(Additional Sheet No 2 for PTD candidates) CETRIFICATE TO BE SUBMITTED BY THE CANDIDATES, WHO ARE/WHERE EMPLOYED IN PRIVATE ORGANISATION. (Separate form to be used for experience of each organization.) a) 1. Name: _________________________________________________ 2. Father's Name: _________________________________________ 3. Name of the Employer/Organization:_________________________ 4. Address of Employer:____________________________________ 5. Exact designation of the candidate:__________________________ 6. Nature of work on which employed Whether Tech. or Non Technical: ________________________ 7. Situation of Work_________________________________________ 8. Timings of Duty: _________________________________________ 9. Nature of Duty: __________________________________________ 10. (i) The date of joining (i) _________________________ (ii) Period of employment (ii) _____________________________ (iii) Total emoluments Paid (iii) _____________________________ (iv) Provident Fund deducted P.M Rs. ____________________P.F. A/C No. ______________________ 11. App. Cost of the work undertaken during the last financial year by the Employment organization: ___________________________ 12. Name of the Department/Organization with whom registered and Undertaken works/contracts.: ______________________________ 13. Can be allowed to attend the classes?_________________________ (a) In the morning of all Sundays: _________________________ (b) In the Evening of other days : _________________________ 14. Any other information/remarks: ______________________________ Certified that the above information supplied by me on behalf of M/s__________________________________________________________ is correct to the best of my knowledge and belief and nothing has been concealed and that I am authorized to sign. This document on behalf the organization __________________________ (Signature of the Authorized person) (Seal) Name (Block Letters)__________________________ Address: ___________________________________ Date: Tel No. ____________________________________
