jw;nray; tpLg;G tpz;zg;gk;jw;nray; tpLg;G tpz;zg;gk;jw;nray; tpLg;G tpz;zg… · 2018-10-20 · kUj;Jt kUj;Jt kUj;Jt

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jw;nray; tpLg;G tpz;zg;gk; jw;nray; tpLg;G tpz;zg;gk; jw;nray; tpLg;G tpz;zg;gk; jw;nray; tpLg;G tpz;zg;gk; jw;nray; tpLg;G tpz;zg;gk;

01. ngau;;:..................................................................

02. gjtp: .................................................................

03. gzpGupAk; gs;sp: .................................................................

: .................................................................

: .................................................................

04. tpLg;G ,Ug;G:..................................................................

05. Njitahd tpLg;G:..................................................................

06. tpLg;Gf;fhd fhuzk;:..................................................................

07. kPjKs;s tpLg;G:..................................................................

08. mDkjp NfhUk; ehs;:..................................................................

09. tpLg;Gf;fhy Kftup:..................................................................

:..................................................................

10. Mrpupau; ifnahg;gk;: .................................................................

11. jiyik Mrpupau; mDkjp: .................................................................

12. jiyik Mrpupau; ifnahg;gk; : .............................................................

jw;nray; tpLg;G tpz;zg;gk;jw;nray; tpLg;G tpz;zg;gk;jw;nray; tpLg;G tpz;zg;gk;jw;nray; tpLg;G tpz;zg;gk;jw;nray; tpLg;G tpz;zg;gk;

01. ngau; ; : ..................................................................

02. gjtp : .................................................................

03. gzpGupAk; gs;sp : .................................................................

: .................................................................

: .................................................................

04. tpLg;G ,Ug;G : ..................................................................

05. Njitahd tpLg;G : ..................................................................

06. tpLg;Gf;fhd fhuzk; : ..................................................................

07. kPjKs;s tpLg;G : ..................................................................

08. mDkjp NfhUk; ehs; : ..................................................................

09. tpLg;Gf;fhy Kftup : ..................................................................

: ..................................................................

10. Mrpupau; ifnahg;gk; : .................................................................

11. jiyik Mrpupau; mDkjp : .................................................................


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TNPTF - ATHOOR - DINDIGUL.

tiuaWf;fg;gl;l tpLg;G tpz;zg;gk; tiuaWf;fg;gl;l tpLg;G tpz;zg;gk; tiuaWf;fg;gl;l tpLg;G tpz;zg;gk; tiuaWf;fg;gl;l tpLg;G tpz;zg;gk; tiuaWf;fg;gl;l tpLg;G tpz;zg;gk;

01. ngau;;:..................................................................

02. gjtp: .................................................................

03. gzpGupAk; gs;sp: .................................................................

: .................................................................

: .................................................................

04. tpLg;G ,Ug;G:..................................................................

05. Njitahd tpLg;G:..................................................................

06. tpLg;Gf;fhd fhuzk;:..................................................................

07. kPjKs;s tpLg;G:..................................................................

08. tpLg;Gf;fhy Kftup:..................................................................

:..................................................................

09. Mrpupau; ifnahg;gk;: .................................................................

10. jiyik Mrpupau; mDkjp: .................................................................


tiuaWf;fg;gl;l tpLg;G tpz;zg;gk;tiuaWf;fg;gl;l tpLg;G tpz;zg;gk;tiuaWf;fg;gl;l tpLg;G tpz;zg;gk;tiuaWf;fg;gl;l tpLg;G tpz;zg;gk;tiuaWf;fg;gl;l tpLg;G tpz;zg;gk;

01. ngau; ; : ..................................................................

02. gjtp : .................................................................

03. gzpGupAk; gs;sp : .................................................................

: .................................................................

: .................................................................

04. tpLg;G ,Ug;G : ..................................................................

05. Njitahd tpLg;G : ..................................................................

06. tpLg;Gf;fhd fhuzk; : ..................................................................

07. kPjKs;s tpLg;G : ..................................................................

08. tpLg;Gf;fhy Kftup : ..................................................................

: ..................................................................

09. Mrpupau; ifnahg;gk; : .................................................................

10. jiyik Mrpupau; mDkjp : .................................................................


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kUj;Jt kUj;Jt kUj;Jt kUj;Jt kUj;Jt / <l;ba tpLg;G tpz;zg;gk; <l;ba tpLg;G tpz;zg;gk; <l;ba tpLg;G tpz;zg;gk; <l;ba tpLg;G tpz;zg;gk; <l;ba tpLg;G tpz;zg;gk;

1. tpz;zg;gjhuu; ngau; : .........................................................................

2. gjtpapd; ngau; : .........................................................................

3. gzpGupAk; Jiw> mYtyfg; gpupT : .........................................................................

.........................................................................

.........................................................................

4. mbg;gil Cjpak; : .........................................................................

5. tpz;zg;gpf;Fk; tpLg;gpd; jd;ik

m) tpz;zg;gpf;Fk; tpLg;gpd; fhy msT

kw;Wk; tpLg;gpy; nry;Yk; ehs; : .........................................................................

M) kUj;Jtr; rhd;wpd; mbg;gilapy;

tpLg;G tpz;zg;gpf;fg;gl;bUg;gpd;

kUj;Jtr;rhd;W ,izf;fg;gl;Ls;sjh? : .........................................................................

6. tpLg;gpy; nry;yf; fhuzk; : .........................................................................

7. nghJ kw;Wk; muR tpLKiwfs; Kd; ,izg;G

gpd; ,izg;G cj;Njrpf;fg;gl;Ls;sjh? : .........................................................................

8. ,jw;F Kd; tpz;zg;gpj;J ,Ue;jhy;

mt;tpLg;Gj; jd;ik> tpLg;Gf;fhd fhy

msT kUj;Jtr; rhd;W ,izf;fg;gl;Ls;sjh? : .........................................................................

9. tpLg;gpy; ,Uf;Fk;NghJ Kftup : .........................................................................

.........................................................................

.........................................................................

10. nghWg;G xg;gilj;jtu; ngau;

( jiyik Mrpupauhf ,Ue;jhy; ) : .........................................................................

11. jkpo;ehL tpLg;G tpjpfs; tpjp 15-V/4d; gb

cWjpnkhop ,izf;fg;gl;Ls;sjh? : .........................................................................

12. Mrpupau; ifnahg;gk; : .........................................................................

tpLg;G mDkjpf;fhd gupe;JiutpLg;G mDkjpf;fhd gupe;JiutpLg;G mDkjpf;fhd gupe;JiutpLg;G mDkjpf;fhd gupe;JiutpLg;G mDkjpf;fhd gupe;Jiu

..................................................... Kjy;; ..................................................... tiu ..................... ehl;fSf;F

jpU / jpUkjp ................................................................................................................................... vd;gtuhy; tpz;zg;gpf;fg;gl;l

................................................................................. tpLg;ig mbg;gil tpjp ....................................... ,d; gb mDkjpf;fyhk;

vd rhd;W mspf;fpNwd;.

jiyik Mrpupau; ifnahg;gk;

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mDg;Geu ;

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ngWeu;

cau;jpU. tl;lhuf; fy;tp mYtyu; mtu;fs;>

tl;lhuf; fy;tp mYtyfk;>

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Iah>

nghUs; :nghUs; :nghUs; :nghUs; :nghUs; : <l;ba tpLg;ig muRf;F xg;gilg;G nra;jy; - rhu;G.

vd;Dila <l ;ba tpLg ;G fzf;fpypUe ;J . . . . . . . . . . . . . . . . . . ehs;fis

.......................................................... md;W> muRf;F xg;gilg;G nra;fpNwd;. xg;gilg;G

nra;j ehs;fSf;Fupa gzg; gyid ngw;Wj; jUkhW r%fk; mtu;fis gzpe;J Nfl;Lf;

nfhs;fpNwd;.

,g;gbf;F>

jq;fs; cz;ikAs;s>

,lk;,lk;,lk;,lk;,lk; :

ehs;ehs;ehs;ehs;ehs; :

jiyikahrpupau; gupe;Jiu :jiyikahrpupau; gupe;Jiu :jiyikahrpupau; gupe;Jiu :jiyikahrpupau; gupe;Jiu :jiyikahrpupau; gupe;Jiu :

tl;lhuf; fy;tp mYtyu; mtu;fSf;F gupe;Jiu nra;J> gzpe;J mDg;gg;gLfpwJ.

jiyikahrpupau; ifnahg;gk;

,izg;G :,izg;G :,izg;G :,izg;G :,izg;G :

1 .1 .1 .1 .1 . <l;ba tpLg;G xg;gilg;G tpz;zg;gk; .<l;ba tpLg;G xg;gilg;G tpz;zg;gk; .<l;ba tpLg;G xg;gilg;G tpz;zg;gk; .<l;ba tpLg;G xg;gilg;G tpz;zg;gk; .<l;ba tpLg;G xg;gilg;G tpz;zg;gk; .

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<l;ba tpLg;G xg;gilg;G tpz;zg;gk;<l;ba tpLg;G xg;gilg;G tpz;zg;gk;<l;ba tpLg;G xg;gilg;G tpz;zg;gk;<l;ba tpLg;G xg;gilg;G tpz;zg;gk;<l;ba tpLg;G xg;gilg;G tpz;zg;gk;

1. Mrpupau; ngau; : ....................................................................................................................

2. gjtp : ....................................................................................................................

3. gs;spapd; ngau; : ....................................................................................................................

....................................................................................................................

4. rk;gs tpfpjk; :

1) mbg;gil Cjpak; : &. &. &. &. &. ...................................

2) mftpiyg;gb : &. &. &. &. &. ...................................

3) rpwg;G / jdp Cjpak : &. &. &. &. &. ...................................

4) tPl;L thlifg;gb : &. &. &. &. &. ...................................

5) kUj;Jtg;gb : &. &. &. &. &. ...................................

nkhj;jk; : &.&.&.&.&.

5. Cjpa cau;T ehs; : ...............................................................................

6. ,jw;F Kd; vLj;j <l;ba tpLg;G : ...............................................................................

7. jw;NghJ ve;j Njjp epiyapy;> vj;jid

ehs;fSf;F xg;gilg;G nra;fpwhu; : ....................................................................................................................

8. xg;gilg;G Njjpf;F Kd; 1 my;yJ 2 Mz;L1 my;yJ 2 Mz;L1 my;yJ 2 Mz;L1 my;yJ 2 Mz;L1 my;yJ 2 Mz;L vLj;j tpLg;Gfs; ( jw;nray; tpLg;G

jtpu ) midj;Jk; fl;lhak; Fwpf;fg;gl NtzLk; :

( m ) kUj;Jt tpLg;GkUj;Jt tpLg;GkUj;Jt tpLg;GkUj;Jt tpLg;GkUj;Jt tpLg;G :

( 1 ) ......................................... Kjy; .................................................. Kba ............ ehs;fs;

( 2 ) ......................................... Kjy; .................................................. Kba ............ ehs;fs;

( 3 ) ......................................... Kjy; .................................................. Kba ............ ehs;fs;

( 4 ) ......................................... Kjy; .................................................. Kba ............ ehs;fs;

( 5 ) ......................................... Kjy; .................................................. Kba ............ ehs;fs;

( M) <l;ba tpLg;G<l;ba tpLg;G<l;ba tpLg;G<l;ba tpLg;G<l;ba tpLg;G :

( 1 ) ......................................... Kjy; .................................................. Kba ............ ehs;fs;

( 2 ) ......................................... Kjy; .................................................. Kba ............ ehs;fs;

( 3 ) ......................................... Kjy; .................................................. Kba ............ ehs;fs;

( 4 ) ......................................... Kjy; .................................................. Kba ............ ehs;fs;

( 5 ) ......................................... Kjy; .................................................. Kba ............ ehs;fs;

9. tpz;zg;gjhuu; ifnahg;gk; : ....................................................................................................................

10. jiyik Mrpupau; gupe;Jiu : gzpe;J mDg;gg;gLfpwJ.gzpe;J mDg;gg;gLfpwJ.gzpe;J mDg;gg;gLfpwJ.gzpe;J mDg;gg;gLfpwJ.gzpe;J mDg;gg;gLfpwJ.

11. jiyik Mrpupau; ifnahg;gk; : ....................................................................................................................

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gz;bif Kd;gzk; NfhUk; tpz;zg;gk;gz;bif Kd;gzk; NfhUk; tpz;zg;gk;gz;bif Kd;gzk; NfhUk; tpz;zg;gk;gz;bif Kd;gzk; NfhUk; tpz;zg;gk;gz;bif Kd;gzk; NfhUk; tpz;zg;gk;

1. tpz;zg;gjhuu; ngau; : .............................................................................

2. gjtp : .............................................................................

3. gs;spapd; ngau; kw;Wk; Kftup : .............................................................................

: .............................................................................

: .............................................................................

4. Kjd;Kjypy; gzpapy; Nru;e;j ehs; : .............................................................................

5. mbg;gilr; rk;gsk; : .............................................................................

6. gpwe;j Njjp : .............................................................................

7. Xa;T ngWk; Njjp : .............................................................................

8. Kd;G ngw;w Kd;gzk; tpguk;

nghq;fyh? jPghtspah? fpwp];Jk]h? : .............................................................................

9. Kd;G ngw;w gz;bif Kd;gzk; : .............................................................................

10. KOtJk; jpUk;g nrYj;jg;gl;ljh? : .............................................................................

11. Kd;G ngw;w gz;bif Kd;gzk;

epYitapy; ,Ug;gpd; tpguk; : .............................................................................

12. jw;NghJ Kd;gzk; NfhUk; gz;bif

nghq;fyh? jPghtspah? fpwp];Jk]h? : .............................................................................

13. jw;NghJ Kd;gzk; NfhUk; njhif : .............................................................................

14. jpUk;g nrYj;Jk; tpguk; : .............................................................................

15. Mrpupau; ifnahg;gk; : .............................................................................

16. jiyik Mrpupau; gupe;Jiu : .............................................................................

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mDg;Geu;

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ngWeu;

cau;jpU. tl;lhuf;fy;tp mYtyu; mtu;fs;>

tl;lhuf;fy;tp mYtyfk;;>

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nghUs; : Mrpupau; itg;Gepjp Kd;gzk; - Mrpupau; tUq;fhy itg;Gepjp

vz; : .......................... jpU/jpUkjp ...................................................................

jw;fhypf Kd;gzk; xg;gspg;G gzpe;J Ntz;Ljy; rhu;ghf - tpz;zg;gk;

gzpe;jspj;jy;.

ghu;it : murhiz gytif vz; : 1606 epjp - epjp Ftpg;G ehs; : 07. 12. 1979.

kjpg;gpw;Fupa Iah>

jq;fs; Nkyhd jiyikapd; fPo; ......................................................................................................................

gs;spapy; ....................................................................................... Mrpupauhfg; gzpahw;wp tUfpNwd;. ,g;nghOJ

....................................................... kUj;Jtr; nryT nra;a Ntz;ba ,d;wpaikahik vOe;Js;sjhy;

vd;Dila Mrpupau; tUq;fhy itg;GepjpapypUe;J jw;fhypf Kd;gzkhf &. .................................................

ngWtjw;F xg;gspg;G nra;J Miz toq;FkhW kpfTk; gzpe;J Ntz;bf; Nfl;Lf;nfhs;fpNwd;.

kw;Wk; Nkw;fz;l Kd;gzk; ngw tiuaWj;j tpz;zg;gk; kw;Wk; Njitahd jfty;fis ,j;Jld;

,izj;Js;Nsd; vd;gij gzpTld; njuptpj;Jf;nfhs;fpNwd;.

jtpuTk;> Vw;fdNt Mrpupau; tUq;fhy itg;Gepjapy; ngw;w Kd;gz Mizf;Fk;>

,g;nghOJ NfhUk; Kd;gz Mizf;Fk; ,ilg;gl;l fhyk; MW khjq;fSf;F Nky; cs;sd vdTk;

cWjp $WfpNwd;.

MfNt ,j;jUzj;jpy; cldbahf jf;f eltbf;if Nkw;nfhz;L vdf;F jw;fhypf

Kd;gzk; toq;Ftjw;F xg;gspg;G Miz toq;FkhW kPz;Lk; gzpe;J Ntz;LfpNwd;.

ehs; : ,g;gbf;F>

,lk; ; : jq;fs; cz;ikAs;s>

jiyikahrpupau; gupe;Jiu :jiyikahrpupau; gupe;Jiu :jiyikahrpupau; gupe;Jiu :jiyikahrpupau; gupe;Jiu :jiyikahrpupau; gupe;Jiu :

cjtpj; njhlf;ff;fy;tp mYtyu; mtu;fSf;F gupe;Jiu nra;J> gzpe;J mDg;gg;gLfpwJ.

jiyik Mrpupau; ifnahg;gk;>

,izg;G :,izg;G :,izg;G :,izg;G :,izg;G : 1) jw;fhypf Kd;gzk; Ntz;Lk; tpz;zg;gk; 2) 20 - 20 Mk; Mz;bd; fzf;Fr;rPl;L 3) Vw;fdNt ngw;w Kd;gz Miz. 4) ,ilg;gl;l fhyj;jpy; nrYj;jg;gl;l njhif tptuq;fs;.

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Mrpupau; Nrkey epjpapypUe;J jw;fhypf Kd;gzk; ngWtjw;fhd tpz;zg;gk;Mrpupau; Nrkey epjpapypUe;J jw;fhypf Kd;gzk; ngWtjw;fhd tpz;zg;gk;Mrpupau; Nrkey epjpapypUe;J jw;fhypf Kd;gzk; ngWtjw;fhd tpz;zg;gk;Mrpupau; Nrkey epjpapypUe;J jw;fhypf Kd;gzk; ngWtjw;fhd tpz;zg;gk;Mrpupau; Nrkey epjpapypUe;J jw;fhypf Kd;gzk; ngWtjw;fhd tpz;zg;gk;

1. re;jhjhuupd; ngau; : .................................................

2. gjtpapd; ngau; : .................................................

3. gs;sp : .................................................

: .................................................

4. Nrkeyepjpf; fzf;F vz; : .................................................

5. gzpapy; Nru;e;j ehs; : .................................................

6. taJ Kjpu;tpy; Xa;T ngWk; ehs; : .................................................

7. i. mbg;gil Cjpak;> jdp Cjpak; kw;Wk; ju Cjpak; : .................................................

ii. MW khj Cjpak; : .................................................

8. ,Wjpahfg; ngwg;gl;l fzf;Fr; rPl;bd; gb cs;s njhif

( Cjpaf; FO epYitj; njhifiaj; jtpu;j;J ) : .................................................

9. gpd;du; nrYj;jpa re;jh kw;Wk; jtizj; njhiffs; : .................................................

10. nkhj;jk; ; : .................................................

11. gpd;du; ngw;w jw;fhypf Kd;gzk; kw;Wk; gFjp ,Wjpj;

njhiffs; ( fopf;fTk; ) : .................................................

12. tpz;zg;g ehspy; ,Ug;gpy; cs;s njhif : .................................................

13. ,Ug;Gj; njhifapy; 75% / 90% : .................................................

14. ,jw;F Kd; filrpahfg; ngw;w gFjp ,Wjpj; njhif / : .................................................

jw;fhypf Kd;gzk; mDkjpj;j Miz vz;> ehs; .................................................

15. Xuhz;L fhyk; / MW khj fhyk; Kbe;Jtpl;ljh? : .................................................

16. fle;j Kiw ngw;w jw;fhypf Kd;gzj; njhif : .................................................

17. fle;j Kiw jw;fhypf Kd;gzk; ngw;wjw;fhd fhuzk; : .................................................

18. fle;j Kiw jw;fhypf Kd;gzk; ngw;wNghJ

xd;whf;fg;gl;l Kd;gzj; njhif : .................................................

19. ,Jtiu jpUg;gg;gl;lj; njhif : .................................................

20. ,d;dKk; jpUg;gg;gl Ntz;ba njhif : .................................................

21. jw;NghJ NfhUk; njhif : .................................................

22. nkhj;jk; : .................................................

23. jpUk;gr; nrYj;Jk; fhyk; : .................... khjq;fs;; : .................... njhif : ....................

24. Nkw;gb njhif Nfhuf; fhuzk; : .................................................

25. ,f;Nfhupf;if epahakhdJ vdf; fhl;Lk; #o;epiy gw;wpa

tptuk; : .................................................

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Kd;gzk; NfhUjy; njhlu;ghf $Ljy; jfty;fs;Kd;gzk; NfhUjy; njhlu;ghf $Ljy; jfty;fs;Kd;gzk; NfhUjy; njhlu;ghf $Ljy; jfty;fs;Kd;gzk; NfhUjy; njhlu;ghf $Ljy; jfty;fs;Kd;gzk; NfhUjy; njhlu;ghf $Ljy; jfty;fs;

1) Ke;ija Kd;gzk; xg;gspg;Gj; njhif mYtyu; : ...............................................................................

kw;Wk; gjtp epiy ...............................................................................

2) tpz;zg;gjhuu; Cjpag; gpbj;jk; rhu;ghd jfty;fs; :tpz;zg;gjhuu; Cjpag; gpbj;jk; rhu;ghd jfty;fs; :tpz;zg;gjhuu; Cjpag; gpbj;jk; rhu;ghd jfty;fs; :tpz;zg;gjhuu; Cjpag; gpbj;jk; rhu;ghd jfty;fs; :tpz;zg;gjhuu; Cjpag; gpbj;jk; rhu;ghd jfty;fs; :

m) gz;bif Kd;gzk; : &.&.&.&.&. .........................................................................

M) ifj;jwp Mil Kd;gzk; : &.&.&.&.&. .........................................................................

,) fju; Mil Kd;gzk; : &.&.&.&.&. .........................................................................

<) kpjptz;b Kd;gzk; : &.&.&.&.&. .........................................................................

c) jpUkzk; / tPL fl;l Kd;gzk; : &.&.&.&.&. .........................................................................

C) cau;fy;tp / tsu; Nrkpg;G Kd;gzk; : &.&.&.&.&. .........................................................................

v) MAs; fhg;gPL / mQ;ryf MAs; fhg;gPL : &.&.&.&.&. .........................................................................

nkhj;jk;nkhj;jk;nkhj;jk;nkhj;jk;nkhj;jk; : &.&.&.&.&. .........................................................................

3) itg;Gepjp rhu;ghd gpbj;jq;fs; :itg;Gepjp rhu;ghd gpbj;jq;fs; :itg;Gepjp rhu;ghd gpbj;jq;fs; :itg;Gepjp rhu;ghd gpbj;jq;fs; :itg;Gepjp rhu;ghd gpbj;jq;fs; :

m) khjhe;jpu itg;G epjp re;jh : &.&.&.&.&. .........................................................................

M) itg;Gepjp Ftpg;gpy; Kd;gz gpbj;jj; njhif : &.&.&.&.&. .........................................................................

,) FLk;g eyj;jpl;lj; njhif (FBF) : &.&.&.&.&. .........................................................................

<) rpwg;G eyj;jpl;lj; njhif (SPF) : &.&.&.&.&. .........................................................................

c) tUkhdtup & fy;tp tup : &.&.&.&.&. .........................................................................

C) kUj;Jt ey epjp (NHIS 2012) : &.&.&.&.&. ........................................................................

nkhj;jk;nkhj;jk;nkhj;jk;nkhj;jk;nkhj;jk; : &.&.&.&.&. .........................................................................

4) Cjpak; :Cjpak; :Cjpak; :Cjpak; :Cjpak; :

m) mbg;gil Cjpak; (Basic Pay ) : &.&.&.&.&. .........................................................................

M) jdp Cjpak; (Personal Pay) : &.&.&.&.&. .........................................................................

,) mftpiyg;gb (DA) : &.&.&.&.&. .........................................................................

<) rpwg;G Cjpak; (Spl. All.) : &.&.&.&.&. .........................................................................

c) tPl;L thilifg; gb (HRA) : &.&.&.&.&. .........................................................................

C) kUj;Jtg; gb (MA) : &.&.&.&.&. ........................................................................

v) kiyg; gb (Hill All.) : &.&.&.&.&. ........................................................................

nkhj;j Cjpak;nkhj;j Cjpak;nkhj;j Cjpak;nkhj;j Cjpak;nkhj;j Cjpak; : &.&.&.&.&. .........................................................................

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4

5) tpz;zg;gjhuu; tPl;Lf;F vLj;Jr; nry;Yk; Cjpak;tpz;zg;gjhuu; tPl;Lf;F vLj;Jr; nry;Yk; Cjpak;tpz;zg;gjhuu; tPl;Lf;F vLj;Jr; nry;Yk; Cjpak;tpz;zg;gjhuu; tPl;Lf;F vLj;Jr; nry;Yk; Cjpak;tpz;zg;gjhuu; tPl;Lf;F vLj;Jr; nry;Yk; Cjpak; : &. &. &. &. &. ................................................................

tpz;zg;gjhuu; gpwe;j Njjptpz;zg;gjhuu; gpwe;j Njjptpz;zg;gjhuu; gpwe;j Njjptpz;zg;gjhuu; gpwe;j Njjptpz;zg;gjhuu; gpwe;j Njjp : ....................................................................

tpz;zg;gjhuu; Xa;T ngWk; Njjptpz;zg;gjhuu; Xa;T ngWk; Njjptpz;zg;gjhuu; Xa;T ngWk; Njjptpz;zg;gjhuu; Xa;T ngWk; Njjptpz;zg;gjhuu; Xa;T ngWk; Njjp : ....................................................................

tpz;zg;gjhuu; Kjd; Kjypy; gzpapy; Nru;e;j Njjptpz;zg;gjhuu; Kjd; Kjypy; gzpapy; Nru;e;j Njjptpz;zg;gjhuu; Kjd; Kjypy; gzpapy; Nru;e;j Njjptpz;zg;gjhuu; Kjd; Kjypy; gzpapy; Nru;e;j Njjptpz;zg;gjhuu; Kjd; Kjypy; gzpapy; Nru;e;j Njjp : ....................................................................

Jizf; fUTyj;jpd; ngau;Jizf; fUTyj;jpd; ngau;Jizf; fUTyj;jpd; ngau;Jizf; fUTyj;jpd; ngau;Jizf; fUTyj;jpd; ngau; : ....................................................................

....................................................................

Mtzq;fs; rupghu;f;fg;gl;ld.

jiyik Mrpupau; ifnahg;gk; tpz;zg;gjhuu; ifnahg;gk;jiyik Mrpupau; ifnahg;gk; tpz;zg;gjhuu; ifnahg;gk;jiyik Mrpupau; ifnahg;gk; tpz;zg;gjhuu; ifnahg;gk;jiyik Mrpupau; ifnahg;gk; tpz;zg;gjhuu; ifnahg;gk;jiyik Mrpupau; ifnahg;gk; tpz;zg;gjhuu; ifnahg;gk;

rhd;wpjo;rhd;wpjo;rhd;wpjo;rhd;wpjo;rhd;wpjo;

fyk; 6(c) ,d;gb tpz;zg;gjhuupd; itg;Gepjp fzf;fpYs;s epfuj; ,Ug;Gj;njhif rup

ghu ;f;fg;gl;lJ. rupnadr; rhd;W toq;fp md;dhu; NfhUk; Kd;gzj; njhif toq;f

Mizaplg;gLfpwJ.

tl;lhuf ;fy;tp mYtyutl;lhuf ;fy;tp mYtyutl;lhuf ;fy;tp mYtyutl;lhuf ;fy;tp mYtyutl;lhuf ;fy;tp mYtyu ;; ;; ;

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5

1) 20 - 20 Mz;L fzf;Fr; rPl;bd; gb ,Ug;G : &. ....................................

2) Nkw;nfhz;L nrYj;jpaJ (re;jh & jw;fhypf Kd;gz gpbj;jk;) : &. ....................................

Mf nkhj;jk; ............................................................................. : &. ....................................

3) fopf;f Ntz;baJ (jw;fhypf Kd;gzk; + gFjp ,Wjpj; njhif) : &. ....................................

epfu ,Ug;G ............................................................................. : &. ....................................

jiyik Mrpupau; ifnahg;gk; Mrpupau; ifnahg;gk;jiyik Mrpupau; ifnahg;gk; Mrpupau; ifnahg;gk;jiyik Mrpupau; ifnahg;gk; Mrpupau; ifnahg;gk;jiyik Mrpupau; ifnahg;gk; Mrpupau; ifnahg;gk;jiyik Mrpupau; ifnahg;gk; Mrpupau; ifnahg;gk;

tupir

vz;itg;Gepjp

re;jh

jw;fhypf

Kd;gz

gpbj;jk;

jtiz

vz;nkhj;jk;

ngw;w jw;fhypf

Kd; gzk; / gFjp

,Wjpj; njhif

Miz

vz;>

ehs;

khjk;

Mz;L

khu;r; 20

Vg; 20

Nk 20

[_d; 20

[_iy 20

Mf 20

nrg; 20

mf; 20

et 20

br 20

[d 20

gpg; 20

nkhj;jk;nkhj;jk;nkhj;jk;nkhj;jk;nkhj;jk;

tUq;fhy itg;G epjpf; Ftpg;gpy; ngw;w Kd;gzk;> fld;tUq;fhy itg;G epjpf; Ftpg;gpy; ngw;w Kd;gzk;> fld;tUq;fhy itg;G epjpf; Ftpg;gpy; ngw;w Kd;gzk;> fld;tUq;fhy itg;G epjpf; Ftpg;gpy; ngw;w Kd;gzk;> fld;tUq;fhy itg;G epjpf; Ftpg;gpy; ngw;w Kd;gzk;> fld;

kw;Wk; re;jh tptuq;fs; mlq;fpa gl;bay; re;jh tptuq;fs; mlq;fpa gl;bay; re;jh tptuq;fs; mlq;fpa gl;bay; re;jh tptuq;fs; mlq;fpa gl;bay; re;jh tptuq;fs; mlq;fpa gl;bay;

1) tpz;zg;gjhuu; ngau; : ..................................................................................

2) gzp epiy : ..................................................................................

3) itg;G epjp vz; ( TPF No. ) : ..................................................................................

4) tq;fp fzf;F vz; : ..................................................................................

5) gzpahw;Wk; gs;sp : ..................................................................................

: ..................................................................................

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6

........................................ tl;lhuf; fy;tp mYtyupd; nray;Kiwfs;tl;lhuf; fy;tp mYtyupd; nray;Kiwfs;tl;lhuf; fy;tp mYtyupd; nray;Kiwfs;tl;lhuf; fy;tp mYtyupd; nray;Kiwfs;tl;lhuf; fy;tp mYtyupd; nray;Kiwfs;

Kd;dpiy : .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Kd;dpiy : .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Kd;dpiy : .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Kd;dpiy : .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Kd;dpiy : .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e. f. vz; : ........................................... ehs; : .....................................e. f. vz; : ........................................... ehs; : .....................................e. f. vz; : ........................................... ehs; : .....................................e. f. vz; : ........................................... ehs; : .....................................e. f. vz; : ........................................... ehs; : .....................................

nghUs;nghUs;nghUs;nghUs;nghUs; ::::: nghJ tUq;fhy itg;Gepjp / g. A+. M. t. it. epjp / c. g. M. t. it. epjp /

efuit M. t. it. epjp - jw;fhypf Kd;gzk; xg;gspg;G toq;Fjy;.

ghu ;itghu ;itghu ;itghu ;itghu ;it ::::: 1) muR Miz vz; : 1063 epjpj;Jiw ehs; : 03.07.1986

2) muR Miz vz; : 1133 fy;tp ehs; : 22.06.1988

3) muR Miz vz; : 1176 ,. v];. b. ehs; : 14.12.1984

4) muR Miz vz; : 1228 fy;tp ehs; : 30.12.1994

5) tpz;zg;gjhuu; tpz;zg;gk;. ehs; :

Miz>Miz>Miz>Miz>Miz>nghJ tUq;fhy itg;Gepjp / g. A+. M. t. it. epjp / c. g. M . t . it . e p j p /

efuit M. t. it. epjp tpjp 14(1) m (i) (rp) (iii) Mfpaitfspd;gb fzf;F vz; ....................................... tUq;fhy

itg ; G e p j p a p y p U e ; J r p w g ; G f h uzj ; j p id Kd ; d p l ; L j w ; f h y p f Kd ; gzk h f & .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . jpU / jpUkjp.

................................................................................................................................. vd;ghUf;F md;dhupd; ............................................................ nryTf;fhf xg;gspg;G

toq;fg;gLfpwJ.

md;dhUf;F ,jw;F Kd; ................................... ,y; toq;fg;gl;l jw;fhypf Kd;gzk; $l;Lj;njhif

&. .......................................................... ( ............................................................................................................................................................................................... .................................................. )

,d;iwa ehspy; &. .......................................................... ( ...............................................................................................................................................................................................

.................................................. ) epYitahf cs;sJ. Nkw;gb njhifAld; jw;NghJ Kjy; gj;jpapy; toq;fg;gLk; Kd;gzk;

&................................ Ir; Nru;j;jhy; nkhj;jk; & ....................................... ( ...............................................................................................................................................................................................

.................................................. ) $l;Lj; njhif MfpwJ. ,e;j xd;W jpul;ba njhifapid &. ................................... tPjk; ...................

rk jtizfspy; gpbj;jk; nra;a Mizaplg;gLfpwJ. Nkw;gbj; njhif ................................................................ khjk; Kjy;

gpbj;jk; nra;ag;gLk;.

,tUf;F fle;j MW khj fhy ,ilntspapy; tUq;fhy itg;G epjpapypUe;J vt;tpj

jw;fhypf Kd; gzNkh ,Wjp Kd; gzNkh toq;fg;gltpy;iy vdr; rhd;wspf;fg;gLfpwJ.

fzf;Fj; jiyg;Gfzf;Fj; jiyg;Gfzf;Fj; jiyg;Gfzf;Fj; jiyg;Gfzf;Fj; jiyg;G

,izg;G,izg;G,izg;G,izg;G,izg;G

1. rk;gsk; : &. ................................................

2. ,d;iwa ehspy; fzf;fpy; ,Ug;gpy; cs;s njhif gw;wpa tpguq;fs;

m) khepy fzf;fhau; mtu;fs; 20 - 20 tUl

fzf;Fr; rPl;bd; gb ,Ug;Gj; njhif : &. ................................................ (((((+ )))))

M) .......................................................... Kjy; .......................................................... Kba nrYj;jpa

re;jh & jw;fhypf Kd;gzk; jpUk;g nrYj;jpa njhif : &. ................................................

nkhj;jk; : &. ................................................

,) ,jw;fpilNa ngw;w jw;fhypf Kd; gzk; / gFjp ,Wjp Kd;gzk; : &. ................................................ (((((- )))))

<) ,d;iwa ehspy; nkhj;j ,Ug;G : &. ................................................

c) Xa;T ngWk; ehs; : .......................................................

3 .3 .3 .3 .3 . epYitapy; cs;s jw;fhypf Kd;gzk; toq;fg;gl fhuzk; gw;wpa tpguq;fs; :epYitapy; cs;s jw;fhypf Kd;gzk; toq;fg;gl fhuzk; gw;wpa tpguq;fs; :epYitapy; cs;s jw;fhypf Kd;gzk; toq;fg;gl fhuzk; gw;wpa tpguq;fs; :epYitapy; cs;s jw;fhypf Kd;gzk; toq;fg;gl fhuzk; gw;wpa tpguq;fs; :epYitapy; cs;s jw;fhypf Kd;gzk; toq;fg;gl fhuzk; gw;wpa tpguq;fs; :

m) toq;fg;gl;lj; njhif : &. .................................... M) Miz vz; & ehs; : .........................................................................................

,) toq;fg;gl;l fhuzk; : ......................................................................... <) epYitj; njhif : &. .........................................................

efy; ngWeu;:efy; ngWeu;:efy; ngWeu;:efy; ngWeu;:efy; ngWeu;:

1. rk;ge;jg;gl;l gzpahsu;/Mrpupau;

2. gs;spr; nrayhsu;/epu;thfp;/jiyik Mrpupau;

3. gl;baYf;F

4. rhu;epiyf; fUT+y mYtyu;> Mj;J}u;.

5. Mizau;> muR Gs;sp tpgu ikak;> nrd;id.

6. khepy fzf;fhau;> nrd;id.

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mDg;Geu;

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........................................................................................

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ngWeu;

cau;jpU. tl;lhuf; fy;tp mYtyu; mtu;fs;>

tl;lhuf; fy;tp mYtyfk;;>

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nghUs; : Mrpupau; itg;Gepjp gFjp ,Wjpj; njhif - Mrpupau; tUq;fhy

itg;Gepjp vz; : .......................... jpU/jpUkjp...................................................

gFjp ,Wjpj; njhif xg;gspg;G gzpe;J Ntz;Ljy; rhu;ghf -

tpz;zg;gk; gzpe;jspj;jy;.

kjpg;gpw;Fupa Iah>

jq;fs; Nkyhd jiyikapd; fPo; ......................................................................................................................

gs;spapy; ....................................................................................... Mrpupauhfg; gzpahw;wp tUfpNwd;. ,g;nghOJ

....................................................... kUj;Jtr; nryT nra;a Ntz;ba ,d;wpaikahik vOe;Js;sjhy;

vd;Dila Mrpupau; tUq;fhy itg;GepjpapypUe;J gFjp ,Wjpj; njhif &. .................................................

ngWtjw;F xg;gspg;G nra;J Miz toq;FkhW kpfTk; gzpe;J Ntz;bf; Nfl;Lf;nfhs;fpNwd;.

kw;Wk; Nkw;fz;l gFjp ,Wjpj; njhig; ngw tiuaWj;j tpz;zg;gk; kw;Wk; Njitahd jfty;fis

,j;Jld; ,izj;Js;Nsd; vd;gij gzpTld; njuptpj;Jf;nfhs;fpNwd;.

jtpuTk;> Vw;fdNt Mrpupau; tUq;fhy itg;Gepjapy; ngw;w gFjp ,Wjpj; njhif

Mizf;Fk;> ,g;nghOJ NfhUk; gFjp ,Wjpj; njhif Mizf;Fk; ,ilg;gl;l fhyk; 12 khjq;fSf;F

Nky; cs;sd vdTk; cWjp $WfpNwd;.

MfNt ,j;jUzj;jpy; cldbahf jf;f eltbf;if Nkw;nfhz;L vdf;F gFjp ,Wjpj;

njhif toq;Ftjw;F xg;gspg;G Miz toq;FkhW kPz;Lk; gzpe;J Ntz;LfpNwd;.

ehs; : ,g;gbf;F>

,lk;; : jq;fs; cz;ikAs;s>

jiyikahrpupau ; gupe ;Jiu :jiyikahrpupau ; gupe ;Jiu :jiyikahrpupau ; gupe ;Jiu :jiyikahrpupau ; gupe ;Jiu :jiyikahrpupau ; gupe ;Jiu :

tl;lhuf; fy;tp mYtyu; mtu;fSf;F gupe;Jiu nra;J> gzpe;J mDg;gg;gLfpwJ.

jiyik Mrpupau; ifnahg;gk;>

,izg;G :,izg;G :,izg;G :,izg;G :,izg;G :

1) gFjp ,Wjpj; njhif Ntz;Lk; tpz;zg;gk;

2) 20 - 20 Mk; Mz;bd; fzf;Fr;rPl;L 3) Vw;fdNt ngw;w Kd;gz Miz. 4) ,ilg;gl;l fhyj;jpy; nrYj;jg;gl;l njhif tptuq;fs;.

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Mrpupau; nghJ tUq;fhy itg;G epjpapypUe;J gFjp ,Wjpj; njhifMrpupau; nghJ tUq;fhy itg;G epjpapypUe;J gFjp ,Wjpj; njhifMrpupau; nghJ tUq;fhy itg;G epjpapypUe;J gFjp ,Wjpj; njhifMrpupau; nghJ tUq;fhy itg;G epjpapypUe;J gFjp ,Wjpj; njhifMrpupau; nghJ tUq;fhy itg;G epjpapypUe;J gFjp ,Wjpj; njhif

ngWtjw;fhd tpz;zg;gk;ngWtjw;fhd tpz;zg;gk;ngWtjw;fhd tpz;zg;gk;ngWtjw;fhd tpz;zg;gk;ngWtjw;fhd tpz;zg;gk;

gzpahsu; ngau;gzpahsu; ngau;gzpahsu; ngau;gzpahsu; ngau;gzpahsu; ngau;

gjtp ngau; ( vj;njhFjpia (m> M> ,> <)

rhu;e;jtu; vd;gJ Fwpg;gpl Ntz;Lk;. )

tUq;fhy itg;Gepjpf; fzf;F vz; (Jiwapd;

ngaUld;)

gFjp / ,Wjpj; njhif ngWiff;F xg;gspg;G

toq;Fk;NghJ gzpahsupd; rk;gsk; ( mbg;gil

tpjpfspy; tiuaWf;fg;gl;Ls;sthW )

nkhj;jg; gzpf;fhyk; ( ,ilKwpTf;Fupa gzpf;fhyk; )

Kjd; Kjypy; gzpapy; Nru;e;j ehs;

gjpide;jhz;L gzpf;fhyj;ij gzpahsu; Kbj;j

ehs; ( ,ilKwpTf;Fupa gzpf;fhyk; cl;gl )

gpwe;j ehs;

taJ Kjpu;tpdhy; Xa;T ngWk; ehs;

gFjp / ,Wjp ngWiff;Fu pa njhif

(vz;zhYk;> vOj;jhYk; Fwpg;gplg;gl Ntz;Lk;.)

tpz;zg;gj;jpw;Fupa ehspy; gzpahsUilatpz;zg;gj;jpw;Fupa ehspy; gzpahsUilatpz;zg;gj;jpw;Fupa ehspy; gzpahsUilatpz;zg;gj;jpw;Fupa ehspy; gzpahsUilatpz;zg;gj;jpw;Fupa ehspy; gzpahsUila

fzf;fpyike;j ,Ug;Gj; njhif ( tptuq;fs;fzf;fpyike;j ,Ug;Gj; njhif ( tptuq;fs;fzf;fpyike;j ,Ug;Gj; njhif ( tptuq;fs;fzf;fpyike;j ,Ug;Gj; njhif ( tptuq;fs;fzf;fpyike;j ,Ug;Gj; njhif ( tptuq;fs;

gpd;tUkhW )gpd;tUkhW )gpd;tUkhW )gpd;tUkhW )gpd;tUkhW )

khepyf; fzf;fha;Tj; jiytuplk; ,Ue;J

,Wjpahf tug;ngw;w fzf;Fj; jhspd;gb ,Ug;Gj;

njhif

gpd;du; nrYj;jg; ngw;w jtizj; njhifiaAk;

flDf;fhfr; nrYj;jg; ngw;w njhifiaAk;

Nru;j;jpLf

g pd ;du ; fldhf VNjDk ; njhif

ngwg;gl;bUe;jhy; mj;njhifiaf; fopj;jpLf

tpz;zg;gj;jpw;Fupa ehspy; ,Ug;gpYs;s njhif

ngWiff;fhd Nehf;fk;ngWiff;fhd Nehf;fk;ngWiff;fhd Nehf;fk;ngWiff;fhd Nehf;fk;ngWiff;fhd Nehf;fk;

m) m) m) m) m) jpUkzk;jpUkzk;jpUkzk;jpUkzk;jpUkzk;

jpUkzk; nra;J nfhs;gtUf;Fg; gzpahsUld;

mike;j cwTKiw

1

2

3

4

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(ii)

(iii)

(iv)

(v)

6

7

(i)

(ii)

(iii)

(iv)

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(i)

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:

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gzpahsupd; kfs; jtpu NtnwhU ngz;cwt pdu pd ; j pUkzkha pd ; mtu ; >cz;ikapNyNa gzpahsiu Kw;wpYkhfr;rhu;e;J tuo;fpwhuh vd;gijf; Fwpg;gpLf.

,e;Nehf;fj;jpw;fhf ,jw;F Kd;du; jw;fhypkhff;fld; VJk; ngwtpy;iy vd;gjw;Fr; rhd;wpLf.

,jw;F Kd;du;> ,Nj Nehf;fj;jpw;fhfg; gFjp,Wjpj; njhif VNjDk; ngwg;gl;bUe;jhy;mjw;fhd tptuq;fis mspj;jpLf.

M) M) M) M) M) cau;fy;tpcau;fy;tpcau;fy;tpcau;fy;tpcau;fy;tp

fy;tp gapy;gtUf;Fg; gzpahsUld; mike;jcwTKiw

gbg;gpd; jd;ikAk; gbg;gpd; fhy msTk;(fiyapaw; fy;tp> njhopy; El;gf;fy;tp>nghwpapay; fy;tp> kUj;Jtf; fy;tp> mwptpay;fy;tp Mfpait)

fy;tp gapYkplk; ,e;jpahTf;Fs;sh my;yJ,e;jpahtpw;F ntspapyh?

,e;Nehf;fj;fpw;fhf ,jw;F Kd;du; xg;gspg;Gnra;ag;ngw;w gFjp ,Wjpg; ngWiff;fhdtptuq;fs; ( vk; khjj;jpy; ngwg;gl;lJ vd;fpwtptuq;fSld; )

xg;gspg;Gr; nra;ag;gl;l njhifahdJ mLj;j6 khjj;jpw;F cs;sgbahfj; Njitg;gLk;msTf;Ff; fl;Lg;gLj;jg;gl;Ls;sjh? ( gFjp,Wjpj; njhif ngWifahdJ 6 khjq;fSf;FxU Kiw mDkjpf;fg;glf;$bajhFk;. NkYk;xt;nthU KiwAk; mikAk; ngWifahdJjdp Nehf;fj;jpw;fhf vdf; fUjg;gLtjhFk; )

,) ,) ,) ,) ,) kUj;Jtr; rpfpr ;irkUj;Jtr; rpfpr ;irkUj;Jtr; rpfpr ;irkUj;Jtr; rpfpr ;irkUj;Jtr; rpfpr ;ir

ngWifahdJ cly ; ey pTw ; wgzpahsUf;fhfth? my;yJ mtiur; rhu;e;Jtho;gtUf;fhfth?

mtUf;Fg; gzpahsUldike;j cwT Kiw>mtu; cs;sgbNa gzpahsiur; rhu;e ;Jtho;gtuh?

<) tPL fl;Ljy;<) tPL fl;Ljy;<) tPL fl;Ljy;<) tPL fl;Ljy;<) tPL fl;Ljy;

Fwpg;gpl;l Nehf;fkhdJ vJ vd;gij mjhtJtPL> my;yJ tPl;Lkid thq;Fjy; my;yJ tPLfl;Ltjw;F my;yJ tPl;il rPu;gLj;jpf; fl;Ltjw;Fmy;yJ fld; jpUg;gpr; nrYj;Jtjw;F vd;gijf;Fwpg;gpl Ntz;Lk;.

gzpahsUf;F Kd;dNu nrhe;jkhd tPL my;yJtPl;L kid cs;sjh?

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itg;G epjpapypUe;J ngwg;gl;l fld; njhifiaf;nfhz;L thq;fg; ngw;w tPl;L kidapy; tPLfl;lg;gl;Ls;snjdpy; tPl;L kid thq;Ftjw;fhfKd;du; ngw;w njhifiaAk;> ngwg;gl;lkhjq;fisAk; Fwpg;gpLf.

ngWiff;Fupa njhifahdJ flidj; jpUg;gpr;nrYj;Jtjw;F vdpy;> Kd;du; ngwg;gl;l fld;>tPL fl;Lk; Nehf;fj;jpw;fhfNt ngwg;gl;Ls;sjh>fld; njhif ahuplkpUe;J ngwg;gl;lJ> fld;ngwg;gl;l ehs; Mfpa tptuq;fisf; Fwpg;gpLf.

ika murhy;> khepy murhy; njhlq;fg; ngw;wtPl;L trjpj; jpl;lj;jpd; fPo; ngwg;gl;l fldhf,Ug;gpd; mJ gw;wpa tptuq;fisAk; mj;jifajpl;lj;jpd; fPo; ngwg;gl;l fld; njhifiaAk;Fwpg;gpLf.

tPL fl;Lk; rq;fq;fs; my;yJ mtw;iwg; Nghd;wepWtdq;fs; thapyhf thlifj; jtizKiwapy; my;yJ jtiz Kiwapy; tPL fl;Lk;kid thq;fpaikf;fhd njhifiaj; jpUg;gpr;nrYj;Jtjw;fhf ,g;ngWif vdpy;>

vj;jid jtizfspy; jpUg;gpr; nrYj;j Ntz;Lk;vd;gijAk;> vt;tsT fhyj;jpw;Fs; jpUg;gpr;nrYj;Jjy; KbTWk; vd;gijAk; Fwpg;gpLf.

tPL fl;Lk; rq;fj;jpd; ngau;

tPL fl;Lk; rq;fj;jpw;Fr; nrYj;jg;gl Ntz;banjhif

tPL fl;Ltjw;fhf Kd;du; xg;gspg;Gr; nra;ag;gl;lgFjp ,Wjpg; ngWif tptuq;fs; ( Fwpg;gpl;lNehf;fk;> xg;gspf;fg; ngw;wj; njhif> njhifngwg;gl;l khjk; Mfpatw;iwf; Fwpg;gpLf. )

c) rPUe;J Kd;gzk;c) rPUe;J Kd;gzk;c) rPUe;J Kd;gzk;c) rPUe;J Kd;gzk;c) rPUe;J Kd;gzk;

gjpide;J Mz;Lfs; gzpf;fhyj;ij gzpahsu;Kbj;j ehs;

rPUe;jpd; cs;sgbahd tpiy

ngWifahdJ r PUe ;J thq ;Ftjw ;fhfNtz ;lg ; gLf pd ; wjh ? my ;yJ r PUe ;Jthq;Ftjw;fhf Vw;fdNt ngwg;gl;l muRf;flidj ; j pUk ; gr ; nrYj ;Jtjw ;f hfNtz;lg ;gLfpd ;wjh? flidj; jpUk ;gr ;nrYj;Jtjw;F vdpy;> ngwg;gl;l fld;njhifiaAk; fld; ngwg;gl; ehspidAk;jpUk;gr; nrYj;jg;gl Ntz;ba njhifiaAk;Fwpg;gpLf.

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gFjp ,Wjpg; ngWifapid xg;gspg;Gr;nra;tjw;F mbg;gilahf mikAk; tpjpfisf;Fwpg;gpLf.

xg;gspg;G toq;Fk; Miz> jFjp tha;e;jmYtyuhy; mspf;fg;gl;Ls;sjh? ( jFjp tha;e;jmYtyuhy ; jw ; f hy pf Kd ; gzk ;xg;gspf;fg;gLtjw;F Ntz;lg;gLk; mj;jifamjpfhu xg;gspg;Gf;Fj; njhlu;Gila jdpf;fhuzq;fis mspj;jpLf. )

gzk; ngw;W toq;Ftjw;fhd mjpfhukhdJkhe pyf ; fzf ;f ha ;Tj ; jiytuhy ;mDkjpf;fg;gl;l gzk; ngw;W toq;Fk; mYtyu;

gzk; toq;Fk; fUT+yk; my;yJ rhu;epiyf;fUT+yk;

NkNy fz;l gj;jp ( 9 ) ,y; mike;j tpjpmy;yJ tpjpfspy; Fwpg;gplg;ngw;w tiuaiwfs;midj;Jk; epiwT nra;ag;gl;Ls;sd vdr;rhd;wplg;gLfpwJ.

,J gzpahsUf;F Nkw;gb fhuzj;jpw;fhfxg;gspg;Gr; nra;ag; ngWk; Kjy; gFjp ,Wjpg;ngWifahFk; vdr; rhd;wplg;gLfpwJ.

Kd; xg;gspg;G nra;ag; ngw;w Kd; gzj;jpw;Fupaxg;gspg;G ehspypUe;J MW khj fhy msTKbtile;Js;sJ vdr; rhd;wplg;gLfpwJ.

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tpz;zg;gjhuupd; ifnahg;gk;tpz;zg;gjhuupd; ifnahg;gk;tpz;zg;gjhuupd; ifnahg;gk;tpz;zg;gjhuupd; ifnahg;gk;tpz;zg;gjhuupd; ifnahg;gk;

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tl;lhuf; fy;tp mYtyutl;lhuf; fy;tp mYtyutl;lhuf; fy;tp mYtyutl;lhuf; fy;tp mYtyutl;lhuf; fy;tp mYtyu ; mtu;fspd; nray;Kiw Miz

Kd;dpiy jpU / jpUkjp ....................................................................................

e. f. vz; : ........................................................................................... ehs; : ...............................................................

nghUsnghUsnghUsnghUsnghUs ; : Mrpupau; Nrkeyepjp / nghJ tUq;fhy itg;Gepjp. gFjp ,Wjp

Kd;gzk; jpU / jpUkjp ........................................................................................................

fzf;F vz; ......................... &. .................................................. mDkjpj;jy; rhu;G.

ghu;itghu;itghu;itghu;itghu;it : 1. murhiz vz; 1606 ePjpj;Jiw. ehs; : 7.12.1979

2. murhiz vz; 551 ePjpj;Jiw. ehs; : 18.4.1980

3. rk;ge;jg;gl;l / Mrpupaupd; tpz;zg;g ehs; :

MizMizMizMizMiz : fPo;f;fz;l MrpupaUf;F t. vz;. 6 ,y; cs;s njhif

gFjpapWjp Kd;gzk; % mDkjpj;J MizaplyhfpwJ.

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gzpahsu; ngau;gzpahsu; ngau;gzpahsu; ngau;gzpahsu; ngau;gzpahsu; ngau;

gjtp ngau; ( vj;njhFjpia (m> M> ,> <)

rhu;e;jtu; vd;gJ Fwpg;gpl Ntz;Lk;. )

tUq;fhy itg;Gepjpf; fzf;F vz; (Jiwapd;

ngaUld;)

gFjp / ,Wjpj; njhif ngWiff;F xg;gspg;G

toq;Fk;NghJ gzpahsupd; rk;gsk; ( mbg;gil

tpjpfspy; tiuaWf;fg;gl;Ls;sthW )

nkhj;jg; gzpf;fhyk; ( ,ilKwpTf;Fupa gzpf;fhyk; )

Kjd; Kjypy; gzpapy; Nru;e;j ehs;

gjpide;jhz;L gzpf;fhyj;ij gzpahsu; Kbj;j

ehs; ( ,ilKwpTf;Fupa gzpf;fhyk; cl;gl )

gpwe;j ehs;

taJ Kjpu;tpdhy; Xa;T ngWk; ehs;

gFjp / ,Wjp ngWiff;Fu pa njhif

(vz;zhYk;> vOj;jhYk; Fwpg;gplg;gl Ntz;Lk;.)

tpz;zg;gj;jpw;Fupa ehspy; gzpahsUilatpz;zg;gj;jpw;Fupa ehspy; gzpahsUilatpz;zg;gj;jpw;Fupa ehspy; gzpahsUilatpz;zg;gj;jpw;Fupa ehspy; gzpahsUilatpz;zg;gj;jpw;Fupa ehspy; gzpahsUila

fzf;fpyike;j ,Ug;Gj; njhif ( tptuq;fs;fzf;fpyike;j ,Ug;Gj; njhif ( tptuq;fs;fzf;fpyike;j ,Ug;Gj; njhif ( tptuq;fs;fzf;fpyike;j ,Ug;Gj; njhif ( tptuq;fs;fzf;fpyike;j ,Ug;Gj; njhif ( tptuq;fs;

gpd;tUkhW )gpd;tUkhW )gpd;tUkhW )gpd;tUkhW )gpd;tUkhW )

khepyf; fzf;fha;Tj; jiytuplk; ,Ue;J

,Wjpahf tug;ngw;w fzf;Fj; jhspd;gb ,Ug;Gj;

njhif

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gpd;du; nrYj;jg; ngw;w jtizj; njhifiaAk;

flDf;fhfr; nrYj;jg; ngw;w njhifiaAk;

Nru;j;jpLf

g pd ;du ; fldhf VNjDk ; njhif

ngwg;gl;bUe;jhy;mj;njhifiaf; fopj;jpLf

tpz;zg;gj;jpw;Fupa ehspy; ,Ug;gpYs;s njhif

ngWiff;fhd Nehf;fk;ngWiff;fhd Nehf;fk;ngWiff;fhd Nehf;fk;ngWiff;fhd Nehf;fk;ngWiff;fhd Nehf;fk;

m) m) m) m) m) jpUkzk;jpUkzk;jpUkzk;jpUkzk;jpUkzk;

jpUkzk; nra;J nfhs;gtUf;Fg; gzpahsUld;mike;j cwTKiw

gzpahsupd; kfs; jtpu NtnwhU ngz;cwt pdu pd ; j pUkzkha pd ; mtu ; >cz;ikapNyNa gzpahsiu Kw;wpYkhfr;rhu;e;J tuo;fpwhuh vd;gijf; Fwpg;gpLf.

,e;Nehf;fj;jpw;fhf ,jw;F Kd;du; jw;fhypkhff;fld; VJk; ngwtpy;iy vd;gjw;Fr; rhd;wpLf.

,jw;F Kd;du;> ,Nj Nehf;fj;jpw;fhfg; gFjp,Wjpj; njhif VNjDk; ngwg;gl;bUe;jhy;mjw;fhd tptuq;fis mspj;jpLf.

M) M) M) M) M) cau;fy;tpcau;fy;tpcau;fy;tpcau;fy;tpcau;fy;tp

fy;tp gapy;gtUf;Fg; gzpahsUld; mike;jcwTKiw

gbg;gpd; jd;ikAk; gbg;gpd; fhy msTk;(fiyapaw; fy;tp> njhopy; El;gf;fy;tp>nghwpapay; fy;tp> kUj;Jtf; fy;tp> mwptpay;fy;tp Mfpait)

fy;tp gapYkplk; ,e;jpahTf;Fs;sh my;yJ,e;jpahtpw;F ntspapyh?

,e;Nehf;fj;fpw;fhf ,jw;F Kd;du; xg;gspg;Gnra;ag;ngw;w gFjp ,Wjpg; ngWiff;fhdtptuq;fs; ( vk; khjj;jpy; ngwg;gl;lJ vd;fpwtptuq;fSld; )

xg;gspg;Gr; nra;ag;gl;l njhifahdJ mLj;j6 khjj;jpw;F cs;sgbahfj; Njitg;gLk;msTf;Ff; fl;Lg;gLj;jg;gl;Ls;sjh? ( gFjp,Wjpj; njhif ngWifahdJ 6 khjq;fSf;FxU Kiw mDkjpf;fg;glf;$bajhFk;. NkYk;xt;nthU KiwAk; mikAk; ngWifahdJjdp Nehf;fj;jpw;fhf vdf; fUjg;gLtjhFk; )

,) ,) ,) ,) ,) kUj;Jtr; rpfpr ;irkUj;Jtr; rpfpr ;irkUj;Jtr; rpfpr ;irkUj;Jtr; rpfpr ;irkUj;Jtr; rpfpr ;ir

ngWifahdJ cly ; ey pTw ; wgzpahsUf;fhfth? my;yJ mtiur; rhu;e;Jtho;gtUf;fhfth?

mtUf;Fg; gzpahsUldike;j cwT Kiw>mtu; cs;sgbNa gzpahsiur; rhu;e ;Jtho;gtuh?

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<) tPL fl;Ljy;<) tPL fl;Ljy;<) tPL fl;Ljy;<) tPL fl;Ljy;<) tPL fl;Ljy;

Fwpg;gpl;l Nehf;fkhdJ vJ vd;gij mjhtJtPL> my;yJ tPl;Lkid thq;Fjy; my;yJ tPLfl;Ltjw;F my;yJ tPl;il rPu;gLj;jpf; fl;Ltjw;Fmy;yJ fld; jpUg;gpr; nrYj;Jtjw;F vd;gijf;Fwpg;gpl Ntz;Lk;.

gzpahsUf;F Kd;dNu nrhe;jkhd tPL my;yJtPl;L kid cs;sjh?

itg;G epjpapypUe;J ngwg;gl;l fld; njhifiaf;nfhz;L thq;fg; ngw;w tPl;L kidapy; tPLfl;lg;gl;Ls;snjdpy; tPl;L kid thq;Ftjw;fhfKd;du; ngw;w njhifiaAk;> ngwg;gl;lkhjq;fisAk; Fwpg;gpLf.

ngWiff;Fupa njhifahdJ flidj; jpUg;gpr;nrYj;Jtjw;F vdpy;> Kd;du; ngwg;gl;l fld;>tPL fl;Lk; Nehf;fj;jpw;fhfNt ngwg;gl;Ls;sjh>fld; njhif ahuplkpUe;J ngwg;gl;lJ> fld;ngwg;gl;l ehs; Mfpa tptuq;fisf; Fwpg;gpLf.

ika murhy;> khepy murhy; njhlq;fg; ngw;wtPl;L trjpj; jpl;lj;jpd; fPo; ngwg;gl;l fldhf,Ug;gpd; mJ gw;wpa tptuq;fisAk; mj;jifajpl;lj;jpd; fPo; ngwg;gl;l fld; njhifiaAk;Fwpg;gpLf.

tPL fl;Lk; rq;fq;fs; my;yJ mtw;iwg; Nghd;wepWtdq;fs; thapyhf thlifj; jtizKiwapy; my;yJ jtiz Kiwapy; tPL fl;Lk;kid thq;fpaikf;fhd njhifiaj; jpUg;gpr;nrYj;Jtjw;fhf ,g;ngWif vdpy;>

vj;jid jtizfspy; jpUg;gpr; nrYj;j Ntz;Lk;vd;gijAk;> vt;tsT fhyj;jpw;Fs; jpUg;gpr;nrYj;Jjy; KbTWk; vd;gijAk; Fwpg;gpLf.

tPL fl;Lk; rq;fj;jpd; ngau;

tPL fl;Lk; rq;fj;jpw;Fr; nrYj;jg;gl Ntz;banjhif

tPL fl;Ltjw;fhf Kd;du; xg;gspg;Gr; nra;ag;gl;lgFjp ,Wjpg; ngWif tptuq;fs; ( Fwpg;gpl;lNehf;fk;> xg;gspf;fg; ngw;wj; njhif> njhifngwg;gl;l khjk; Mfpatw;iwf; Fwpg;gpLf. )

c) rPUe;J Kd;gzk;c) rPUe;J Kd;gzk;c) rPUe;J Kd;gzk;c) rPUe;J Kd;gzk;c) rPUe;J Kd;gzk;

gjpide;J Mz;Lfs; gzpf;fhyj;ij gzpahsu;Kbj;j ehs;

rPUe;jpd; cs;sgbahd tpiy

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ngWifahdJ r PUe ;J thq ;Ftjw ;fhfNtz ;lg ; gLf pd ; wjh ? my ;yJ r PUe ;Jthq;Ftjw;fhf Vw;fdNt ngwg;gl;l muRf;flidj ; j pUk ; gr ; nrYj ;Jtjw ;f hfNtz;lg ;gLfpd ;wjh? flidj; jpUk ;gr ;nrYj;Jtjw;F vdpy;> ngwg;gl;l fld;njhifiaAk; fld; ngwg;gl; ehspidAk;jpUk;gr; nrYj;jg;gl Ntz;ba njhifiaAk;Fwpg;gpLf.

gFjp ,Wjpg; ngWifapid xg;gspg;Gr;nra;tjw;F mbg;gilahf mikAk; tpjpfisf;Fwpg;gpLf.

xg;gspg;G toq;Fk; Miz> jFjp tha;e;jmYtyuhy; mspf;fg;gl;Ls;sjh? ( jFjp tha;e;jmYtyuhy ; jw ; f hy pf Kd ; gzk ;xg;gspf;fg;gLtjw;F Ntz;lg;gLk; mj;jifamjpfhu xg;gspg;Gf;Fj; njhlu;Gila jdpf;fhuzq;fis mspj;jpLf. )

gzk; ngw;W toq;Ftjw;fhd mjpfhukhdJkhe pyf ; fzf ;f ha ;Tj ; jiytuhy ;mDkjpf;fg;gl;l gzk; ngw;W toq;Fk; mYtyu

gzk; toq;Fk; fUT+yk; my;yJ rhu;epiyf;fUT+yk;

NkNy fz;l gj;jp ( 9 ) ,y; mike;j tpjpmy;yJ tpjpfspy; Fwpg;gplg;ngw;w tiuaiwfs;midj;Jk; epiwT nra;ag;gl;Ls;sd vdr;rhd;wplg;gLfpwJ.

,J gzpahsUf;F Nkw;gb fhuzj;jpw;fhfxg;gspg;Gr; nra;ag; ngWk; Kjy; gFjp ,Wjpg;ngWifahFk; vdr; rhd;wplg;gLfpwJ.

Kd; xg;gspg;G nra;ag; ngw;w Kd; gzj;jpw;Fupaxg;gspg;G ehspypUe;J MW khj fhy msTKbtile;Js;sJ vdr; rhd;wplg;gLfpwJ.

Nkw;fz;l nrytpdk; fPo;f;fz;l jiyg;gpy; nryTnra;ag;gLk;.;

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xg;gspg;G mYtyuxg;gspg;G mYtyuxg;gspg;G mYtyuxg;gspg;G mYtyuxg;gspg;G mYtyu ;

ngWeu;ngWeu;ngWeu;ngWeu;ngWeu; : rk;ge;jg;gl;l Mrpupau;

efy;efy;efy;efy;efy; : 1. epu;thfp / jiyik Mrpupau;

2. gl;baYf;F

3. cjtpf; fUT+y mYtyu;> rhu;epiyf; fUT+yk;> Mj;J}u ; .

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20 - 20 Mk; Mz;L fzf;Fr;rPl;bd; gb ,Ug;G : &.

khjr; re;jh kw;Wk; jpUk;gr; nrYj;jpa jtizj; njhif : &.

nkhj;jk; : &.

ngw;w jw;fhypf Kd;gzk; / gFjp ,Wjp Kd;gzk; : &.

kPjpj; njhif : &.

75 % : &.

fld; NfhUk; njhif : &.

Nknyhg;gkplg;gLfpwJ Nknyhg;gkplg;gLfpwJ Nknyhg;gkplg;gLfpwJ Nknyhg;gkplg;gLfpwJ Nknyhg;gkplg;gLfpwJ re;jhjhuu; ifnahg;gk; re;jhjhuu; ifnahg;gk; re;jhjhuu; ifnahg;gk; re;jhjhuu; ifnahg;gk; re;jhjhuu; ifnahg;gk;

Mrpupau; nghJ tUq;fhy itg;G epjpapy; nrYj;jg;gl;l khj re;jhj; njhif> jpUk;gpr;Mrpupau; nghJ tUq;fhy itg;G epjpapy; nrYj;jg;gl;l khj re;jhj; njhif> jpUk;gpr;Mrpupau; nghJ tUq;fhy itg;G epjpapy; nrYj;jg;gl;l khj re;jhj; njhif> jpUk;gpr;Mrpupau; nghJ tUq;fhy itg;G epjpapy; nrYj;jg;gl;l khj re;jhj; njhif> jpUk;gpr;Mrpupau; nghJ tUq;fhy itg;G epjpapy; nrYj;jg;gl;l khj re;jhj; njhif> jpUk;gpr;

nrYj;jg;gl;l nrYj;jg;gl;l nrYj;jg;gl;l nrYj;jg;gl;l nrYj;jg;gl;l Kd;gzj; jtizj; njhif Kd;gzj; jtizj; njhif Kd;gzj; jtizj; njhif Kd;gzj; jtizj; njhif Kd;gzj; jtizj; njhif kw;Wk; ngw;w Kd;gzk; mlq;fpa gl;bay;ngw;w Kd;gzk; mlq;fpa gl;bay;ngw;w Kd;gzk; mlq;fpa gl;bay;ngw;w Kd;gzk; mlq;fpa gl;bay;ngw;w Kd;gzk; mlq;fpa gl;bay;

1 tpz;zg;gjhuu; ngau; : ................................................................................................................................

2 gzp epiy : ................................................................................................................................

3 itg;G epjp vz; ( TPF No. ) : ................................................................................................................................

4 tq;fp fzf;F vz; : ................................................................................................................................

5 gzpahw;Wk; gs;sp : ................................................................................................................................

: ................................................................................................................................

tupir

vz;

itg;Gepjp

re;jh

jw;fhypf

Kd;gz

gpbj;jk;

jtiz

vz;nkhj;jk;

ngw;w jw;fhypf

Kd;gzk;khjk; Mz;L

11111

22222

33333

44444

55555

66666

77777

88888

99999

1010101010

1111111111

1212121212

khu;r; 20

Vg;uy; 20

Nk 20

[_d; 20

[_iy 20

Mf];l; 20

nrg;lk;gu;; 20

mf;Nlhgu;; 20

etk;gu;; 20

brk;gu; 20

[dtup; 20

gpg;utup 20

nkhj;jk;nkhj;jk;nkhj;jk;nkhj;jk;nkhj;jk;

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cs;@u; tpLKiw tpz;zg;gk;cs;@u; tpLKiw tpz;zg;gk;cs;@u; tpLKiw tpz;zg;gk;cs;@u; tpLKiw tpz;zg;gk;cs;@u; tpLKiw tpz;zg;gk;

1. gs;spapd; ngau; : ....................................................................................................

....................................................................................................

....................................................................................................

2. cs;@u; tpLKiw NfhUk; ehs;> fpoik : ....................................................................................................

3. cs;@u; tpLKiwf;fhd fhuzk; : ....................................................................................................

4. ,Jtiu fy;tpahz;by; gzpahw;wpa

ehs;fs; : ....................................................................................................

5. tpLKiw gl;baypy; mDkjpj;J cs;s

cs;@u; tpLKiw ehs;fs; : ....................................................................................................

6. ,f;fy;tp Mz;by; tplg;gl;Ls;s

tpLKiwahy; FiwAk; ehs;fs; : ....................................................................................................

7. jw;NghJ tpLk; cs;@u; tpLKiwahy;

FiwAk; ehs;fs; : ....................................................................................................

8. Ntiy ehs; Fiwe;jhy; <L nra;Ak;

ehSk; fpoikAk; : ....................................................................................................

9. jiyik Mrpupau; ifnahg;gk; : ....................................................................................................

10.tl;lhuf; fy;tp mYtyu; mDkjp : ....................................................................................................

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gzp tpLtpg;Gr; rhd;wpjo;gzp tpLtpg;Gr; rhd;wpjo;gzp tpLtpg;Gr; rhd;wpjo;gzp tpLtpg;Gr; rhd;wpjo;gzp tpLtpg;Gr; rhd;wpjo;

1. Mrpupau; ngau; : .................................................................................

2. gjtp : .................................................................................

3. gzpGupe;j gs;spapd; ngau; : .................................................................................

: .................................................................................

: .................................................................................

4. gpwe;j ehs; : .................................................................................

5. Kjypy; gzpapy; Nru;e;j ehs; : .................................................................................

6. ,e;epiyapy; gzpNaw;w ehs; : .................................................................................

7. ,g;gs;spapy; Nru;e;j ehs; : .................................................................................

8. mYtyupd; cj;juT mYtyupd; cj;juT mYtyupd; cj;juT mYtyupd; cj;juT mYtyupd; cj;juT :

..............................khtl;lf; fy;tp mYtyu;: e. f. vz; : ................................ ehs; : .........................

tl;lhuf; fy;tp mYtyu; : e. f. vz; : ................................ ehs; : .........................

9. tpLtpg;G nra;Ak; ehs; : .................................................................................

10. gzp Vw;G nra;a ,Uf;Fk; gs;sp : .................................................................................

.................................................................................

.................................................................................

11. gjtp : .................................................................................

12. nghJf;fy;tp rhd;W vz; : .................................................................................

13. njhopw;fy;tp rhd;W vz; : .................................................................................

14. Cjpa tpfpjk; Cjpa tpfpjk; Cjpa tpfpjk; Cjpa tpfpjk; Cjpa tpfpjk; : .................................................................................

mbg;gil Cjpak; ( Basiic Pay ) : &. ................................... ( Level : ........ Cell : ........ )

nkhj;j Cjpak; : &. ...................................

15. tq;fpapd; ngau; tq;fpapd; ngau; tq;fpapd; ngau; tq;fpapd; ngau; tq;fpapd; ngau; & fpis fpis fpis fpis fpis : .................................................................................

16. tq;fp fzf;F vz;tq;fp fzf;F vz;tq;fp fzf;F vz;tq;fp fzf;F vz;tq;fp fzf;F vz; : .................................................................................

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17. Cjpa cau;T ehs; : .................................................................................

18. <l;ba tpLg;G xg;gilg;G ehs; : .................................................................................

19. TPF / CPS vz; : ..................................

20. TPF / CPS gpbj;jk; : &. ...................................

21. TPF fld; gpbj;jk; / CPS epYit : &. ................................... jtiz : ...........................

22. rpwg;G Nrkey epjp ( SPF ) : &. ...................................

23. FLk;g eyepjp ( FBF ) : &. ...................................

24. kUj;Jt eyepjp ( NHIS ) : &. ...................................

25. tpoh Kd;gzk; ( FA ) : &. ................................... jtiz : ...........................

26. tUkhdtup gpbj;jk; ( INCOME TAX ) : &. .................. fy;tp tup ( Edn CESS ) : &. .............

27. mQ;ryf MAs; fhg;gPL ( PLI ) : &. ....................... vz; : ...........................................

28. tsUk; khj Nrkpg;G ( RD ) : &. ....................... vz; : ...........................................

29. MAs; fhg;gPL ( LIC ) : &. ....................... vz; : ...........................................

30. $l;LwT : &. .......................

31. vLj;j jw;nray; tpLg;G : ................ ehs;fs;

kPjKs;s jw;nray; tpLg;G : ................ ehs;fs;

32. vLj;j kj tpLg;G : ................ ehs;fs;

kPjKs;s kj tpLg;G : ................ ehs;fs;

,g;gs;spapy; jpU. ............................................................................................... mtu;fs;

.............................................. Kjy; .............................................. tiu .............................................. Mrpupauhf

gzpahw;wpdhu; vd;gjw;F gs;spg; gjpNtLfis cWjp nra;J rhd;wspf;fpNwd;.

,lk; : .................................................

ehs; : .................................................

efy; : jiyik Mrpupau;>

Cuhl;rp xd;wpa ........................ gs;sp>

...............................................................

............................................ xd;wpak;.

............................................ khtl;lk;.

jiyik Mrpupau; ifnahg;gk;

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Mrpupau; jd; tptuf; Fwpg;Gfs;Mrpupau; jd; tptuf; Fwpg;Gfs;Mrpupau; jd; tptuf; Fwpg;Gfs;Mrpupau; jd; tptuf; Fwpg;Gfs;Mrpupau; jd; tptuf; Fwpg;Gfs;

Mz;L 20 - 20Mz;L 20 - 20Mz;L 20 - 20Mz;L 20 - 20Mz;L 20 - 20

1. ngau; : .................................................................................................................

2. gjtp : .................................................................................................................

3. gzpGupAk; gs;sp : .................................................................................................................

.................................................................................................................

.................................................................................................................

4. gpwe;j Njjp : .................................................................................................................

5. Xa;T ngWk; Njjp : .................................................................................................................

6. Kftup : .................................................................................................................

.................................................................................................................

.................................................................................................................

7. ,uj;j tif : .................................................................................................................

8. njhiyNgrp vz;fs; : .................................................................................................................

: .................................................................................................................

9. kpd;dQ;ry; Kftup : .................................................................................................................

Kf;fpa vz;fs; :Kf;fpa vz;fs; :Kf;fpa vz;fs; :Kf;fpa vz;fs; :Kf;fpa vz;fs; :

1. Staff Code No. : .................................................................................................................

2. GPF / CPS No. : .................................................................................................................

3. BANK SB A/C No. : .................................................................................................................

: .................................................................................................................

4. PAN CARD No. : .................................................................................................................

5. PLI No. : .................................................................................................................

6. HEALTH CARD ( NHIS ) No. : .................................................................................................................

7. EPIC ID No. : .................................................................................................................

8. AADHAR ID No. : .................................................................................................................

9. LIC No. : .................................................................................................................

: .................................................................................................................

10. SOCIETY MEMBERSHIP No. : .................................................................................................................

11. DRIVING LICENCE ( 2 / 4 WHEELER)No. : .................................................................................................................

: .................................................................................................................

12. RATION CARD No. : .................................................................................................................

13. ........................................................................ No. : .................................................................................................................

14. ........................................................................ No. : .................................................................................................................

15. ........................................................................ No. : .................................................................................................................

16. ........................................................................ No. : .................................................................................................................

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Kjy; epakd tptuq;fs; :Kjy; epakd tptuq;fs; :Kjy; epakd tptuq;fs; :Kjy; epakd tptuq;fs; :Kjy; epakd tptuq;fs; :

1. gzpapd; ngau; : .................................................................................................................

2. gs;spapd; ngau; : .................................................................................................................

.................................................................................................................

.................................................................................................................

.................................................................................................................

3. Kjd; Kjypy; gzpapy; Nru;e;j Njjp : .................................................................................................................

4. Nju;T thupa tupir vz; : .................................................................................................................

5. Miz tptuk;Miz tptuk;Miz tptuk;Miz tptuk;Miz tptuk;

khtl;lj; njhlf;ff; fy;tp mYtyu; : .................................................................................................................

cj;juT vz; .................................................................................................................

$Ljy; / cjtpj; njhlf;ff; fy;tp : .................................................................................................................

mYtyu; cj;juT vz; .................................................................................................................

6.6.6.6.6. gzptud; Kiw tptuk;gzptud; Kiw tptuk;gzptud; Kiw tptuk;gzptud; Kiw tptuk;gzptud; Kiw tptuk;

gzpapd; ngau; : .................................................................................................................

gzptud; Kiw nra;ag;gl;l ehs; : .................................................................................................................

Miz tptuk; : .................................................................................................................

.................................................................................................................

7.7.7.7.7. jFjpfhz; gUtk; tptuk;jFjpfhz; gUtk; tptuk;jFjpfhz; gUtk; tptuk;jFjpfhz; gUtk; tptuk;jFjpfhz; gUtk; tptuk;

gzpapd; ngau; : .................................................................................................................

jFjpfhz; gUtk; Kbj;j ehs; : .................................................................................................................

Miz tptuk; : .................................................................................................................

.................................................................................................................

8.8.8.8.8. gjtp cau;T tptuk;gjtp cau;T tptuk;gjtp cau;T tptuk;gjtp cau;T tptuk;gjtp cau;T tptuk;

1. gjtpapd; ngau; : .................................................................................................................

gjtp cau;T ngw;w ehs; : .................................................................................................................

Miz tptuk; : .................................................................................................................

.................................................................................................................

2. gjtpapd; ngau; : .................................................................................................................

gjtp cau;T ngw;w ehs; : .................................................................................................................

Miz tptuk; : .................................................................................................................

.................................................................................................................

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9. Nju;T epiy> rpwg;G epiy tptuq;fs;9. Nju;T epiy> rpwg;G epiy tptuq;fs;9. Nju;T epiy> rpwg;G epiy tptuq;fs;9. Nju;T epiy> rpwg;G epiy tptuq;fs;9. Nju;T epiy> rpwg;G epiy tptuq;fs;

1. gjtpapd; ngau; : .................................................................................................................

Nju;T epiy ngw;w ehs; : .................................................................................................................

Miz tptuk; : .................................................................................................................

.................................................................................................................

2. gjtpapd; ngau; : .................................................................................................................

rpwg;G epiy ngw;w ehs; : .................................................................................................................

Miz tptuk; : .................................................................................................................

.................................................................................................................

10. Cjpa tptuq;fs; :10. Cjpa tptuq;fs; :10. Cjpa tptuq;fs; :10. Cjpa tptuq;fs; :10. Cjpa tptuq;fs; :

1. Cjpa cau;T ehs; : .................................................................................................................

2. <l;ba tpLg;G xg;gilg;G Njjp : .................................................................................................................

3. Kjy; Cf;f Cjpa cau;T Njjp : .................................................................................................................

4. ,uz;lhk; Cf;f Cjpa cau;T Njjp : .................................................................................................................

5. Cjpak;Cjpak;Cjpak;Cjpak;Cjpak;

Cjpa tpfpjk;Cjpa tpfpjk;Cjpa tpfpjk;Cjpa tpfpjk;Cjpa tpfpjk; : ..............................................................................

mbg;gil Cjpak; : &. &. &. &. &. ..................................

ju Cjpak; : &. &. &. &. &. ..................................

jdp Cjpak; : &. &. &. &. &. ..................................

mftpiyg; gb : &. &. &. &. &. ..................................

rpwg;Gg; gb : &. &. &. &. &. ..................................

kUj;Jtg; gb : &. &. &. &. &. ..................................

tPl;L thlifg; gb : &. &. &. &. &. ..................................

kiyg; gb : &. &. &. &. &. ..................................

efu <l;Lg; gb : &. &. &. &. &. ..................................

nkhj;jk;nkhj;jk;nkhj;jk;nkhj;jk;nkhj;jk; : &. &. &. &. &. ..................................

T.P.F./ C.P.S re;jh : &. &. &. &. &. ..................................

T.P.F. fld;/ C.P.S. Arr. : &. &. &. &. &. ..................................

F.B.F. : &. &. &. &. &. ..................................

S.P.F. : &. &. &. &. &. ..................................

NHIS 2012 : &. &. &. &. &. ..................................

F.A. : &. &. &. &. &. ..................................

SOCIETY : &. &. &. &. &. ..................................

R.D. : &. &. &. &. &. ..................................

I.T. : &. &. &. &. &. ..................................

EDUCATION CESS : &. &. &. &. &. ..................................

L.I.C. : &. &. &. &. &. ..................................

nkhj;jk; nkhj;jk; nkhj;jk; nkhj;jk; nkhj;jk; : &. &. &. &. &. ..................................

Cjpak;Cjpak;Cjpak;Cjpak;Cjpak; Cjpag; gpbj;jq;fs;Cjpag; gpbj;jq;fs;Cjpag; gpbj;jq;fs;Cjpag; gpbj;jq;fs;Cjpag; gpbj;jq;fs;

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11. fy;tp tptuq;fs; :11. fy;tp tptuq;fs; :11. fy;tp tptuq;fs; :11. fy;tp tptuq;fs; :11. fy;tp tptuq;fs; :

nghJf; fy;tpnghJf; fy;tpnghJf; fy;tpnghJf; fy;tpnghJf; fy;tp 1. SSLC rhd;W vz;rhd;W vz;rhd;W vz;rhd;W vz;rhd;W vz; : ............................................................

2. +2 rhd;W vz;rhd;W vz;rhd;W vz;rhd;W vz;rhd;W vz; : ............................................................

Nghjdh Kiwf; fy;tpNghjdh Kiwf; fy;tpNghjdh Kiwf; fy;tpNghjdh Kiwf; fy;tpNghjdh Kiwf; fy;tp 1. D. T. Ed. rhd;W vz;rhd;W vz;rhd;W vz;rhd;W vz;rhd;W vz; : ............................................................

2. B. Ed. rhd;W vz;rhd;W vz;rhd;W vz;rhd;W vz;rhd;W vz; : ............................................................

,sq;fiy gl;lg; gbg;G,sq;fiy gl;lg; gbg;G,sq;fiy gl;lg; gbg;G,sq;fiy gl;lg; gbg;G,sq;fiy gl;lg; gbg;G 1. ................................... rhd;W vz;rhd;W vz;rhd;W vz;rhd;W vz;rhd;W vz; : ............................................................

2. ................................... rhd;W vz;rhd;W vz;rhd;W vz;rhd;W vz;rhd;W vz; : ............................................................

KJfiy gl;lg; gbg;GKJfiy gl;lg; gbg;GKJfiy gl;lg; gbg;GKJfiy gl;lg; gbg;GKJfiy gl;lg; gbg;G 1. ................................... rhd;W vz;rhd;W vz;rhd;W vz;rhd;W vz;rhd;W vz; : ............................................................

2. ................................... rhd;W vz;rhd;W vz;rhd;W vz;rhd;W vz;rhd;W vz; : ............................................................

12. gzpGupe;j gs;spfs; :12. gzpGupe;j gs;spfs; :12. gzpGupe;j gs;spfs; :12. gzpGupe;j gs;spfs; :12. gzpGupe;j gs;spfs; :

1. gs;sp ngau; & Cu; : ...........................................................................................................................................................

...........................................................................................................................................................

........................................................ Kjy; ........................................................ Kba

2. gs;sp ngau; & Cu; : ...........................................................................................................................................................

...........................................................................................................................................................

........................................................ Kjy; ........................................................ Kba

3. gs;sp ngau; & Cu; : ...........................................................................................................................................................

...........................................................................................................................................................

........................................................ Kjy; ........................................................ Kba

4. gs;sp ngau; & Cu; : ...........................................................................................................................................................

...........................................................................................................................................................

........................................................ Kjy; ........................................................ Kba

5. gs;sp ngau; & Cu; : ...........................................................................................................................................................

...........................................................................................................................................................

........................................................ Kjy; ........................................................ Kba

6. gs;sp ngau; & Cu; : ...........................................................................................................................................................

...........................................................................................................................................................

........................................................ Kjy; ........................................................ Kba

7. gs;sp ngau; & Cu; : ...........................................................................................................................................................

...........................................................................................................................................................

........................................................ Kjy; ........................................................ Kba

8. gs;sp ngau; & Cu; : ...........................................................................................................................................................

...........................................................................................................................................................

........................................................ Kjy; ........................................................ Kba

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PAY CERTIFICATE

This is to Certify Thiru. ...............................................................................................................

working as a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , in the

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SCHOOL, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNION, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DISTRICT.

His / Her PAY PARTICULARS are as follows :

PAY : Rs. ..........................

P. PAY : Rs. ..........................

D. A. : Rs. ..........................

H. R. A. : Rs. ..........................

M. A. : Rs. ..........................

S. A. : Rs. ..........................

C. C. A. / H.A. : Rs. ..........................

Total Rs.

T. P. F. / C. P. S. : Rs. ...................

TPF Loans / CPS Arr. : Rs. ...................

S. P. F. : Rs. ...................

F. B. F. : Rs. ...................

F. A. : Rs. ...................

NHIS : Rs. ...................

RD / PLI : Rs. ...................

SOCIETY : Rs. ...................

Total Rs.

DEDUCTIONSDUES

NET PAY Rs. . .................................................

( Rpees ................................................................................................................................................

....................................................................................................... only )

Date :

Place :

Block Educational Officer

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cau;fy;tp gapy mDkjp NfhUk; tpz;zg;gk;cau;fy;tp gapy mDkjp NfhUk; tpz;zg;gk;cau;fy;tp gapy mDkjp NfhUk; tpz;zg;gk;cau;fy;tp gapy mDkjp NfhUk; tpz;zg;gk;cau;fy;tp gapy mDkjp NfhUk; tpz;zg;gk;

01. Mrpupau; ngau; ; : ..............................................................................................

02. gjtp : ..............................................................................................

03. gzpGupAk; gs;sp : ..............................................................................................

: ..............................................................................................

: ..............................................................................................

04. jw;Nghija fy;tpj;njhFjp : ..............................................................................................

05. gzpapy; Nru;e;j ehs; : ..............................................................................................

06. gapy cs;s cau;fy;tp : ..............................................................................................

07. mDkjp Ntz;lg;gLk; Mz;L : ..............................................................................................

08. gapy cs;s gy;fiyf;fofk; : ..............................................................................................

09. cau;fy;tp gapy fhuzk; : ..............................................................................................

10. tpz;zg;gjhuupd; ifnahg;gk; : ..............................................................................................

rhd;Wrhd;Wrhd;Wrhd;Wrhd;W

Nkw;fz;l tpguq;fs; midj;Jk; rupahdit vdTk;> ehd; cau;fy;tp gapy;tjhy;

vd;Dila fy;tpg; gzpf;F ve;jtpjkhd ,ilA+Wk; Vw;glhjtz;zk; ele;J nfhs;Ntd;

vd cWjpaspf;fpNwd;.

tpz;zg;gjhuupd; ifnahg;gktpz;zg;gjhuupd; ifnahg;gktpz;zg;gjhuupd; ifnahg;gktpz;zg;gjhuupd; ifnahg;gktpz;zg;gjhuupd; ifnahg;gk;

Mrpupau; jpU / jpUkjp ......................................................................... mtu;fs; cau;fy;tp

gapy;tjhy; ,g;gs;spapd; gs;spg; gzpapYk; fw;gpj;jy; gzpapYk; vt;tpjkhd ,ilA+Wk;

Vw;glhjthW ele;J nfhs;thu; ; vd rhd;wspj;J gupe;Jiu nra;ag;gLfp;wJ.

jiyik Mrpupau; ifnahg;gk;;jiyik Mrpupau; ifnahg;gk;;jiyik Mrpupau; ifnahg;gk;;jiyik Mrpupau; ifnahg;gk;;jiyik Mrpupau; ifnahg;gk;;

ehs; :

,lk; :

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jw;nray; tpLg;G tpz;zg;gk;jw;nray; tpLg;G tpz;zg;gk;jw;nray; tpLg;G tpz;zg… · 2018-10-20 · kUj;Jt kUj;Jt kUj;Jt