Appendix C

(Refer to Para 7.2.2 of Call Up Instructions)

SELF CERTIFICATION (ONE FOR EACH TATTOO) UNDERTAKING BY CANDIDATES (OTHER

THAN THOSE FROM TRIBAL COMMUNITIES WITH PERMANENT BODY TATTOO(S) ON
PERMISSIBLE BODY PART

1. I,_______________________ (Name of candidate), Son of __________________ (Name of

Father/ Mother / Guardian as applicable ____________(date of Birth) hereby give an undertaking
that* I do not have any permanent body tattoo on my body * I have one / two / three / four / more
than four permanent body tattoo(s) as per details given and shown in the photograph(s) below
(*strike out whichever is not applicable):-

Photograph of Tattoo Details of Tattoo

(Post card size to be pasted here duly signed Size of Tattoo -

by the candidates with name please do not (In Cms)
use staple pins / clips)
Language -
(if Applicable)

Significance of Tattoo -
(If applicable)

2. I hereby declare that beside the tattoos as declared by me in Paragraph 1 of Annexure VI

above. I will not have any other permanent body tattoo(s) in future if I am selected to undergo pre-
commission training.

3. The above information given by me is true and correct to the best of my knowledge and
behalf.

4. I understand that misrepresentation of any facts/ concealment of any information regarding

permanent body tattoo(s) will lead to cancellation of my candidature at any stage from
commencement of the selection process and I shall be solely responsible for the same.

Place: _______________________
(Signature of the Candidate)

Date: Name, Entry & SSB Batch No

Note 1. Each tattoo will have will have a separate photographs and will be described
separately additional pages will be used for the purpose and each page will be signed by the
candidate.

Note 2. Commandant Selection Centre or Commandants of a Pre-Commission Training

Academy are empowered to reject a candidate for non-permissible permanent body tattoo(s).
 Appendix D
(Refer to Para 8.7 of Call Up Instructions)

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 per 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 or
other ranks 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 / her death which I/ he / she
may suffer as a result of or in connection with any of the tests given to me/ him / her 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 or other ranks of 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 other ranks 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 (SSB).

Dated, the ________________ day of __________________ 20___ (Year).

Signature of Candidate
Aadhar No__________________
Mobile No___________________

__________________ __________________________
Signature of Witness Signature of Legal / Natural Guardian
(Age above 18 yrs) (if candidate’s 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 parents if he/she is below
18 years.
 Appendix E
(Refer to Para 8.8 of Call Up Instructions)

UNDERTAKING / DECLARATION FOR CORRECT DETAILS OF PERCENTAGE IN 12 TH CLASS

(PCM) AND JEE (MAINS)

1. I ________________ (Name) _______________S/o ________(Father Name)_________

Roll No _______ Batch No __________ Chest No ___________an a candidate of TES-55 Course
hereby declare that I have cumulatively obtained more than 60% marks in Physics. Chemistry and
Mathematics in 10+2.

2. The details filled in the application form for TES-55 Course are correct. The JEE (Mains)
Application No JEE (Mains) Roll No of the Best attempts. NTA Score and Rank as per Common
Rank List (CRL) filled in the application are as per my NTA Score Card of JEE (Mains) - 2025 being
produced and submitted by me. The same is also mentioned in the documents and certificates.

3. I, further undertake that I may be allowed to appear this interview at my own risk and in case
of any variation, if any detected at any stage of recruitment process, my candidature for the TES-55
Course be cancelled at any stage of selection thereafter.

Place : ________ (Signature of candidate)

Date : _________
 Appendix F
(Refer to Para 8.9 of Call Up Instructions)

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 ID) on [Link] whose user
names are as under :-

2.1 __________________________

2.2 __________________________

2.3 __________________________

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) :-

3.1 _________________________

3.2 _________________________

4. In case the above information submitted by me is found to be false, I understand that all my
current application are liable to be cancelled at any stage of the selection process.

Date :______________ (Signature of Candidate)

Name : ________________

Station :_____________ Course : ________________

Roll No : ________________
 Appendix G
(Refer to Para 8.10 of Call Up Instructions)

CANDIDATES WHO HAVE SUBMITTED THEIR CERTIFICATES AND MARK SHEETS IN

COLLEGE OR INSTITUTION FOR PURSUING HIGHER STUDIES

It is certified that ____________________ S/o Shri______________________ is a bonafide

student of _______________________ (College / University / Institution / School) and is presently
studying ______________________ (herein name of course pursuing is to be mentioned). The
following certificates and mark-sheets in respect of the above named individual have been
deposited with this College / University / Institution in original for verification purposes:-

1. _______________________________

2. _______________________________

It is further certified that photocopy/xerox of above documents have been verified by the
undersigned and attested.

Place : (Signature of the Principal / Registrar of the

Date : College / University where studying with stamp)

 Appendix H
(Refer to Para 8.11 of Call Up Instructions)

CERTIFICATE

DETAILS OF PREVIOUS SSBs INTERVIEW ATTEMPTS

1. I Mr ____________________________ S/o Shri _______________________ appearing for

Service Selection Board 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 Result

Commission/Entry Chest No Interview

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 :
(Signature of the Candidate)
Date :
 Appendix J
(Refer to Para 13 of Call Up Instructions)

Roll No_________

TRAVELLING ALLOWANCE FORM

PART-I
(TO BE FILLED BY THE CANDIDATE)

1. Batch No _______________________ Stage I Chest No____________

2. Name of candidate as per Dossier ______________________________

3. Name of the nearest railway station _____________________________

4. Banker’ details of the individual for making payment of TA through NEFT:-

4.1 Details:-

4.1.1 Name of the Candidate : ___________________________

4.1.2 Name of the account holder: _______________________

4.2 Account No and Type: ____________________ (Savings/Current Account)

4.3 IFSC Code ____________________

4.4 Bank Name ___________________

4.5 Branch with full address

______________________________________________
______________________________________________

5. Actual Train Fare paid:-

5.1 From __________________ to ___________________

5.2 Class ____________________________

5.3 Amount Rs. _________________________

5.4 Train PNR/Ticket No ________________________

6. Actual Bus Fare paid:-

6.1 From __________________ to ___________________

6.2 Amount Rs. __________________________

6.3 Bus Ticket No ________________________

7. Actual Air Fare paid:-

 7.1 From ____________________ to _________________

7.2 Class___________________

7.3 Amount Rs______________________

7.4 Flight Ticket PNR No ________________

8. Grand total (5+6+7) Rs. ________________________________

Note : The TA is authorised for AC Tier III /AC Chair Car Train fare only or actual amount paid
which ever is less.

9. It is certified that I, ____________ S/o ________________ am attending first time for

Permanent/Short Service Commission, 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.

Station: Bangalore

Dated: (Signature of candidate)

PART-II
(TO BE FILLED BY THE ACCTS CLK)

10. Auth Train fare (As per AC Tier III or actual amount paid which ever is less) :-

10.1 From __________________ To ___________________

10.2 Class _____________________________

10.3 Amount Rs. _________________________

11. Admissible Train fare _______________________

(Para 5 or 9 whichever is less)

12. Admissible grand total paid (6+10) x 2 Rs. __________________

(Signature of Account Clerk)

 Appendix K
(Refer to Para 15 of Call Up Instructions)

From,

Roll No : ____________________
Name : ____________________
Father’s Name : ____________________
Postal Address : ____________________
____________________
____________________
Email : ____________________
Mob No : ____________________
____________________

To,

Directorate General of Recruiting (Rtg ‘A’),

Adjutant General’s Branch,
IHQ of MoD (Army),
West Block-lll, 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 New Postal address (to be changed in
application) the application)

Thanking You.
Yours faithfully,
Date: _____________ (Signature of candidate)

Copy to:-

The Call up Officer

Selection Centre South
Cubbon Road
Bangalore-560042
 Appendix L
(Refer to Para 16.3 of Call Up Instructions)

UNDERTAKING CERTIFICATE
BY CANDIDATE PRIOR TO UNDERGOING SSB

I, Roll No _______ Name ______________________ Son of __________________ 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/ Instructions are being fulfilled by me. There is no discrepancy in my school & college
mark sheets/ certificates, online applications and all other documents as required. I fully understand
that if any discrepancy is found in any of my documents or eligibility conditions, at any stage, during
or after the SSB my candidature will be cancelled.

__________________
Date:…………… (Signature of candidate)
 Appendix M
(Refer to Para 16.3 of Call up Instructions)

UNDERTAKING CERTIFICATE BY CANDIDATE

PRIOR TO UNDERGOING SSB

1. I, 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 ineligible for appearing in any selection process of any
Defence Services.

3. Having understood the above, I undertake/ certify that:-

3.1 I have never been debarred from appearing in selection process either at UPSC
written or SSB.

3.2 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 & Withdrawn Reason for

Joined on
Academy Course No on 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 :