CHARACTER/PRE-VERIFICATION CERTIFICATE FROM
VILLAGE SARPANCH
Photo of
Candidate and
Photo be
attested
1. This is certified that __________________________ (Name of Candidate) S/O
________________________ Caste ______________________ Resident Of House
No/Street/Galli _________________________ Village __________________________
Post Office _________________________ Taluk _________________________
District ______________________ State _________________ whose
signatures/thumb impression is appended below, is known to me for the past ________
years.
2. To the best of my knowledge and belief :-
(a) He bears a good moral character.
(b) He has not been convicted by any civil court.
(c) He has never been imprisoned.
(d) He has not been dismissed from any government service.
(e) He has not been serving in the Army/Navy/Air Force/TA or Police.
3. It is further certified that he is not related to me.
Date :
Place : (Signature Of The Village Sarpanch With His
Office Seal)
_____________________________________________
(Signature/Left Thumb Impression of the Recruit)
FAMILY GROUP PHOTO
(Signature of Gram Pradhan with Stamp)
PARTICULARS OF FAMILY MEMBERS
Ser Relation Name Date of Birth Identity Proof Photo
No with DOB
(Photocopy)
1. Father
2. Mother
3.