SCRIBE DECLARATION FORM
GUIDELINES REGARDING PERSONS WITH DISABILITIES
Those candidates who have disability certificate and opted for scribe in their online application under the following::
a. Locomotive disability (OA, OL, BL, OAL),
b. Hard of Hearing (H.H.)
c. Multiple Disabilities from amongst (a) to (b) except deaf blindness
and whose writing speed is affected can use own scribe at own cost during the examination. In all such cases where a
scribe is used, the following rules will apply:
Please ensure you are eligible to use a scribe as per the Government of India rules governing the
recruitment of Persons with Disabilities.
The candidate will have to arrange his/her own scribe at his/her owncost
Both, the candidate as well as the scribe, will have to give a suitable undertaking, in the prescribed format with
passport size photograph of the scribe, confirming that the scribe fulfils all the stipulated eligibility criteria for a
scribe. Further, in case it later transpires that She/he did not fulfill any of the laid-down eligibility criteria or
suppressed material facts, the candidature of the applicant will stand cancelled, irrespective of the result of the
examination.
Such candidate who uses a scribe shall be eligible for compensatory time of 20 minutes for every
hour of the examination.
Please fill up the DECLARATION and submit along with the call letter.
(Pl fill up the DECLARATION and submit along-with call letter)
DECLARATION
We, the undersigned, Shri/Smt./Km. __________________________________________________ eligible candidate for
the ________________________________examination and Shri/Smt./Km._____________________________________
qualification_____________ eligible writer (scribe) for the eligible candidate, do hereby declare that :
1 The scribe is identified by the candidate at his/her own cost and as per own choice. The candidate
. is (a)Locomotive disability (OA/OL/OLA/BL) / (b) Hard of Hearing(HH) /MD (a & b except deaf-blindness)
and his/her writing speed is affected and she/he needs a writer (scribe) as permissible under the Government
of India rules governing the recruitment of Physically Challen-ged persons. (Attach copy of Certificate at Annexure-I)
2. As per the rules, the candidate availing services of a scribe is eligible for compensatory time of 20 minutes for
every hour of the examination.
3. In view of the importance of the time element and the examination being of a competitive nature, the candidate
undertakes to fully satisfy the Medical Officer of the Organization that there was necessity for use of a scribe
as his/her writing speed is affected by the disabilities.
4. In view of the fact that multiple appearance / attendance in the examination are not permitted, the candidate
undertakes that he/she has not appeared / attended the examination more than once and that the scribe
arranged by him/her is not a candidate for the examination . Also, the same scribe cannot be used by more
than one candidate. If violation of the above is detected at any stage of the process, candidature of both the
candidate and the scribe will be cancelled.
5. We hereby declare that all the above statements made by us are true and correct to the best of our knowledge
and belief.
We also understand that in case it is detected at any stage of recruitment that we do not fulfill the
eligibility norms and/or that the information furnished by us is incorrect/false or that we have suppressed any
material fact(s), the candidature of the applicant will stand cancelled, irrespective of the result of the
examination. If any of these shortcoming(s) is/are detected even after the candidate's appointment, his/her
services are liable to be terminated. In such circumstances, both signatories will be liable to criminal
prosecution.
Given under our signature:-
Signature of the Scribe Signature of the Candidate
Name of the Candidate:
Name of the Scribe:
Aadhar No. :_____________________ Roll No.: __________
Postal address: Postal address:
Mobile No: …………………………………… Mobile No.: ……………………
Photograph
of the Scribe Signature of Invigilator
Annexure-I
Certificate Regarding Physical Limitation in an examinee to write
This is to certify that, I have examined Shri/Smt./Km. __________________________________________________
(name of the candidate with disability), a person with ________________________________________ (nature and
percentage of disability as mentioned in the certificate of disability), S/o/D/o________________________________
a resident of ______________________________________________________________Village/District/State) and
to state that he/she has physical limitation which hampers his/her writing capabilities owning to his/ her disability.
Signature
Chief Medical Officer/Civil Surgeon/ Medical Superintendent of a
Government Health Care Institution
Name and Designation
Name of Government Hospital/Health Care Centre with seal
Place :
Date :
Note : Certificate should be given by a specialist of the relevant stream/disability (e.g Locomotive
disability (OA, OL, BL, OAL), Hard of Hearing (H.H.)Multiple Disabilities from amongst (a) to (b)
except deaf blindness.