi.[oI tr*tqi+ g.{sc F{Ez fig.I Ecrfifl ,) - fif ttc r.:!-t!r'r: (rl Jr (b) is 'Yed' fultr 1:rrtl;cul+rs of the cn3c, a.rdst, and fhc n.r ,'.. ni i':c;a.r n.;n'li'rg in tho C.trnrt Ueiv6r.i4r/F.{idcsrio"at

form shor l,i t-.

; 1c,

I

/,i{.r. ,{iq (,\,.o.ir,

1q. i"{} rii.;; it.n;39 , "1::iili

i:-

(s\

ry{

,ir1lin.r ,fliqrE,ii grc"ifrq

6ri{l:.J s;rtr

+)

tl,__

/:r -'.,i '.,,,ii,':d, 1r rc,-

(E)

I

i,rr,,

tfl"rj}

;:,=:'ir :; ,;; q6,1i1r ai,nr ftfl rflk Ei{rl -it1:, 1,.,., asr{ ,qi;a ifl1 tqr fearq ,];;r? thr:ir rernes rnd nhen did lro.morry

x)

.

13.

(a)

l

a{,6'q

*,,ffp and

ry,

i4fr fi+

if.m, w*x ua -

rhan?

li,.nir Emrito da srqffet( ,}Es
u.1,.,:li a-

fiq ffi!

! l. m.l!.c thaa ,)so wifei" {f m, ehat am Ltrh nen+g

(e). E'{it.lr,:iui l,'*sb;;:d. moi* t}sn ooe {

ol tNr Artsstarioo Form.)

F

16.r

i

ttq*rr ,El'rrl,telc p*ar r4r.)

*-.fls?,!e t'leL. lse rhc 'Elsrulng' ar ih.c top

{e') . r .; t..,:';rrii r,nt j{rit fiqfi {? qr;ir{i6i i."r i-1." r.riuiltir i-ti. l,l-rq {;eir i t'b)

(lircafon, 6m, conviction. suntef,cs dc., i;iri, I,f gting ui rtii

["if o-rity-ii.ii iii

*

fuEri #alqr

i.:,r;"'-.'It-a-'Lr r,r$p0trs hlc Frdsotls of Saour locnllqg,o rno r ''i,trr,.ci ir! lrhom yr,1t aft knonlq,

\{/ (b)

(or),..'..... (o) ..-..............".1.. .......i............. {c)

I qil c{rfEir *-
fBqrm

*

krlB

-'----*

arlor rrg:i qrt.

Eq'ssl(IS

I cirrlify that

the foregoing ilfornration is coreir aud complcte to the be.qt ol ury knuwl.:dge an
Rflf aw;rc

{rfit

rff.

belief, I

r;

Fisce

SiBsature ol tbe Candidate. .Llalc

*aw qqpiqa IDENTIII' CERTIIIICATI: (ereai{i

eftiirnh fi {fiEir{ qr n-S ao*).:-(This Certificate is to l:e signed by aly one of the follc'wiDg) q$-T



(.,tr) $s1

:*

Foqi Sr rrrv+rt far srilqr*; 6f Cazetted Omcers the State or Centra'l .(ioyernoscBti

(i) (trr) ,i+rd [*-qr trcq tzflcq.Eidr+ ffig; Iiil Mcmbcrs ol thc Parliam:nt or Staie Legislatrrre. irr.r) :r-t-arn:it+ t;riunrt/*fr+t (i'i) Sr,h-Divi:irrnal M ag.strates/Ofliccrs ; (wr) rn'tt
(iv)

;

or Naib Deputy Talsildars authorisod to exercisfl magisterial powers; qrrqfflyrrft nr{ilsqrqcr+ n'i mfurltr+r {T6cfqs xr+ii*/fio.ir teTriq{q'F; Principals and Head I\r ast€r$ of all recogniserl Coliegcs and/or Secoudary Schooi ;Mamalald,e rs, Tahsildors

(wt) (v)

{Eit

-
q;fnl fq,,q1s1q.qici

-------.-.-

fg+Tsr

w*

2E*n dcrftiT {{'!e-(

fii.

{xE)

(relu i+rr rlqi sfilq r r)

. s

on

Certificated

thit I

have known Sirri/$hrimati,{KuBari"-

/dsughie /wifc of l:hi r

*----_-,*----

_

--:-,-.------_-.'----.---._*-__,_------for

the

last---

_-_.'-----*,,EX(,

u the .rrs bcst u!cr{ of et my rlJ f,.rru\rrcugc knonledge aus paKIClUitfS aDd Uerrel beliefparticr trs IUinjSneO fun:shed by Dy hjlltr;1ef hlfii her.rN tN COffCC-t, ccirrc.cl, - montlrs and thatr o

Pkce Sig(al Date

trsr-.'_

_

__ -r*

_..--_'

j

(Dcsiguaricrr or Status and lddres!) { (r

)

srqM

i.qafl rrfuar"qrt fis, q{?Tr aT fu

(i) Nar:e,

s?rqE

S

dasignation and full addrcas of the authoriry.

*)

(To

qix appointiflg

(f ) errrr:n, etrErrrqr flq'qi r 6-atard ia w[ t va (ifi Posl t,rr nhich {hc cendidato is being contidcred

be

,

frtled in by the Ofict)