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Scribe Declaration for Exam Candidates

This document contains declarations by both a candidate with a disability and their proposed scribe. [1] The candidate declares that the named individual has agreed to act as their scribe for an upcoming online exam due to the candidate's disability. [2] The scribe then declares that they have agreed to act as the scribe and provides their educational qualifications. [3] Both the candidate and scribe sign acknowledging their declarations and the risks of any false declarations.

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Paramasiva Kumar
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597 views2 pages

Scribe Declaration for Exam Candidates

This document contains declarations by both a candidate with a disability and their proposed scribe. [1] The candidate declares that the named individual has agreed to act as their scribe for an upcoming online exam due to the candidate's disability. [2] The scribe then declares that they have agreed to act as the scribe and provides their educational qualifications. [3] Both the candidate and scribe sign acknowledging their declarations and the risks of any false declarations.

Uploaded by

Paramasiva Kumar
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
  • Declaration by Candidate with Disability
  • Declaration by Scribe/Writer

DECLARATION BY CANDIDATE WITH DISABILITY

I
_____________________________________S/o,W/o,D/o____________________________________
________
R/o________________________________________________________________________________
_________
Roll Number : ___________________________ for the examination for the post of
______________________
_____________________ (Post Code : _____) exam schedule on _________________ session
___________
hereby declared that Mr./Ms. _________________________________ S/o, W/o, D/o ______________
__________________, R/o __________________________________________________________
has agreed on my request to act as my scribe for the above online computer based test/examination.
I do hereby undertake that qualification of my scribe is _________________________.In case,
subsequently it is found that his qualification is not as declared by me and beyond my qualification, I shall
forfeit my right to the post and claims relating thereto.

DECLARATION BY SCRIBE/WRITER
I
_____________________________________S/o,W/o,D/o____________________________________
________
R/o
___________________________________________________________________________________
______
holder of identification ________________ have agreed to act as scribe for Mr./Ms. ________________-
____
_____________________________ S/o, W/o, D/o ______________________________________ the
_________________________________(type of disability) candidate having Roll No.
______________________ for the examination for the post of _____________________________
(Post Code: ________) exam scheduled on __________________ and session __________ .

I declared that my educational qualification as on date ________________ is (Tick the box):


Below Metric Metric 10+2 Graduate Post Graduate
Space for pasting of Space for pasting of
recent passport size recent passport size
photograph of Scribe to photograph of Candi-
be cross self attested date to be cross self
attested

If the above declaration is found false, I If the above declaration is found false, I
shall be solely responsible for the con- shall be solely responsible for the conse-
sequences and loss suffered by the can- quences. I am engaging the above scribe at
didate. my own cost and risk. I Understand that if
the declaration of the scribe is found false, I
may be debarred from the examination.

Signature of Scribe Signature of Candidate With Disability


Note: The candidate & scribe should report at half hour before the normal reporting time at the Exam Centre
for this purpose.

DECLARATION BY CANDIDATE WITH DISABILITY I _____________________________________S/o,W/o,D/o____________________
Space for pasting of recent passport size photograph of Scribe to be cross self attested Space for pasting of re

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