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From pre-grge:

1. Dte.GHS, Admn. I/[ Section/O& M Section, Nirman Bhawan, New _Delhi.
   
   
   1. The Assistant Director, Employment News, East Block-IV, Level -5, _R.K. Puram, New Delhi- 110066. It is requested that the vacancy circular may kindly be published in the earliest issue of the Employment News under
      
      
   2. intimation to this Ministry.
2. Director (e-Gov), D/o Health & Family Welfare, New Delhi with a request _to upload the same on this Ministry's website.
   
   
3. Notice Board/ Guard File.
   
   
4. Hindi I Section, with a request to provide hindi version.
   
   

BIO-DATA/CURRICUL UM VITAE PERFORMA

l. Name and Address ( in Block Letters)

1. Date of Birth (in Christian era)
   
   
2. I) Date of entry into service
   
   

ii) Date ofretirement under Central/ State Government Rules

1. EducationalQualifications
   
   
2. Whether Educational and other qualifications required for the post are satisfied. (If any qualilication has been treated as equivalent to the one prescribed in the Rules, state the authority for the same)
   
   

Qualification/ ^{Experience required as Qualifications/ experience possessed by the mentioned in the advertisement / officer vacancy circular Essential Essential}

^A) Qualification A) Qualification B) Experience B) Experience Desirable Desirahle

^A) Qualification A) Qualification B) Experience B) Experience

5.1 Note: This column needs to be amplified to indicate Essential _{and oeiirable Qualifications .as mentioned in the RRs by the Administrative Ministry/ Department / Ofiice at the time of issue of Circular and issue of Advertisement in the Employment News.}

1. ^{in the case of Degree and Post Graduate Qualification Elective / main subjects and subsidiary subjecs may be indicated by the csndidate.}
   
   
2. Please state clearly whether in the light of
   
   

entries made by you above, you meet the ^{requisite Essential} Qualifications ard work experience of the post.

Permanent or

Peimanent

9. In case the present employment is held on deputation/ contract

basis. please statea) The date of initial b) Period of appointment c) Name of the parent d) Name of the appointment on deputation/ contract office/ organization to post and Pay ofthe

which the applicant post held in

belongs. substantive capacity in the parent organ ization

9.1 Note: In case of Officers already on deputation, the applications of such officers should be forwarded by the parent cadre / Department along with Cadre Clearance, Vigilance Clearance and Integrity certificate.

9.2 Note: Information under Column 9 (c) & (d) above must be given in _all cases where a person is holding a post on deputation outside the cadre / organization but still maintaining a lien in his parent cadre / organization

10. If any post held on Deputation in the past by the applicant, date of return

from the last deputation and other details. ll. Additional details about present employment:

Please state whether working under ( indicate the name of your employer

against the relevant column) a) Central Government b) State Govemment c) Autonomous Organization d) Government Undertaking e) Universities f) Others

1. Please state whether you are working in the same Department _{and ari in the feeder grade or feeder to feeder grade.}
   
   
2. ^{Are you in Revised Scale of Pay? If yes, give the dati fiom which-iEi revision took place and also indicalg the pre-revised scale}
   
   
3. Total emoluments pr month now drawn Basis Pay in the PB Grade Pav
   
   
4. In case the applicant belongs to an organization which is not following the Central Govemment
   
   

Total Emoluments

Pay-scales, the latest salary slip issued by the organization showing the following details may be enclosed. Basic Pay with Dearness Pay/ interim relief / Total Emoluments Scale of Pay and other Allowances etc. (with rate of increment break-up details)

16. A Additional Information, ifany, relevant to the

post you applied for in support of your suitability for the post. (This among other things may provide information with regard to (i) additional academic qualifications

(ii) Professional training and (iii) work experience over and above prescribed in the Vacancy Circular/ Advertisement)

(Note: Enclose a separate shee! if the space is insufficient)

16. B Achievement: The candidates are requested to indicate information with regard to;

(i)

Research publications and reports and special projects

(ii)

Awards/Scholarships/Offi cial Appreciation

(iii) Affiliation with the professional bodies/ institutionVsocieties and;

(iv)

Patents registered in own name or achieved for the organization

(v)

Any research / innovative measure involving official recognition (vi) any other information.

(Note: Enclose a sepante sheet if the space is insuflicient)

17. Please state whether you ar applying for deputation (ISTC)i Absorption/ Re-employment Basis#. # (Officers under Centray State Govemments are onlyeligible for "Absorption". Candidates of non-Govemment Organizations are eligible only for Short Term Contract)# ^(The Option of 'STC' / 'Absorption'/ Re

employment' are available only ifthe vacancy circular specially mentioned recruitment by "STC,, or "Absorption" or " Re-employmenf' _).

18. Whether belongs to SC/ ST

^{I have carefully gone through the vacancy circular/ advertisement and I am well aware that _the information fumished in the curriculum vitae _{duly supported by the documents in respect of}}

^Essential Qualification / Work Experience submitted by me will also be assessed by the Selection Committee at the time of selection for the post. The information/ details provided by me _{are correct and true to the best ofmy knowledge and no material fact having a bearing on my selection has been}

suppressed / withheld.

(Signature of the candidate)

Address

Date

Certification by the Employer/Cadre Controlling Authority

The information/ details provided in the above application _{by the applicant are true and}

^{correct as per the facts available on records. He/ she possesses educational qualifications and experience mentioned in the vacancy circular, if selected, he/ _{she will be relieved immediately.}}

2. Also certified that;

i) There is no vigilance or disciplinary case pending/ contemplated against _{Shri/ Smt.}

iD HiV her integrity is certified.

iiD His/ her CR Dossier in original is enclosed./ photocopies of the ACRs for the last ₅ years _duly attested by an officer of the rank of Under Secretary of the Govt. of India or above _are enclosed.

in) No Major/ Minor penalty has been imposed on him/ her during the tast l0 years _{or A list of major/ minor penalties imposed on him/ her during the last 10 years is enclosed (as the case may be).}

Countersigned

(Elnp