Office of the Chief Commissioner of GST, Central Excise &
Customs, Nagpur Zone
GST Bhavan, Telangkhedi Road, Civil Lines, Nagpur - 440 001
Telephone No.0712-2565375 Fax No.0712-2561887
(
[email protected])
To, All candidates as per list enclosed.
Sub: Recruitment to the post of Tax
Assistant under CBIC through Combined Graduate Level Examination ,
2017-reg.
1. 2017 , & You have been nominated for appointment to
the post of Tax Assistant and allocated Nagpur Zone by the Cadre
Controlling Authority, Bhopal Zone on the basis of Combined
Graduate Level Examination 2017, conducted by the Staff Selection
Commission.
2 .() & 05-10-2020 + 11.00 , . . . 0 ), 5-I : ; <
0 You are directed to appear before the Joint Commissioner
(P&V), GST & CX, Nagpur-I on 05-10-2020 at 11:00 A.M. for
verification of documents. 3. : () & 5 ( ; 0) 0 I C
& I : C ; ; 0 5 0 ; ; 0 C 0 G 0 0 G 5 I 0 : () & ; ( 5 ),
)& , , ( 5 ) C 5 ; 0 P 0 The candidates are
directed to submit the duly filled in Attestation Form (in
File No.GCCO/II/(3)/17/2020-ADMN-O/o CC-CGST-ZONE-NAGPUR
three copies). A copy of blank Attestation Form is enclosed. The
candidate shall get the blank Attestation Form photocopied prior to
filling it up and make entries in all the three forms in original.
A recent photograph shall also be pasted on each form which should
be self attested. All the entries should be made neatly and no
column should be left blank. Further candidates are directed to
bring the original certificates/documents related to their Date of
Birth (matriculation certificate), Educational Qualification, Caste
Certificate and Disability Certificate, whichever is applicable,
along with 3 set of self attested photocopies of the same. The
Caste Certificate and Disability Certificate should be in the
prescribed format. 4. : () & C )C )C , 0 “ ” C 5 < 0I
< 0 I Further, the candidates are directed to undergo
medical examination with reference to this letter and produce
Medical Certificate of fitness for Government Service obtained from
a Medical Officer not below the rank of Civil Surgeon or a District
Medical Officer or Medical Officer of equivalent status of a
Government Hospital, duly countersigned by proper authority
wherever required along with a copy of the "Statement and
Declaration" made before the said authority in the enclosed format
duly signed by the issuing authority of the aforesaid certificate.
Further, you are directed to get your recent photograph pasted on
the medical certificate of fitness and get it verified by the said
authorities. 5. Candidates are directed to mandatorily
produce a "Negative Report for Covid-19" test at the time of
appearing for the document verification, issued by an ICMR
recognized laboratory not more than 07 days before the date of
documents verification. 6. : () & < 5 The
candidates are directed to bring with them one of the original
Photo Identity Card on the stipulated date. 7. : C
&
File No.GCCO/II/(3)/17/2020-ADMN-O/o CC-CGST-ZONE-NAGPUR
I ; No T.A. & D.A. will be admissible for the journey
and candidates will have to arrange for their boarding and lodging.
8. I C ) 0 : 0 I ] 0 G In the event of non-reporting
on the scheduled date and time, it will be presumed that the
candidate is not interested in accepting the post of Tax Assistant
in this Department and his/her candidature will be cancelled and
his/her dossier will be returned to Staff Selection
Commission.
9. , , . . . 0 ), 5 < & I
This issues with the approval of the Chief Commissioner, Customs,
GST & Central Excise, Nagpur Zone.
Encl.: As above.
(MUKUL S. PATIL)
JOINT COMMISSIONER (CCO) Copy to:- 1. The Joint Commissioner, GST
& CX, Nagpur-I. 2. The Superintendent (Systems), Nagpur-I
for uploading on official website.
File No.GCCO/II/(3)/17/2020-ADMN-O/o CC-CGST-ZONE-NAGPUR
LIST OF CANDIDATES ALLOCATED TO THE POST OF TAX ASSISTANTS IN
NAGPUR ZONE THROUGH SSC-CGL 2017
SL. NAME EMAIL ADDRESS PHONE
1 MONESH TIWARI
JAIPUR ROAD, ALWAR, RAJASTHAN
HOSPITAL, BPO BAIYNPUR,
SONIPAT, HARYANA 131001
DAYANAND NAGAR, BAHADURGARH,
JHAJHHAR, HARYANA 124507
ASHOK VIHAR, PHASE 03,
NEAR SHITALA GAS GODOWN,
KHARKHODA, SONIPAT, HARYANA
NEAR STATE BANK OF BIKANER& JAIPUR,
BUXAR, BIHAR 802101
File No.GCCO/II/(3)/17/2020-ADMN-O/o CC-CGST-ZONE-NAGPUR
COLONY, GAUTIYA, NEAR
ENCLAVE, DELHI 110093
SHIKSHA NAGAR, PO-BANMNKHI, DIST:
PHOTOGRAPH
WARNING
Affix signed passport size (5 cms x 7 cmsapprox.copy) of recent
photograph
1. The furnishing of false information or suppression of any
factual information in the Attestation Form would be
disqualification, and is likely to render the candidate unfit for
employment under the Government.
2. If detained, arrested, prosecuted, bound down, fined convicted,
debarred, acquitted etc. subsequent to the completion and
submission of this form, the details should be communicated
immediately to the authorities to whom the Attestation Form has
been sent early, failing which it will be deemed to be a
suppression of factual information.
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Thana&
District or House Number, Lane/Street/ Road & Town and Name of
the District Hqrs.)
3.(b) If originally a resident of Pakistan/Bangladesh (erstwhile
East Pakistan),the address in that country and the date of
migration to Indian Union.
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b) District & Stateto which : youbelong
c) District & Stateto which : your father
originallybelongs
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9. a)Your religion :
b) Are you a member ofa : Scheduled Caste/Scheduled Tribe/ OBC
Answer Yes or No
c) If the answer is Yes, state the name of the Castethereof: - - -
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10. Particulars of places (with periods of residence) where you
have resided for more than one year at a time during the preceding
five years. In case of stay abroad (including Pakistan),
particulars of all places where you have resided for more than one
year after attaining the age of 21 years, should begiven.
FROM
TO
House No., Lane/ Street/Road & Town)
Name of the
District Hqrs. of
(if employed,
Father
Mother
Spouse
Brother/s
Sister/s
12. Information to be furnished with regard to son(s) and
daughter(s) in case they are
studying/living in a foreigncountry.
by domicile)
studying/ livingwith
mentioned in
previous
column.
13. Educational Qualifications showing places of education with
years in Schools
&Colleges i.e,. from S.S.C./ Matriculation /10th
andonwards:
Examinatio n Passed
Date of Entry
Page 3 of6
14 (a) Are you holding or have any time held an appointment under
the Central or
State Government or a semi-Government or Quasi-Government body or
an
autonomous body, or a public sector undertaking or a private firm
or
institution? If so, give full particulars with dates of Employment
up-to-date:
PERIOD Designation,
Emoluments and
nature of
under the Government ofIndia/
a State Govt./ undertaking
Govt. of India/ State Govt./ an
autonomous body/
University/Local body:
Central Civil Services (Temp.Services
called upon to explain your
conduct in any matter at time
you gave notice of termination
of
before your service actually
(a) Have you ever beenarrested ? YES /NO
(b) Have you ever beenprosecuted? YES /NO
(c) Have you ever been kept underdetention? YES /NO
(d) Have you ever been fined by a Court ofLaw? YES /NO
(e) Have you ever been bounddown ? YES /NO
(f) Have you ever been convicted byaCourt YES /
NO of Law for any Offence?
(g) Have you ever been debarred from any YES / NO
examination or restricted by anyUniversity
or any other educational authority/ Institution?
(h) Have you ever been debarred/disqualifiedby YES / NO
any Public Service Commission/StaffSelection
Page 4 of 6
Attestation Form ?
NO University/Institution or any other educationalauthority/
Institution at the time of filling
this Attestation Form?
/Institution under the Governmentorotherwise? YES / NO
15 (ii) If the answer to any of the above mentioned questions is
‘YES’, give full
particulars of the case / arrest / detention / fine / conviction /
sentence /
punishment etc., and or the nature of the case pending in the Court
/
University/ Educational Authority etc., at the time of filling
this
AttestationForm:
(i) Please also see the ‘WARNING’ at the top of this Attestation
Form
(ii) Specific answers to each of the questions should be given by
striking out
‘YES’ or ‘NO’ as the case may be.
16. Name and Address of the two responsible Persons of your
locality or two references to whom you are known:
(i). (ii).
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I certify that the foregoing information is correct and complete to
the best of my
knowledge and belief.
I am fully aware that by providing false information or suppressing
material
information while filling this form, the authorities have the full
right to terminate my
appointment letter and I am also liable for appropriate
criminal/civil action as a
consequence.
I am not aware of any circumstances, which might impair my fitness
for
employment under Government.
Certificate to be signed by any one of the following:
i) Gazetted Officers of Central orStateGovernment :
ii) Members of Parliament orStateLegislature : belonging to the
Constituency wherethe Candidate or his parent/ guardian is
ordinarily residing
iii) Sub DivisionalMagistrate/Officer/ BlockDevelopmentOfficers
:
v) Principal/ Head Master oftheRecognized : School / College /
Institution were the candidate Studiedlast
vi) Registrar/DeputyRegistrar/ Assistant RegistrarofUniversity
:
Son / Daughter ofShri_ , forthelast
years months and that to the best of my knowledge and belief
the
particulars furnished by him/ her arecorrect.
Place : SIGNATURE :
Date : Designation :
i) Name, Designation andfulladdress : of the
appointingauthority
ii) Post for which the candidateisbeing : Considered
. . . . . . .
Page 6 of 6
C E R T I F I C A T E
Certified that I knowShri/Smt/Kum
years months and that to the best of my
knowledge and belief he/she bears a respectable character and has
no antecedents
which render him/her unsuitable for Governmentemployment.
Shri /Smt./Kum. is not
SIGNATURE AND DESIGNATION OF THE GAZETTED OFFICER .
C E R T I F I C A T E
Certified that I knowShri/Smt/Kum
years months and that to the best of my
knowledge and belief he/she bears a respectable character and has
no antecedents
which render him/her unsuitable for Governmentemployment.
Shri /Smt./Kum. is not
NOTE: To be signed by two different Gazetted Officers.
ANNEXURE – II CANDIDATE’S STATEMENT AND DECLARATION
The candidate must fill the below columns prior to his/her Medical
Examination and must sign the declaration appended thereto. His/her
attention is specifically drawn to the warning contained in the
NOTE below:
1. State your namein full : (In BlockLetters)
2. State your age and placeofBirth :
3. (a) Have you ever hadsmall-pox intermitten : or any other fever
enlargement orsuppruation of glands spitting of blood, asthama
heart disease, lung disease, fainting attacks, rheumatism,
appendicitis ? OR.
(b) any other disease oraccidentrequiring : confinement to bed and
medical or surgical treatment.
4. When were youlastvaccinated :
5. Have you or any of your nearrelationsbeen : affected with
Consumption of Orofula, gout, asthama, fits epilepsy
orinsanity.
6. Have you been examined anddeclaredUnfit : for Govt. Service by a
Medical Officer/ Medical Board within last 3years.
7. Have you suffered from any formofNervousness : due to overwork
or any othercause.
8. Furnish the followingparticulars Concerning : your family
Father’s age if Livingand state of his health
Father’s age at the time of death and the cause of his death
No. of brothers living, their age &state of health
No. of brothers dead their ages at death & causes of
death.
I declare that all the particulars filled in the above columns are
true and correct to the best of my knowledge and belief.
I also solemnly affirm that I have not received a disability
certificate/pension on account of any disease or other
conditions.
Signed in my presence
SIGNATURE OF THE CANDIDATE
SIGNATURE OF THE MEDICAL OFFICER
NOTE: The candidate will be held Responsible for the accuracy of
the above statement, willful suppression of any information by the
candidate will incur the risk of losing the appointment and if
appointed forfeiting of all claims of Superannuating pension and
Gratuity.
CERTIFICATE OF PHYSICAL FITNESS I have carefully examined Sri/Smt
S/o/D/o/W/o
a candidate for
Employment under the Government of India, Central Board of
Indirect
Taxes & Customs Department as _____________________ and cannot
discover that
he/she has any disease, communicable or otherwise constitutional
affection or bodily
infirmity except that his/her weight is in excess/below the
standard prescribed or
except I do not consider this a disqualification for the employment
in the
office of the Central Excise Department.
His/her age according to his/ her own statement is years
and by appearance about years, I also certify that he has make of
small
pox vaccination.
Height Weight
His/ her vision is normal
Hypermetrophic( ) Enter the degree of defect and the strength of
correctionglasses Myopic( ) Enter the degree of defect and the
strength of correctionglasses Astigmatic (Simple ormixed( ) Here
enter the degree of defect and strength of correctionglasses.
Hearing is normal/defective (much or slight)
Urine: Does Chemical examination show 1. Albumin, 2.Sugar, 3.
State
specific gravity
Date :
Place :
Signature of the Candidate
Certificate to be signed by any one of the following:
TO BE FILLED BY THE OFFICE
C E R T I F I C A T E
C E R T I F I C A T E (1)
ANNEXURE – II