Certificate Specimen

Certified that Mr. / Miss ............................................................................ Son / Daughter of Sh. ............................................................................ Resident of ............................................................................ is known to me for the last three years.

He / She bears a good moral character.

I, ............................................................................ daughter / son of Sh. ............................................................................, resident of ............................................................................, do hereby solemnly affirm and declare as under:

1. That I am seeking admission in ............................................................................ course in the College, Chandigarh.
2. That I will submit the following document(s) within one month from the date of admission. (Tick the relevant column)
   • ☐ Character Certificate*
   • ☐ Migration Certificate**
3. That in case I am unable to submit the above document(s) within the stipulated time, my admission automatically stands cancelled.

I, ............................................................................ Son / Daughter of Sh. ............................................................................, Resident of ............................................................................, do hereby solemnly affirm and declare as under:

1. That I am seeking admission in ............................................................................, Chandigarh.
2. That I passed my .............................. examination during 20......
3. That during my gap period from .............................. to .............................. I did not take part in any political activity.
4. That during my gap period from .............................. to .............................. there is no criminal case lying pending against me in any Court or Police Station.
5. That due to .............................., I had to drop my regular studies for ............ year / years.
6. That I was not disqualified by any board / body / council / university.
7. That I am not already registered with Panjab University, Chandigarh (wherever applicable).
8. That I bear a good moral character.

Verification

Verified that the contents of the above affidavit are true and correct and that nothing has been concealed therein.

The Caste / Tribe Certificate should necessarily contain the following information:

1. Name of the person
2. Father's name
3. Permanent place of residence
4. Name of the Caste / Tribe
5. Constitutional order under which the caste / tribe has been notified
6. Signature of issuing authority along with the designation, seal and date

Authorities Empowered to Issue SC / ST Certificate

1. District Magistrate / Additional District Magistrate / Collector / Deputy Commissioner / Additional Deputy Commissioner / Deputy Collector / 1st Class Stipendiary Magistrate / Sub-Divisional Magistrate / Taluka Magistrate / Executive Magistrate / Extra Assistant Commissioner.
2. Chief Presidency Magistrate / Additional Chief Presidency Magistrate / Presidency Magistrate.
3. Revenue Officer not below the rank of Tehsildar.
4. Sub-Divisional Officer of the area where the candidate and / or his / her family normally resides.
5. Administrator / Secretary to Administrator / Development Officer (Lakshadweep Islands).

Dispatch No. .............................. Dated ..............................

Certified that Mr. / Ms. ............................................................................ (Freedom Fighter) son / daughter of Shri ............................................................................ of Village ........................... Post Office ........................... Tehsil ........................... District ........................... and Parent / Grandparent of Mr. / Ms. ............................................................................ (Name of the Candidate), is a bonafide political sufferer and has been drawing freedom fighter's pension from .............................. Treasury or has been awarded Tamar Patra for his / her political suffering.

Dispatch No. .............................. Dated ..............................

Certified that ............................................................................ Widow / Ward of ............................................................................ Rank .............................. (if applicable), an applicant for admission to .............................. course(s) in the College ............................................................................ under Panjab University, is:

1. Widow / Ward of such Defence and Central Armed Police Force (CAPF)* personnel who died in action on .............................. during .............................. (Only those who are wholly dependent on such personnel shall be considered).
2. Ward of such Defence and Central Armed Police Force (CAPF)* personnel who was disabled in action on .............................. during .............................. and boarded out from service.
3. Widow / Ward of such Defence and CAPF personnel who died on .............................. while in service with death attributable to military service.
4. Ward of such Defence and Central Armed Police Force (CAPF)* personnel who was disabled in action on .............................. during .............................. and boarded out with disability attributable to military service.
5. Ward of Ex-Serviceman and serving personnel who are in receipt of Gallantry Award ..............................
6. Ward of Ex-Serviceman ..............................
7. Wife of ..............................
   1. Defence personnel in action and boarded out from service
   2. Defence personnel disabled in service and boarded out with disability attributable to military service
   3. Ex-servicemen and serving personnel who are in receipt of Gallantry Awards
8. Ward of Serving Personnel ..............................
9. Wife of Serving Personnel ..............................

Dispatch No. .............................. Dated ..............................

This is to certify that Mr. / Ms. ............................................................................ is a Son / Daughter / Husband / Wife / Brother / Sister of Shri ............................................................................ (Terrorist / Riot affected person) of Village ........................... Post Office ........................... Tehsil ........................... District ........................... who was (killed / incapacitated in November 1984 riots) / (killed / incapacitated in terrorist violence in Punjab and Chandigarh).

I / We ............................................................................ (father) and ............................................................................ (mother) of Miss ............................................................................ (full address to be given), resident of House No. ........................... Street / Sector ........................... Town / City / Village ........................... District / State ........................... do hereby solemnly declare and affirm as under:

1. That I am / we are citizens of India.
2. That Miss ............................................................................ born on .............................. is our girl child.
3. That we have no male child.
4. That we have the following only two girls and none else:
   1. Name: ..........................................   Date of Birth: ..........................................
   2. Name: ..........................................   Date of Birth: ..........................................
5. That none of the above-mentioned two girl children has obtained / availed the benefit granted under this category, in this University / Institute including its affiliated colleges.

Detailed address of issuing physician and hospital. Mention serial number and date with phone number and address.

This is to certify that Ms. / Mr. ............................................................................ (Name of the student), Date of Birth: .............................., C.R. / OPD No. .............................., D/o / S/o ............................................................................ (Mother's / Father's Name), resident of ............................................................................ (complete address), is a diagnosed case of .............................. (Cancer / Thalassemia / AIDS)*. She / He is undergoing treatment for the same under my care.

Certified that Mr. / Ms. ............................................................................ son / daughter of Sh. ............................................................................ is from Rural School(s) that does not fall in the area of the Municipal Corporation / Municipal Committee / Small Town / Notified Area / Cantonment Area. The date of joining and leaving school is given below:

Certified that Mr. / Ms. ............................................................................ son / daughter of Sh. and Smt. ............................................................................, Resident of .............................. has passed the Matriculation from .............................., a school situated in border area. It is further certified that Mr. / Ms. .............................. has studied in the institution(s) that is situated within 20 kms from the International Border, as per date of joining and leaving school given below:

This is to certify that Shri / Smt. / Kumari ............................................................................ son / daughter / wife of ............................................................................, permanent resident of .............................. Village / Street ........................... Post Office ........................... District ........................... in the State / Union Territory ........................... Pin Code .............................., whose photograph is attested below, belongs to Economically Weaker Sections, since the gross annual income* of his / her "family"** is below Rs. 8 lakh (Rupees Eight Lakh only) for the financial year ............................... His / her family does not own or possess any of the following assets***:

1. 5 acres of agricultural land and above;
2. Residential flat of 1000 sq. ft. and above;
3. Residential plot of 100 sq. yards and above in notified municipalities;
4. Residential plot of 200 sq. yards and above in areas other than the notified municipalities.

Shri / Smt. / Kumari ............................................................................ belongs to .............................. caste, which is not recognised as a Scheduled Caste, Scheduled Tribe and Other Backward Classes (Central List).