9
Appendix ‘A’.
Selection Board :___________________ Batch No :__________
Application No : ___________________ Chest No :__________
NO CLAIM/ RISK CERTIFICATE
(INDEMNITY BOND TO UNDERGO SELECTION PROCESS AT SSBS)
To,
The President of India
In consideration of the Union of India having called me/ my ward (Name as par official record)
___________________________________________________________a minor of whom I am the legal/
natural guardian to appear before selection board for conducting selection tests for grant for commission in the
Indian Army, I undertake and agree that neither I nor may my heirs nor my executors nor administrators will
make any claim against the Union of India or against any officer of the Indian Army or against any person in
the service of Union of India in respect of any loss or injury to me/ my ward including injury resulting in my/ his
death which I/ he may suffer as a result of or in connection with any of the tests given to me/ him at the
Service Selection Board and I understand and agree that no compensation will be paid by the Union of India in
respect of any such loss or injury or death and I further agree so as to bind myself, my heirs, my executors and
administrators to indemnify the Union of India, any officer of the Indian Army and any person in the service of
the Union of India against any claim which may be made by any third party against the Union of India, or any
officer or person in the service of the Union of India, arising out of any act or default on the part of myself/
minor or in connection with such tests before Service Selection Board (SSBs).
Dated, the _________________ day of ____________________ 202___ (years).
__________________
Signature of Candidate
AADHAR No : _____________________
Mob No : _____________________
________________ _____________________________
Signature of Witness Signature of Legal/ Natural Guardian
(Age above 18 yrs) (if candidate age is below 18 yrs)
Name _________________________ Relationship ______________________
Address _______________________ Address _________________________
______________________________ ________________________________
Mob No _______________________ Mob No _________________________
Note : 1. Delete portions which are not applicable.
2. Candidate must note that they will not be admitted to the Service Selection Board
interview without this certificate.
3. Certificate is to be signed by the candidate himself/ herself and also by parents if he/
she is below 18 years.
10
Appendix ‘B‟
UNDERTAKING CERTIFICATE
I, Roll No __________________ Name _________________ s/o ______________________am
appearing for SSB of _____________________Entry commencing from to . I undertake /
certify that all criteria / eligibility conditions, as mentioned in the Course Notification and Call Up letter
are being fulfilled by me. There is no discrepancy in my School & College mark sheets/ certificates, online
applications and all other documents as required. If any discrepancy is found in any of my documents or
eligibility conditions, at any stage, during or after the SSB. I fully understand that my candidature will be
cancelled.
Place : ........................... Signature of Candidate
Date : ............................
COUNTERSIGNED
Place : ........................... Signature of Parents / Guardian
Date : ............................ Address ……………………………
11
Appendix ‘C’
CERTIFICATE FOR NOT HAVING DUPLICATE PROFILES/REGISTRATION IDs
1. I understand that creating duplicate profiles (registration IDs) on [Link] is not
allowed.
2. I hereby certify, that I have only one profile (registration ID) on [Link] whose
user name is _______________________.
OR
I have more than one profiles (registration IDs) on [Link] whose user names are
as under :-
(a) _______________________
(b) _______________________
(c) _______________________
3. For candidates having more than one Profile/ Registration ID. Having understood that I can
maintain only one profile (Registration ID). I have already requested the authority concerned at DG Recruiting
by email/letter on ______________ to delete my profile(s) (registration IDs) with following user name(s) :-
(a) _______________________
(b) _______________________
4. In case the above information submitted by me is found to be false, I understand that all my current
applications are liable to be cancelled at any stage of the selection process.
Date : _________________ (Signature of the Candidate)
Name :_________________
Station : _____________ Course :_________________
Roll No : _______________
12
Appendix ‘D’
BONAFIDE CUM CUSTODIAN CERTIFICATE
(CERTIFICATE FOR CANDIDATES WHO HAVE SUBMITTED THEIR CERTIFICATES
AND MARKSHEETS FOR PURSUING HIGHER STUDIES)
(This certificate is required on the original letter head)
1. Certified that ______________________S/o Shri _______________________ is a bonafide student of
_______________________(name of college/ university) and presently studying in
_______________________ (name of course to be mentioned). The following certificates and mark sheets in
respect of the above individual have been deposited with this College/University/Institution in original for
verification purpose: -
(a) ......................................................................................................................................................
(b) ......................................................................................................................................................
(c) ......................................................................................................................................................
2. It is further certified that Photostat copies of the above documents have been verified and attested by the
undersigned.
Place : (Signature of Principal/Registrar of the
Date :
College/ University where studying with stamp)
College/University round stamp
15
Appendix ‘G’
CERTIFICATE
DETAILS OF PREVIOUS SSBs INTERVIEW ATTEMPTS
1. I, __________________ S/o Shri ______________________ appearing for SSB Interview for
___________________(Name of Entry) Course, Roll No ____________ hereby declare that I have earlier
attended the following SSBs Interview :-
Ser No Type of SSB Centre Batch No & Date of Interview Result
Commission/ Entry Chest No
2. I hereby declare that to the best of my knowledge in belief the above information is correct and
understand that my candidature will be cancelled if found incorrect.
Place:
Date: (Signature of the candidate)
16
Appendix ‘H‟
UNDERTAKING CERTIFICATE BY CANDIDATE
PRIOR TO UNDERGOING SSB
1. Roll No __________ Name _____________________ (name of candidate),S/o _____________ am
appearing for SSB in Batch No _________, __________ SSB/ Selection Centre of _________________ Entry
commencing from _________ to _________ .
2. I am aware that, as highlighted in notification, having being debarred from Selection Process i.e.
UPSC written or SSB any time in past makes me ineligible for appearing again in any of the Selection
Process. Also, being withdrawn from any Pre Commissioning Training Academy (PCTAs) of Army, Navy or Air
Force also makes me in eligible for appearing in any selection process of any Defence Services.
3. Having understood the above, I undertake/certify that:-
(a) I have never been debarred from appearing in selection process either at UPSC written or at SSB.
(b) I have never been withdrawn/ invalidated from any Pre-Commission Training Academy (PCTAs) of
Army, Navy & Air Force.
(Candidates withdrawn from any Defence Training Academy on any ground are not eligible for any
Selection Process)
4. Candidates Withdrawn From Training Academy Previously. I have been previously withdrawn from
Pre-Commission Training Academy, the details of the same are as under :-
Trg Entry & Course Joined on Withdrawn on Reason for
Academy No withdrawal
Note: Candidates who have voluntarily withdrawn from Training Academy on purely personal
reason (other than disciplinary ground) after paying the cost of trg are eligible for SSB).
5. I understand that withholding information or giving false information in this regard will render me liable
for cancellation of my candidature and I shall be solely responsible for the same.
Place: (Signature of the Candidate)
Date :
17
Appendix ‘J‟
TO WHO-EVER IT MAY CONCERN
CONSENT
I……………………………………………….Son of …………………………..……………….India Passport
No…………………………………………..…………hereby give my consent that details of my stay in
…………………….…………………..during the period from…………………..………to………….……………may
be verified to concerned Indian Authorities.
Signature___________________
Name______________________
Address____________________
__________________________
Place ______________
Date _______________
-----------------------------------------------------------------------------------------------------------------------------------------------
19
Appendix ‘L’
Roll No________________
(PLEASE FILL DETAILS BEFORE REACHING FOR SSB CENTRE AND CARRY IT FOR SSB AND SUBMIT
THE SAME IN THE MORNING BEFORE STAGE-I TESTING ON THE SAME DAY ALONGWITH
SUPPORTING DOCUTMENTS LIKE HARD COPY OF JOURNEY TICKETS & BANK COPY)
(APPLICABLE ONLY FOR FIRST ATTEMPT OF PERMANENT / SHORT SERVICE COMMISSION)
TRAVELLING ALLOWANCE FORM (PAYMENT THROUGH NEFT SYSTEM)
PART- I
(FILL ALL DETAILS IN CAPITAL LETTERS)
Roll No________________ of previous attempt of Commission (Permanent / Short Service)_____________
Applying TA for first attempt as Fresher for which Commission : (Permanent / Short Service)_______
1. Batch No __________________________ Stage I Chest No _______________________________
(Para No 1 as mentioned above to be filled after reporting at SSB)
2. Name of CANDIDATE as per Dossier _________________________________________________
3. Email ID____________________________________ Mobile No ____________________________
4. Banker‟s details of the individual for making payment of TA through NEFT (Bank details of any
Nationalised Bank i.e copy of Cancelled Cheque/ First Page of Passbook to be enclosed is compulsory):-
(a) Name of the ACCOUNT HOLDER: _____________________________________________
(Enter only saving bank account)
(b) Saving Bank Account No
(i) In figures eg 3,4,9
(ii) In words eg. Three, four, nine
(c) IFSC Code
(i) In figures eg 3,4,9
(II) In words eg. Three, four nine
(d) Bank Name________________________________________________________________
(e) Branch with full address ______________________________________________________
______________________________________________________
It is certified that above information pertains to me correct, I am fully responsible for
authenticity.
5. Name of the nearest Railway Station _________________________________________________
6. Actual TRAIN fare paid (Hard Copy of Original Tickets to be enclosed is compulsory ) :-
(a) From (Boarding Station)________________ To (Arrival Station)____________________
(b) Date of Journey ____________________________________________________________
(c) Class (AC – III, Sleeper, General/ 2 Sitting) _____________________________________
(d) Amount of one side of the candidate only to be written Rs (₹). _______________________
(e) Train No, Train Name and Ticket PNR No ________________________________________
(f) Reservation Quota (GENERAL/ TATKAL) _______________________________________
(g) Current status of the Journey Ticket (Waiting List/Confirmed Seat No) ________________
20
7. Actual BUS fare paid (Hard Copy of Original Tickets to be enclosed is compulsory):-
(a) From (Boarding) _____________________ To (Arrival) ___________________________
(b) AC / Non AC & Govt / Private ___________________& _____________________________
(c) Amount of one side of the candidate only to be written Rs (₹). _______________________
(c) Bus Ticket No. _____________________________________________________________
8. Actual AIR fare paid (Hard Copy of Original Tickets/ Boarding Pass to be enclosed is
compulsory):-
(a) From (Boarding) _____________________ To (Arrival) ___________________________
(c) Amount of one side of the candidate only to be written Rs (₹). _______________________
(c) PNR Ticket No. _____________________________________________________________
9. Grand Total (6+7+8) Rs (₹). _________________________________________________________
(RETURN JOURNEY TA WILL ONLY BE DISBURSED SUBJECT TO PRODUCTION / FURNISHING OF
DETAILS OF RETURN JOURNEY TICKETS (BUS/ TRAIN/ AIR)
DECLARATION BY THE CANDIDATES
(a) It is certified that I, ___________________________S/o ________________________ am appearing
for SSB Interview for __________________________(Permanent / Short Service Commission) for the first
time in Army/Navy/Air Force. I will be personally responsible for any intentional/non intentional wrong
information as furnished above and I will not claim TA in future for this particular entry. I will be responsible if
TA amount is not credited into my given account because of wrong data/incorrect banker‟s details filled by me
and I will also not blame Selection Centre Central, Bhopal for the same in future.
(b) It is certified that I have not travelled on Concession Voucher/ Form D/ LTC/ Railway free pass student.
Note: If any of the above bank details submitted by the candidate is incorrect (including spelling of
name of account holder), then the TA amount will not be credited into the account by the bank and candidate
will be responsible for the same. Once the process is initiated, the undisbursed TA amount is deposited into
Govt Treasury through MRO and there is no provision to re- claim the same.
Station : Bhopal
Dated : (Signature of Candidate)
Note : DOCUEMENTS REQUIRED & INSTRUCTIONS FOR TA
(a) Travelling Allowance Form having TWO PAGES duly filled and signed by the Candidate.
(b). Hard Copy of Bank Details of ONLY NATIONALISED BANK with updated IFS Code i.e Cancelled
Cheque OR Photocopy of First Page of Passbook Duly Self Attested. NOT ACCEPTABLE
Account Details of GRAMIN BANKS / IPOS BANKS/ LOCAL BANKS.
(c) Hard Copy of Original Journey Tickets is compulsory (TRAIN/BUS/AIR).
(d) Actual AC-III tier fare for mail/ express trains will be paid on submission of tickets. TATKAL
quota is not entertained, General quota AC-III fare will be paid.
(e) If travelled by BUS or AIR, on submission of BUS/ AIR tickets, AC-III tier fare less reservation
charged will be paid for both ways.
(f) For all the above fare will be calculated for shortest Main Route.
PART – II
(TO BE FILLED BY THE ACCOUNTS CLERK)
10. Auth Train fare (as per AC III Tier or actual amount paid which ever is less) :-
(a) From ____________________________ To ___________________________________
(b) Class ____________________________________________________________________
(c) Amount Rs (₹). ____________________________________________________________
11. Admissible Train fare_______________________________________________________________
(Para 6 or 9 whichever is less)
12. Admissible grand total paid (6+10) x 2 Rs (₹).____________________________________________
(Signature of Account Clerk)
21
Appendix ‘M’
From,
Roll No : _________________________________
Name : _________________________________
Father‟s Name : _________________________________
Postal Address : _________________________________
_________________________________
_________________________________
Email : _________________________________
Mob No : _________________________________
To,
Dte Gen of Rtg (Rtg „A‟),
Adjutant General‟s Branch,
IHQ of MoD (Army),
West Block-III, RK Puram,
New Delhi - 110066
APPLICATION FOR CHANGE OF ADDRESS
Sir,
1. I am a candidate for ______________ Course.
2. My Postal address has been changed. I request you to please update my postal address in the
application for further correspondence:-
Postal Address (as given in the application) New Postal Address (To be changed in the
application)
Thanking You.
Yours faithfully,
Date : ___________________ (Signature of candidate)
Copy to :-
The Call Up Officer
Selection Centre Central
Sultania Infantry Lines,
Bhopal (MP) – 462001