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Page 1 of 18 (Established by Haryana Legislature Act No. 7 of 2010) Advertisement No. 1/2021 The applicants are advised to read the instructions/conditions carefully before applying and ensure that they fulfil the requisite qualifications and other conditions. The candidature of the candidates will be rejected if they are found ineligible at a later stage even after appointment also. 1. Offline applications are invited for direct recruitment for various Non Teaching and Technical posts mentioned under para-2 from the eligible candidates from 04.01.2021 to 23.01.2021 (29.01.2021 for candidates residing abroad & his/her application form must be posted from abroad) for filling up in Lala Lajpat Rai University of Veterinary & Animal Sciences, Hisar. The duly filled in application form complete in all respect along with self-attested photo copies of required certificates, documents and Demand Draft should reach “The Registrar, LUVAS, Hisar-125004” on or before 23.01.2021 (29.01.2021 for candidates residing abroad his/her application form must be posted from abroad). The application format Form ‘B’ for non teaching and technical posts (at Sr. No. 1 to 6) along with, essential qualifications, benefit of reservation, application processing fee and terms / conditions , selection criteria and syllabi (for written examinations) etc. are available and can be downloaded from the University website www.luvas.edu.in Sr. No. Events Date 1 Date of Publication in Newspaper Before 03.01.2021 2 Opening date for submission of offline application 04.01.2021 (From 09:00 AM) 3 Last date for submission of offline application 23.01.2021 (29.01.2021 for candidates residing abroad and his/her application form must be posted from abroad) (by 04:30 PM) 2. Details of Posts and Pay Scale Sr. No . Name of Post Nos. & Category of Post Pay Scale 1 Junior Engineer (Public Health) (Group ‘C’) 01 (EWS) 35400-112400 (FPL-6) 2 Junior Engineer (Electrical) (Group ‘C’) 01 (Gen.) 35400-112400 (FPL-6)
Transcript

Page 1 of 18

(Established by Haryana Legislature Act No. 7 of 2010)

Advertisement No. 1/2021

The applicants are advised to read the instructions/conditions carefully before

applying and ensure that they fulfil the requisite qualifications and other

conditions. The candidature of the candidates will be rejected if they are found

ineligible at a later stage even after appointment also.

1. Offline applications are invited for direct recruitment for various Non Teaching and

Technical posts mentioned under para-2 from the eligible candidates from 04.01.2021 to

23.01.2021 (29.01.2021 for candidates residing abroad & his/her application form

must be posted from abroad) for filling up in Lala Lajpat Rai University of Veterinary &

Animal Sciences, Hisar. The duly filled in application form complete in all respect along

with self-attested photo copies of required certificates, documents and Demand Draft

should reach “The Registrar, LUVAS, Hisar-125004” on or before 23.01.2021

(29.01.2021 for candidates residing abroad his/her application form must be posted

from abroad). The application format Form ‘B’ for non teaching and technical posts (at

Sr. No. 1 to 6) along with, essential qualifications, benefit of reservation, application

processing fee and terms / conditions , selection criteria and syllabi (for written

examinations) etc. are available and can be downloaded from the University website

www.luvas.edu.in

Sr. No. Events Date

1 Date of Publication in Newspaper

Before 03.01.2021

2 Opening date for submission of offline application

04.01.2021 (From 09:00 AM)

3 Last date for submission of offline application

23.01.2021 (29.01.2021 for candidates residing abroad and his/her application form must be posted from abroad) (by 04:30 PM)

2. Details of Posts and Pay Scale

Sr. No.

Name of Post Nos. & Category of Post

Pay Scale

1 Junior Engineer (Public Health) (Group ‘C’)

01 (EWS) 35400-112400 (FPL-6)

2 Junior Engineer (Electrical) (Group ‘C’)

01 (Gen.) 35400-112400 (FPL-6)

Page 2 of 18

3 Sub Divisional Engineer (Public Health) (Group ‘B’)

01 (Gen.) 53100-167800 (FPL-9)

4 Sub Divisional Engineer ( Electrical) (Group ‘B’)

01 (Gen.) 53100-167800 (FPL-9)

5 Hostel Warden (Group ‘C’) 01 (Gen.) 35400-112400 (FPL-6)

6 Lady Hostel Warden (Group ‘C’) 01 (Gen.) 35400-112400 (FPL-6)

3. Essential Qualification A. Junior Engineer (Public Health)

(i) Diploma Course in Civil with atleast 50% marks from any recognized Institution with

atleast two years experience in related fields.

(ii) Hindi/Sanskrit as one of the subject upto Matric or Higher education.

Age Limit – 42 years

OR

(i) Bachelor in Engineering/B.Tech. (Civil) with atleast 50% marks from any recognized

Institution/University.

(ii) Hindi/Sanskrit as one of the subject upto Matric or Higher education.

Age Limit – 42 years

B. Junior Engineer (Electrical)

(i) Diploma Course in Electrical with atleast 50% marks from any recognized Institution with

atleast two years experience in related fields.

(ii) Hindi/Sanskrit as one of the subject upto Matric or Higher education.

Age Limit – 42 years

OR

(i) Bachelor in Engineering/B.Tech. (Electrical) with atleast 50% marks from any recognized

Institution/University.

(ii) Hindi/Sanskrit as one of the subject upto Matric or Higher education.

Age Limit – 42 years

C. Sub Divisional Engineer (Public Health)

(i) Bachelor in Engineering/B.Tech. (Civil) atleast 50% marks from any recognized

Institution/University.

(ii) Three years experience as Junior Engineer (Civil) in Public Health

Works/construction/maintenance of buildings in Govt./Semi Govt./Board Corporation &

Govt. undertaking Institutes.

(iii) Hindi/Sanskrit as one of the subject upto Matric or Higher education.

Age Limit – 42 years

D. Sub Divisional Engineer (Electrical)

(i) Bachelor in Engineering/B.Tech. (Electrical) atleast 50% marks from any recognized

Institution/University.

(ii) Three years experience as Junior Engineer (Electrical) in Electrical works in Govt./Semi

Govt./Board Corporation & Govt. undertaking Institutes .

(iii) Hindi/Sanskrit as one of the subject upto Matric or Higher education.

Age Limit – 42 years

Page 3 of 18

E. Hostel Warden

(i) Graduate with atleast 60% marks from a recognized University/ Institution.

OR

Post Graduate with atleast 50% marks from a recognized University/ Institution.

(ii) One Year experience as Hostel Warden in a recognized University.

(iii) Hindi/Sanskrit upto Matric or Higher Standard.

(iv) Age: Minimum 30 Years

Note: This Post is for Male Candidates only

F. Lady Hostel Warden

(i) Graduate with atleast 60% marks from a recognized University/ Institution.

OR

Post Graduate with atleast 50% marks from a recognized University/ Institution.

(ii) One Year experience as Hostel Warden in a recognized University.

(iii) Hindi/Sanskrit upto Matric or Higher Standard.

(iv) Age: Minimum 30 Years

Note: This Post is for Female Candidates only

4. Relaxation in Age:

i) Minimum age limit for the post under Para 3 (A to D) is 18 years and (E to F) is 30 years.

Upper age limit is relaxable upto 5 years in the case of Scheduled Caste (SC), Backward

Class (A) & Backward Class (B) as per Haryana Govt. instructions.

ii) In the case of PwD General Candidates, the upper age limit is relaxable by 10 years (15

years for SCs/BCs) as per Haryana Government instructions No. 22/10/2013- 1GS-III,

dated 15.07.2014.

iii) For Ex-servicemen Candidates, relaxation up to continuous Military service added by

three years is permissible.

iv) The upper age limit in respect of widow, legally separated woman, divorcee, deserted

woman and unmarried woman will be upto 47 years as per Government instructions.

v) Relaxation in maximum age to the persons who have already worked or are presently

working on adhoc/contract/work-charged/daily wages/under outsourcing policy in any

Department/Board/Corporation of Haryana Government to make them eligible to

compete for regular recruitment. This relaxation in maximum age will be admissible equal

to the period he has worked on adhoc/contract/work-charged/daily wages/under

outsourcing policy excluding the period of break, if any, for appointment to a post on

regular basis. It is clarified here that once a person is selected for regular appointment

availing benefit of relaxation in age, he/she will not be entitled to avail such benefit again

for subsequent appointment to any post (Vide Instructions No. 6/36/2019-1GS-I, dated

3rd July 2019, Haryana Government).

Page 4 of 18

5. Application Processing Fees in Rupees for Offline application.

Sr. No.

Name of Post (s) General SC/BC/EWS Candidates of Haryana State

Male/Female Female (Haryana State Only)

Male Female

1 Junior Engineer (Public Health), Junior Engineer(Electrical) Hostel Warden & Lady

Hostel Warden

1000/- 500/- 250/- 125/-

2 Sub Divisional Engineer (Public Health) & Sub Divisional Engineer (Electrical)

1600/- 800/- 400/- 200/-

(i) The dependent of ESM and DFF are required to pay the fee as of their original category

i.e. General/BCA/BCB/ as the case may be.

(ii) Application processing fee (details given in above table) in the shape of Demand Draft of

any Nationalized Bank drawn in favour of “The Registrar, LUVAS, Hisar” and payable at

Hisar should be attached with each application form.

(iii) Person with disability and Ex-Servicemen of Haryana State will be exempted from

application fee.

6. Selection Criteria & Syllabus for Written Examination for Group C Posts.

(i) As per notification issued by the State Govt. vide No. G.S.R-25/Const./Art. 309/2019

dated 11.06.2019, the scheme of marks in respect of selection to the posts shall comprise

of total 100 marks as per detail given below.

Sr.

No.

Examination Marks

1 Written Examination 90

2 Socio-Economic Criteria and Experience

10

(ii) The written examination of 90 marks shall be divided into two parts comprising:-

a. 75% weightage for General Awareness, Reasoning, Maths, Science, Computer,

English, Hindi and concerned or relevant subject, as applicable.

b. 25% weightage for History, Current Affairs, Literature, Geography, Civics,

Environment, Culture etc. of Haryana.

Page 5 of 18

(iii) The 10 marks for socio-economic criteria and experience shall be allocated as

follows:

a. if neither the applicant nor any person from among the applicant’s family viz father,

mother, spouse, brother, and Son is, was or has been a regular employee in any

Department/Board/ Corporation/Company/Statutory Body/Commission/Authority of

Government of Haryana or any other State Government or Government of India.

(Affidavit attested by Executive Magistrate in prescribed format regard point: Refer

Annexure E1 to be attached alongwith application form and brought at the time of

Scrutiny. )

(5 Marks)

b. if the applicant is:-

i) a widow; or (Widow Certificate issued by Tehsildar: Refer Annexure BI, BII)

ii) the first or the second child and his father had died before attaining the age of 42 years:

Or

the first or the second child and his father had died before the applicant had attained the

age of 15 years:

(Certificate issued by Competent Authority: Refer Annexure AI, AII.)

(5 marks)

c. If the applicant belongs to such a denotified tribe (Vimukt Jatis and Tapriwas Jatis) or

Nomadic tribe of the State of Haryana which is neither a Scheduled Caste nor a Backward

Class.

(Vimuktjati and Tapriwas jati Certificate issued by Tehsildar).

(5

marks)

d. Experience:

One-half (0.5) marks for each year or part thereof exceeding six months of experience, out

of a maximum of sixteen years, on the same or a higher post in any

Department/Board/Corporation/Company/Statutory Body/Commission/Authority of

Government of Haryana. No marks shall be awarded for any period less than six months.

(Maximum of 8 marks)

(Experience Certificate issued by the concerned Appointing Authority: Refer

Annexure D1)

Note 1: No applicant shall be given more than 10 marks for socio economic criteria and

experience under any circumstances. Marks of experience will be granted above the

required experience as per essential qualifications. The Experience Certificate of the

persons employed through outsourcing policy part 1, will be considered if the certificate is

issued by the concerned contractor and duly verified by the Controlling Officer. The

Experience Certificate of persons employed under outsourcing policy part 2 will be

considered if the same is issued by the concerned controlling officer.

Page 6 of 18

Note 2: Performa/Formats for certificates and Self Declaration are available as Annexures- A-I, A-II, B-I, B-II, D-I, E-I to this advertisement.

Note 3: Marks of experience under socio economic criteria will be given as per State Govt.

Instructions irrespective of essential qualification for Group ‘C’ posts

Note 4 : The benefit of socio economic criteria will be granted only as per details given in

the application form and relevant documents attached with the application form for

claiming the marks under socio economic criteria. No request of change /addition of any

document for claiming mark under Socio Economic Criteria will be considered under any

circumstances after submission of offline application form.

7. Selection Criteria for Group B Posts

Sr. No. Subject Marks

1 Educational Qualifications (B.E./B.Tech.-20 Marks & M.E./M.Tech-10 Marks

30

2 Written test comprising of B.E./B.Tech Syllabus 50

3 Experience from Govt. /Recognized institute in relevant field (Max. 5 marks)

05 (one marks for each year above the required experience as per essential qualification)

4 Interview 15

Total 100

8. General Instructions/Conditions for offline applications.

(i) The applicant must possess prescribed qualifications on the last date of receipt of

applications. If a candidate is found ineligible at a later stage, his candidature will be

rejected. The fulfilment of prescribed essential qualifications will not entitle a candidate to

be called for interview/ final selection.

(ii) The candidate should give details of all the examinations passed from Matriculation or its

equivalents to onwards and mention total and percentage of marks obtained and

maximum marks in each examination in the offline application form. The candidate, who

has obtained degree or Diploma or Certificates for the various courses from any

institution declared fake by the University Grants Commission/VCI and other

institutions/agencies, shall not be eligible for being considered for recruitment to the

post(s) advertised.

(iii) The decision of the University in all matters relating to acceptance or rejections of an

application, eligibility of the candidates, mode and criteria for selection etc. will be final

and binding on the candidates. No inquiry or correspondence will be entertained in this

regard.

Page 7 of 18

(iv) Candidates applying for a post must ensure that they fulfil all the eligibility conditions on

the last date of application.

(v) If on verification at any stage starting from submitting offline application form till

appointment and any time even after appointment, it is found that any candidate does

not fulfil any of the eligibility condition or it is found that the information furnished is

false or incorrect, his/her candidature will be cancelled and he/she will also be liable to

be criminally prosecuted. This is irrespective of whether the candidate was benefitted by

furnishing the false or incorrect information in his/her application.

(vi) It is strictly directed here that the marks under the socio economic criteria, if any, shall

be admissible to those candidates who fill the detail in application form and enclose the

requisite original certificate/document/undertaking along with their offline application in

support of their claim to avail the marks under socio economic criteria and experience

failing which, no marks will be awarded under socio economic criteria and experience. No

request in this regard will be entertained after the last date i.e.23.01.2021 (29.01.2021

candidates residing abroad).

(vii) If quota reserved for Ex-servicemen or Backward Classes remains unfilled to that extent

due to non-availability of suitable Ex-servicemen or their dependents or non-availability

of suitable candidates from Backward Classes then overall reservation either from the

unfilled vacancies of Ex-serviceman or from the Backward Classes for Freedom

fighter/their Children/Grand Children will remain limited 2% only. This benefit will be

available to all Grand Children i.e. sons and daughters of sons and daughters (paternal

as well as maternal) of the Freedom fighter(Chief Secretary Instruction No. 22/10/2013-

1GSIII, dated 15.07.2014).

(viii) The dependents of ESM will include wife/widow, dependent sons/daughters and who

fulfill all conditions of qualifications; age etc. prescribed for posts & will be considered on

merit for the posts reserved for ESM to the extent of non-availability of suitable ESM

candidates.

(ix) DESM candidates of Haryana claiming benefit must have valid eligibility certificate on last

date of submission of online application form and will have to produce the valid Eligibility

Certificate from the concerned Zila Sainik Board when called upon to do so by Haryana

Staff Selection Commission. Mere dependent certificate will not be entertained. ESM

candidates should also produce attested photo copy of Identity Card issued by concerned

Zila Sainik Board & Discharge Book whenever required.

(x) Qualifications and other term and conditions of eligibility will be determined with regard

to the last date fixed for receipt of offline application. No any documents after the last

date i.e. 23.01.2021 (29.01.2021) will be added with the application form under any

circumstances.

Page 8 of 18

(xi) Reservation of posts: Reservation for persons will be as per Haryana Government

Instructions contained in letter No. 22/10/2013-1GS-III, dated 15.07.2014 and Govt.

Instructions issued from time to time. The candidates belonging to other than Haryana

State will be treated as General for reservation.

(xii) Candidates already in regular/temporary/ad hoc/contract service must apply through

proper channel or produce “No Objection Certificate” from the appointing authority

otherwise they will not be allowed to appear in interview/verification of documents. They

may, however, submit an advance copy alongwith prescribed application processing fee

&self-attested copies of all the documents.

(xiii) Applications which are incomplete/not on prescribed application form of LUVAS/ received

late will not be considered. The University shall not be responsible for any postal

delay/lapse.

(xiv) The number of posts indicated in the Advertisement can vary. The University also

reserves the right to withdraw / add one or more of the post(s) advertised.

(xv) Besides pay, as per scale mentioned in the advertisement, ADA, HRA, Medical Allowance

etc. are admissible as per University rules adopted from time to time.

(xvi) No TA/DA shall be paid by the LUVAS for any written examination/verification of

documents/interview.

(xvii) The benefit of reservation will be given only to those SC/BCA/BCB/EWS/ Persons with

disabilities/ESM/DESM/Eligible Sports Person and DFF candidates who are domicile of

Haryana State. The SC/BCA/BCB/EWS/Persons with disabilities/DFF candidates are

required to enclosed the SC/BCA/BCB/EWS/Persons with disabilities/DFF certificate

duly issued by the competent authority with the application form. Likewise the Eligible

Sportsperson shall be required to enclose the sports gradation certificate issued by the

competent authority with the application for as per Government instructions. DESM

shall be required to enclose the fresh Eligibility Certificate duly issued by the respective

Zila Sainik Board with the offline application form. No certificate issued after last date

shall be considered.

(xviii) Persons appointed at outstations will not be transferred to Headquarter at Hisar for at

least 5 years.

(xix) All claims mentioned in the application forms should be supported by relevant and

authenticated documents only and such documents/records will be taken into

consideration for award of marks.

Page 9 of 18

(xx) In case of tie in a particular post, the tie will be resolved as under:

If more than one candidate (s) obtains equal marks in the Selection Criteria including

written examination, Socio Economic Criteria and Experience the merit will be decided on

the basis of marks obtained in the essential qualifying examination of that post, meaning

thereby if the essential qualification for the post of Junior Engineer (Electrical) is Diploma

in Electrical Engineering , the deciding factor will be the marks obtained in Diploma

Electrical. If in the qualifying examination also the marks are equal, the merit will be on

the basis of next lower examination. If still the marks in the lower examination are equal

then the older in age will be senior on merit.

(xxi) The Eligibility of Eligible Sports Persons (ESP) will be determined according to Govt.

Notification No. 4/40/2017-4SYA dated 25.05.2018 and notification dated 15.11.2018, if

any.

(xxii) Candidates can apply for more than one post as per their qualifications. However, he/she

should apply separately for each post. Application fee is also to be paid separately for

each post.

(xxiii) Candidates are advised not change their Mobile No./Email ID as mentioned in the

application form. The University shall not be responsible for non delivery of SMS/Email at

any stage due to switching off the mobile phone or some technical fault on the part of

candidate.

(xxiv) Applicants are advised to visit the university website www.luvas.edu.in regularly. Every

information regarding the recruitment process shall be displayed on the university

website.

NONE OF THE PERSON MENTIONED BELOW SHALL FALL WITHIN DEFINITION OF

WARD/ DEPENDENT OF EX-SERVICEMEN IN TERMS OF HARYANA GOVT. LETTER

NO.12/37/79-GSIII DATED 21-11-1980:-

i) A person may be working on an ad hoc basis against the post advertised or somewhere

else.

ii) A person may be unemployed at the time of making the application but he may have

other source of income viz., from agriculture, trade, property, bank balance etc.

iii) A person who is a member of the joint Hindu family and remains dependent upon the

Karta till there is partition in the family or he/she ceases to be a member of the joint

Hindu family and is obliged to pass on all his/her income to the Karta and he/she draws

money for his/her subsistence from the pool of the joint Hindu family with the consent of

the Karta.

iv) A candidate who is a member of the joint Hindu family is employed on ad hoc basis but

he/she is otherwise dependent on his/her father.

Page 10 of 18

9. Documents to be enclosed with Application Form

(i) Self attested Copy of Essential Academic Qualifications and Certificate of Matric and

onwards showing Date of Birth and other relevant details.

(ii) Self attested Copy of SC/BCA/BCB/EWS/ESP/ESM/DESM/DFF/PwD (Person with

Disabilities) certificate alongwith Haryana domicile Certificate issued by competent

authority.

(iii) Duly attested copy of Certificate/undertaking claiming weightage/marks under socio-

economic criteria and experience.

(iv) In Case of Regular Govt. Employee, the checklist duly filled by the competent authority is

mandatory.

(v) Passport Size Coloured Photo showing 80% face visible duly signed by the

Candidate. Photograph should not be more than three months old. The date of

taken of photograph should be mentioned on the photo. The same photograph as

affixed on the application form must be affixed on the admit card at the time of

written examination of the candidate (wherever applicable) . The candidates whose

photograph is found different to that pasted on the application form will not be

allowed to appear in the written examination.

10. An application form will be summarily rejected in the following events:-

(i) If a candidate makes more than one application form for the same post.

(ii) If the application is not on the prescribed application form.

(iii) If the application is unsigned/incomplete.

(iv) If the experience certificate is without detail of salary per month received (wherever the

condition of experience apply).

(v) If in-service candidates who apply through proper channel do not attach duly certified

check list along with their application form.

(vi) If a candidate does not possess the qualifications of Hindi/Sanskrit upto Matric

standard/Higher Standard.

(vii) If a candidate does not possess the prescribed academic qualifications on the last date for

submission of offline application.

(viii) If a candidate is under age/over age on the last date for submission of offline application..

(ix) If the application is received after the last date i.e. 23.01.2021 (29.01.2021 candidates

residing abroad), University will not be responsible for any postal delay.

(x) If the application is without application processing fee.

11. Candidates are warned that they should not furnish any particulars that are false,

tampered/fabricated or should not suppress any material information while filling up the

application form. At the time of written examination(if applicable/scrutiny , if a candidate

is (or has been) found guilty of:

Page 11 of 18

a) Using unfair means during the examination.

b) Impersonating or procuring impersonation by any person.

c) Misbehaving in the examination hall or taking away the answer sheet from the

examination hall.

d) Resorting to any irregular of improper means in connection with his/her candidature for

selection.

e) Obtaining support for his/her candidature by any unfair means. Not complying with

instructions issued from time to time, such a candidate may, in addition to rendering

himself/ herself liable to criminal prosecution, be liable.

i. To be disqualified from the examination/scrutiny for which he/she is a candidate.

ii. To be debarred either permanently or for a specified period, from any examination

or recruitment conducted by LUVAS.

iii. To be terminated from service, if he/she already in this University Service.

NOTE: ELECTRONIC DEVICES IN INTERVIEW/EXAMINATION ARE STRICTLY PROHIBITED. -Sd- REGISTRAR

Page 12 of 18

Annexure-A-I

APPLICATION FORM FOR CERTIFICATE FOR AN APPLICANT WHOSE FATHER HAS DIED

To

The Naib Tehsildar/Tehsildar

Sub:- CERTIFICATE FOR AN APPLICANT WHOSE FATHER HAS DIED.

1 Name of applicant (IN BLOCK LETTERS)

2 Date of Birth (enclose proof)

3 Age of applicant at the time of father death

4 Applicant is first or second child

5 Present Address, Village

6 Post Office

7 Police Station

8 District

9 Caste

10 Father’s Name

11 Date of birth of father

12 Age of father at the time of his death

13 Date of father’s Death (enclose death certificate)

14 Mother’s Name

15 Occupation

16 Aadhar No/PAN Card No/Voter Id No ( if any)

Please issue me a “Certificate for an applicant whose father has died”.

Signature of applicant

Place:

Date: Signature and Address of Witness

i)

ii)

Page 13 of 18

Annexure-A-II

GOVERNMENT OF HARYANA

Certificate for an applicant whose father has died

No Date

Certified that the person with the details mentioned below is an applicant whose father has

died-:

1 Name of applicant(IN BLOCK LETTERS)

2 Date of Birth(enclose proof)

3 Age of applicant at the time of father death

4 Applicant is first or second child

5 Present Address, Village

6 Post Office

7 Police Station

8 District

9 Caste

10 Father’s Name

11 Date of birth of father

12 Age of father at the time of his death

13 Date of father’s Death (enclose death certificate)

14 Mother’s Name

15 Occupation

16 Aadhar No/PAN Card No/Voter Id No ( if any)

This certificate is issued based on the details given in the application, local enquiry, facts and

records produced by the applicant.

Signature with seal of the Naib Tehsildar/Tehsildar

Page 14 of 18

VERIFICATION

I ,s/o ,Member Panchayat/Sarpanch/Councilor/MLA/MP

of concerned Village/area/constituency verified personally and statement furnished by

the applicant are correct to the best of my knowledge and belief.

Signature with seal of Member Panchayat/Councilor/MLA/MP of the concerned Village/area/constituency

Page 15 of 18

Annexure-B-I

APPLICATION FORM FOR WIDOW CERTIFICATE

To

The Naib Tehsildar/Tehsildar

Sub:- Issuance of Widow Certificate.

I ............................................., Widow of Sh ....................................... hereby give my

particular as under:-

1 Name of Applicant (IN BLOCK LETTERS)

2 Address

3 Village

4 Tehsil

5 District

6 Post office with PIN Code

7 Name of Father/Mother

8 Name of Husband

9 Date of Death of Husband (Death Certificate to be attached)

10 Aadhaar No. (if any)/PAN Card No. (if any)/Voter ID No. (if any)

Please issue me a “WIDOW” Certificate.

Place: Date:

VERIFICATION

Signature of Applicant

I...............................s/o, d/o, w/o,............................, Member Panchayat /Sarpanch

/Councilor/ MLA/MP of concerned Village/area/constituency......................................

verified personally and statement furnished by the applicant are correct to the best of my

knowledge and belief.

Signature with seal of Member

Panchayat/Sarpanch/Councilor/MLA/MP of the concerned Village

area/ constituency

Page 16 of 18

Annexure-B-II

GOVERNMENT OF HARYANA

WIDOW Certificate

No Date

Certified that the person with the details mentioned below is a Widow.

1. Name (IN BLOCK LETTERS)

2. Address

3. Village

4. Tehsil

5. District

6. Post office with PIN Code

7. Name of Father/Mother

8. Name of Husband

9. Date of Death of Husband

10. Aadhaar No./PAN Card No./Voter ID No. (if any)

This certificate is issued based on the details given in the application,

Verification Report, local enquiry, facts and records produced.

Signature with seal of the Naib Tehsildar/Tehsildar

Page 17 of 18

Annexure-D-I

Experience Certificate

1. This is to certify that Shri /Smt/Ms/Kumari, .............................................................

Son/ daughter/ wife of Shri ..................................................................................

resident of ....................................................... village/town .................................

Tehsil .............................................................. District .............................................

of Haryana State/Union Territory has been serving as ..............................................

(Complete nomenclature of the post in the office of ....................................................

(Department/ Board /Corporation /Company/ Statutory Body / Commission /

Authority of Government of Haryana or any State Government or Government of

India.)

2. The period of engagement was from............................................................................

to ............................................................................... and the completed years and

months are ................................................................... (years & months.)

3. The EPF account no. (if any) is /was..................................................................

4. Details of Pay (Year wise) received during the period mentioned above for claiming the benefits of Experience.

Place: Signature with seal of Issuing Authority (Head of Office)

Date: Full Name Designation

Address

Telephone No. With code

Page 18 of 18

Annexure-E-I

UNDERTAKING

I........................................,Son/Daughter of.................................................

aged.........................................,years,R/o ......................................................................,

District .........................................., do hereby submit the following information for claiming

marks under the Socio-economic criteria namely:-

(1) That I am to apply for the post of ............................................................ in LUVAS

against Category No. ...............................................,Advt.No. 1/2021

Dated 0 3 / 0 1 / 2 0 2 1 .

(2) That my Aadhaar No. / PAN Card No. / Voter ID No. (if any) is

................................................,

(3) That neither the applicant nor any person among the applicant’s family viz. father,

mother, spouse, brothers and sons is, was or has been a regular employee in any

Department / Board / Corporation/ Company/ Statutory Body/ Commission /

Authority of Government of Haryana or any other State Government or Government of

India.

(4) That as no person as mentioned above had been in employment, I may be allotted marks

under the socio-economic criteria.

(5) That I fully understand that the marks are given on the basis of information supplied by

me and if at any stage it is found that the information has been provided wrongly then

not only my service can be terminated on the ground of supply of wrong information

even if without these marks also my name would have figured within the select list /

recommendation list. I also understand that criminal action can be taken against me for

providing wrong / false information.

(6) That the deponent shall not take advantage of the certificate(s) issued by the Competent

Authority if in meantime any other eligible person in my family obtains the benefits

thereof in the recruitment.

Place:- DEPONENT

Date:-

VERIFICATION:-

Verified that the contents of all the above paras are true to my knowledge

and belief and nothing has been concealed therein.

Place:- DEPONENT

Date:-


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