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ogmurenrrlupnryriooflrir GlunfluSludl LopErn Gunfltgludr g4riuonp ururi8rfloloeir Experience


Certificate-eir Glpn$ki: griu6 oeirofl Slru&gonryarb srniurs GLoGlzunrlu6 (Countersigned)

6f6lforgl Glpnuriuno, o5lefrrennriupnnrioeir g4eonnzulgrir Gleeireonr&g o'l$gt GLoGlnrnrlurir


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$tu6oorb gcrglrl Glgn$leir giuril oeiloSl Sluti;gprfleir orniuno, Experience Certificate-+ir


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glldleorri Glunflufluf odugnrfloerflrir grpeilorrioeocnqri Regional Nodal Officer-s5nns
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Experience Certificate-+il Gr-oGlonrluri Gsnrfl ofleuorermrluri Glorirgt GlonohdTrnlrnb.

Glsnfiurfhl orrcil6uurgu -Sor6uurfio6lflfir oflornit.

1 Request Letter
2. Experience Certificate prescribed by TRB - 3 Nos. (in Original)'
3. Original Service Certificate duly signed by the Principal &
Correspondent (or) Chairman.
4. Xerox copies of Pay Acquaintance duly attested by the Principal
in each page. (or)
ECS (griluro crLrardl seuor&dkfu oor$uLrb oLprareriuigtDppneil,
t r+gei:er rfl oir enoirGlpniupgJttin
s"gul Ban k Statem e nt.
5. Xerox copies of Attendance Register duly attested by the
Principal in each page. (or)
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urueiru@$priuL-g6$gn2, g4gnnnn& g$nr5lu@ otilgrrfl grpdrof
eiLpdrgilr eneirgl.
6. Affidavit in the prescribed format in the Bond Paper of Rs.20l-
with Signature of the Notary Public and two witnesses.
7. odgUfrflugkfu urynLnrfl &ouuiu ggcu nrurriro oir, Glorriremi (Fl ood) gfil5ug1
6 oflupgt (Fire Accident) Guneirp onrJoinrriroennoil
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glory6flLoir gqgeonn& 1qdnCIL@ grprirori eryrugrb enoirE.
8. Serv'rce Certificate u6ogtu Gp$unrir GtupdlO;i;png1i, Principal &
Correspondent (or) Chairman (or) Secretary eoaGlunfru$gL-eir
Gkrr&tqdr uL-o3!$|il clfrUrfi Glsneirenonrb.

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MODEL AFFIDAVIT

Certificate to the effect that l, was working as

Assistant Professor / Lecturer ...... in the


Department (Teaching Staff) in College,

which is a / Government Aided /


Government Self Financing
Engineering College for the period from .... to as per the
Experience Certificate issued by the institution signed by appropriate authority.

I hereby declare that the information furnished in the Experience Certificate is

bonafide one and tr.ue to the best of my knowledge. lf any discrepancies found later,

I am fully aware of the legal consequences and proceedings to be initiated against

me in case of falsification of records if any made by me and I will abide by the orders

issued by the Teachers Recruitment Board, which is the Recruiting Agency and in

such eventuality I know that my candidature shall be forfeited.

Signature of the Individual

I have verified with proof of records.

Signature of Notary Public

Witness 1:

Witness 2:
o.q{*
for Director of Technical Education

*"#'
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