Attestation Form Police Verification In Marathi Language 2q5r51

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

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

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

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{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
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&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.

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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

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or surname), E4Iqr

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Prese_nt addrcss

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

Number, Lane/Street/Road and fown).

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(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).

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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 ,

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Quarter of the place mentioiol in the preceding column

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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

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ol tNr Artsstarioo Form.)

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I cirrlify that

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



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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
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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

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Certificated

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have known Sirri/$hrimati,{KuBari"-

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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

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dasignation and full addrcas of the authoriry.

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be

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frtled in by the Ofict)