National Institute of Pharmaceutical Education and Research (NIPER), Raebareli

(An Autonomous Institute under the Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers, Govt. of India)

Transit Campus - Bijnor-Sisendi Road, Sarojini Nagar, Near CRPF Base Camp, Lucknow (UP)- 226002,
Phone # 0522 - 2497903, Email: recruitment.niperr@gmail.com Website: www.niperraebareli.edu.in

Ref. No.: NIPER-R/Recruit/01/2019-20 Date: September 8, 2019

National Institute of Pharmaceutical Education & Research, Raebareli (NIPER-R) is an

Autonomous Institute of National importance set up by the Department of Pharmaceuticals,
Ministry of Chemicals & Fertilizers, Govt. of India by an Act of Parliament, to impart high quality
Education and Research in the area of Pharmaceutical Sciences.

NIPER-R invites application from eligible candidates for the following teaching positions to be filled
by direct recruitment/deputation on regular basis:

Teaching Positions
Post Department Name of Pay No. Category Max. Age
Code the Posts Level of Limit
th
(7 CPC) Post
s
001 Pharmacology & Associate 13 1 UR - 45
Toxicology Professor
002 Medicinal Chemistry Associate 13 1 UR - 45
Professor
003 Pharmaceutics Associate 13 1 UR - 45
Professor
004 Pharmacology & Assistant 12 2 UR - 40
Toxicology/ Professor
Regulatory Toxicology
005 Medicinal Chemistry Assistant 12 2 UR - 40
Professor
006 Pharmaceutics Assistant 12 1+1 1-UR 1- 40
Professor OBC
UR- Unreserved; OBC – Other backward Classes, SC – Scheduled Castes, ST- Scheduled Tribe

Page 1 of 24
Department of Pharmacology & Toxicology
001 Associate 01 - Essential:
Professor UR Ph. D. with first class or equivalent 45 years
grade at the preceding degree in the
Level-13 appropriate branch with a very good
Basic Pay – academic record throughout and at
Rs 1,39,600 least 8 years of Teaching/ Research/
+ other Govt Industrial experience with published
benefits work of high quality and an
established reputation of having
made conspicuous seminal
contribution to knowledge in
pharmaceutical and allied areas.

Desirable:
- Experience in in vitro and in vivo
pharmacology relevant to
neurodegenerative disease,
inflammatory, Neuropharmacology
and metabolic diseases and in
establishing Institutional Animal
House facility as well as day to day
record and activities
- Experience of independent
Research in terms of guidance of at
least one Ph.D. student and with
publication in SCI journals.
Period of Probation, 1 (one year)
if any
Department of Pharmacology & Toxicology/ Regulatory Toxicology
002 Assistant 02- UR Essential: 40 years
Professor Ph. D. with first class or
equivalent grade at the preceding
degree in the appropriate branch
Level-12 with a very good academic record
Basic Pay: throughout and at least 5 years of
Rs. Teaching/ Research/ Industrial
1,01,500/- experience with published work of
+ other Govt high quality.
benefits
Desirable:
- Experience in in vitro and in vivo
Pharmacology relevant to neuro
degenerative, cardiovascular
diseases, Nanotoxicology, and
Chelation therapy.
- Experience in obtaining
extramural grants and
consultancy projects. Preference

Page 2 of 24
 will be given to the candidate
having strong record of relevant
publications in SCI indexed peer
reviewed journals and patents.
Period of Probation, if 1 (one year)
any
Department of Medicinal Chemistry
003 Associate 01 UR Essential: 45 years
Professor Ph. D. with first class or equivalent
grade at the preceding degree in the
Level-13 appropriate branch with a very good
Basic Pay: academic record throughout and at
Rs. least 8 years of Teaching/ Research/
1,39,600/- + Industrial experience with published
other Govt work of high quality and an
benefits established reputation of having
made conspicuous seminal
contribution to knowledge in
pharmaceutical and allied areas.

Desirable:
- The candidate should have
experience in carrying out medicinal
chemistry programs on various
therapeutics targets using both
synthetic/ natural products to
develop NCEs. Should have
experience / expertise towards drug
development for different therapeutic
areas such as neurodegenerative
disorders, organophosphorus
toxicity, CNS disorders and
infectious diseases etc.
- Should have demonstrated
outstanding experience of
independent research in terms of
executing research grants/
consultancy program, strong record
of high quality research publications,
patents etc. Should have contributed
to organizational building activities at
departmental, institutional,
professional and public level.
Period of Probation, if any 1 (one year)
004 Assistant 02 UR Essential: 40 years
Professor Ph. D. with first class or equivalent
grade at the preceding degree in the
Level-12 appropriate branch with a very good
Basic Pay: academic record throughout and at
Rs. least 5 years of Teaching/ Research/
1,01,500/- + Industrial experience with published
other Govt work of high quality.
benefits
Desirable:
- Experience in the synthesis of
biologically active compounds of
medicinal importance. Experience in
handling bio-analytical/
spectroscopic techniques.
Page 3 of 24
 - Experience in obtaining extramural
grants and consultancy projects.
Preference will be given to the
candidate having strong record of
relevant publication in SCI indexed
peer reviewed journal and patents.
Period of Probation, if any 1 (one year)

Department of Pharmaceutics
005 Associate 01 UR Essential: 45 years
Professor Ph. D. with first class or equivalent
grade at the preceding degree in the
Level-13 appropriate branch with a very good
Basic Pay: academic record throughout and at
Rs. least 8 years of Teaching/ Research/
1,39,600/- + Industrial experience with published
other Govt work of high quality and an
benefits established reputation of having
made conspicuous seminal
contribution to the knowledge in
pharmaceutical and allied areas.

Desirable:
- Established researcher in the field
of nanomedicine, Targeted Drug
Delivery Experience in PK and PD
studies.
- Experience of teaching and direct
supervision of PhD students.
Experience in obtaining extramural
grants, national/ international
fellowships, consultancy projects,
curriculum development and
innovative teaching and learning
methods. Experience in contributing
in organizational building/ activities
at departmental, institutional,
profession and public level including
serving on committee.
Period of Probation, if any 1 (one year)
006 Assistant 01 UR Essential:
Professor + Ph.D. with first class or equivalent 40 years
01 OBC grade at the preceding degree in the
Level-12 appropriate branch with a very good
Basic Pay: academic record and at least 5 years
Rs. of Teaching/ Research/ Industrial
1,01,500/- + experience with published works of
other Govt., high quality.
benefits.
Desirable:
Experience in conventional and
advanced drug delivery systems
especially nanotechnology,
developing crystallization for NCE/
natural product for developing new
formulation with experience in PK/
PD studies..

Experience in obtaining extramural

grants and consultancy projects.
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 Preference will be given to the
candidate having strong record of
relevant publication in SCI indexed
peer reviewed journals and patents.
Period of Probation, if any 1 (one year)

Relaxation of upper age limit for Departmental Candidates for all faculty positions as per Norms for
appointment by Direct Recruitment.

Page 5 of 24
GENERAL INSTRUCTIONS, ESSENTIAL INFORMATION AND CLARIFICATIONS:
1. Candidates of only Indian Nationality can apply for these posts.
Only the online applications with required uploaded enclosures will be accepted. Applicants should send
2. ONE hard copy of the application on or before 11th November 2019 along with all self-attested testimonials,
certificates and all supporting documents wherever required without which the application will not be
considered. Applicants must produce original testimonials, certificates and other documents at the time of
interview, if called.
The envelope should be super scribed as Application for the Post of
Postal Address for sending the Application:

I/c Registrar, National Institute of Pharmaceutical Education and Research (NIPER), Raebareli
New Transit Campus, Ahmedpur-Kamlapur (Near CRPF Base Camp and Bijnor Chowki), PO: Mati,
Sarojini Nagar, Lucknow-226 002, Uttar Pradesh
Phone:0522-2497903
Email: recruitment.niperr@gmail.com
Website: www.niperraebareli.edu.in
3. Applicants are advised to ensure before applying that they possess essential qualification and experience for
the post. The Experience and Qualification will be reckoned as on the last date for submission of application.
No updating of qualification and experience will be entertained after the last
date. Mere fulfillment of minimum qualifications and experience does not entitle any candidate to receive call
letter for interview and the decision of the NIPER Raebareli shall be final.
4. The maximum age limit and eligibility conditions shall be reckoned as on the date of last date for receipt of
applications and the experience for Teaching posts will be considered by excluding the experience gained
while pursuing Ph.D. (copies of documents of date of registration and date of completion of Ph.D. must be
enclosed). Relaxation of upper age limit for Departmental Candidates for all faculty positions is as per the
Norms for appointment by Direct Recruitment.
5. Application once submitted cannot be altered/ resubmitted, under any circumstances. Further, no request
with respect to making changes in any data/particulars entered by the candidate in the Online Application
will be entertained, once the application is submitted successfully. Therefore, please keep all data/details
ready before you start filling up the Application Online.
6. The persons applying for more than one post must apply separately for each post (along with payment of
prescribed fees for each post). Incomplete application in any respect will not be considered.
7. It is advised that the Applications to the Institute may be sent well in advance without waiting for the last
date to avoid postal delay or any delay due to other unforeseen events or circumstances. The Institute will
not be responsible for any postal delay at any stage.
8. The Institute shall verify the antecedents and documents submitted by applicants at any time, at the time of
appointment or during the tenure of service. In case, it is found that the Applicants have submitted fake
documents or the Applicants have undesirable clandestine antecedents/background and have suppressed the
material information, his/her services shall be liable to be terminated.
9. The character of a person for direct recruitment to the service must be such as to render him/her suitable in
all respect for appointment to the service. Persons dismissed by the Union Government or by a State
Government or by a Local Authority or a Government Corporation owned or controlled by the Central
Government or State Government will be deemed to be ineligible for appointment.
10. In case of any inadvertent mistake in the process of selection which may be detected at any stage even after the
issuance of appointment letter, the Institute reserves the right to modify/withdraw/cancel any communication
made to the Applicants.
11. The reservations/relaxations policy for SC/ ST/ OBC/PwBD/EWS applicants will be as per the existing Govt.
of India policy.
12. Reservations and concessions for SC, ST, OBC and Persons with Benchmark Disabilities will be as per
existing Government of India norms as amended from time to time. Applicants applying for the reserved
posts should clearly state to which category they belong.
13. Applicants seeking reservation under SC/ST category are required to submit certificate on the format
prescribed by the Government of India, Department of Personnel & Training (Annexure-I).

14. Applicants seeking reservation under OBC category are required to submit certificate on the format
prescribed by the Government of India, Department of Personnel & Training (Annexure-II).

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15. Applicants applying for the post(s) reserved for OBC, should submit a self-attested copy of valid caste
certificate specifically mentioning Creamy Layer-exclusion in the format prescribed by Govt. of India,
issued by competent authority, vide Column 3 of GOI Dept. of Personnel and Training O.M. No.
36012/22/93-Estt.(SCT) dated 8.9.1993 and modified vide DoPT's O.M. No. 36033/3/2004-Estt.(Res) dated
9.3.2004, subsequently revised vide O.M. No.36033/3/2004-Estt.(Res) dated 14.10.2008. The Caste
Certificate must be in the format as prescribed by the Govt. of India vide OM No. 36036/2/2013- Estt (Res.)
dated 30/05/2014.
16. The person with Degree of Disability of 40% and above are eligible for applying for the PwBD.
Proof to this effect, must be enclosed with the application as per Annexure - III-(a), III-(b), III-
(c) (which ever applicable) without which the application will be treated as 'General
(unreserved)'.
17. The applicants serving in Govt./Semi-Govt./PSUs/Autonomous organization must send their application (in
the prescribed format) along with the relevant documents “Through Proper Channel”. In case the applicants
are in service and delay is expected in getting endorsement of the employer concerned on the original
application, the applicants may submit an advance copy of the application along with all enclosures directly
(with or without the employer's endorsement on the advance copy). The candidates should submit original
application through proper channel by the last date mentioned in this employment notification, the applicants
will have to submit a 'NO OBJECTION CERTIFICATE' along with Vigilance Clearance Certificate in a
sealed cover from his/her employer to the Institute at the time of interview. The candidates are required to
send advance copies of their applications but their candidature shall only be considered if their applications
are received through proper channel within
10 days after the closing date for receipt of applications (Annexure-IV).
18. Canvassing in any form on behalf of or by any applicant will disqualify him/her from being considered for
post.
19. All the appointees including the in-service candidates shall be governed by the New Pension Scheme (NPS)
introduced by Govt. of India.
20. Appointments under Direct Recruitment are regular in nature with a probation period as per the norms of the
institute and the same shall be confirmed depending upon satisfactory performance of the incumbent.
21. The Institute reserves the right to:
(a) Withdraw the advertisement either partly or wholly at any time without assigning any reason to this
effect.
(b) Fill or not to fill up some or all the posts advertised for any reasons whatsoever
(c) Increase/decrease the number of posts without giving any reason.
(d) Any edition/deletion and changes in matter of terms and conditions given in this notification of
recruitment.
22. Request for change of mailing address or e-mail address during the process of recruitment will not be
entertained under any circumstances. The Institute will not be responsible for any loss of e-mail, loss of any
communication due to wrong address provided by the candidates.
23. Incomplete Hard copy of application or those without relevant supporting documents (self-attested copies of
Date of birth/Degrees/Certificates/Mark sheets/Experience Certificates/documents, etc.) will be rejected.
Applicants shall have to produce original testimonials at the time of Test / interview,
failing which they will not be allowed to appear in Test / interview.
24. Selection committee reserves the right to recommend higher initial pay and position to exceptionally qualified
and deserving selected applicants.
25. Applicants have to pay a non-refundable application fees of Rs.1000/- for posts having Pay Level 10 and
above and Rs.500/- posts having Pay Level 9 and below. Persons from the SC, ST, PwBD, Ex- Servicemen
and women categories are not required to pay application fee. Submission of the application form and
payment of fee should be done only through the online process. Please visit Institute’s website
www.niperraebareli.edu.in or application portal for the same. After submission of application and payment
of fee, a PDF will be generated of the completed form and fees receipt. Applicants are required to print hard
copies of application form and fee receipt, sign and send the same along with all self-attested relevant
supporting documents by post to:
I/c Registrar, National Institute of Pharmaceutical Education and Research (NIPER), Raebareli
New Transit Campus, Ahmedpur-Kamlapur (Near CRPF Base Camp and Bijnor Chowki), PO: Mati,
Sarojini Nagar, Lucknow, Uttar Pradesh
PIN:226002
26. In case of any corrigendum/addendum pertaining to this advertisement, the same shall be published on the
Institute’s website only. Accordingly, all applicants in their own interests are advised to regularly visit the
Institute’s website www.niperraebareli.edu.in. They should also regularly check their email account for
updates.

Page 7 of 24
27. No TA/DA and accommodation shall be provided for attending interview and presentation.
28. Call letters and other correspondence for attending the interview, etc., will be sent only to the
eligible candidates by Email only and will be displayed on the Institute’s website.
29. After joining the service of the Institute, the persons will have to abide by the Rules, Regulations,
Ordinances, Statutes and Act of the Institute applicable from time to time. He/She may be assigned any duty
within or outside the Institute depending upon the exigency of the work.
30. Candidates, who have obtained degrees or diplomas or certificates for various courses from any Institution
declared fake/derecognized by the UGC/AICTE/PCI shall not be eligible for being considered
for recruitment to the posts advertised. If this is detected at any stage during their service, their service will be
terminated forthwith.
31. No interim correspondence whatsoever will be entertained from Applicants regarding conduct and result of
test(s) and reasons for not being called for test(s) or interview.
32. In case of any dispute/ambiguity that may occur in the process of selection, the decision of the Director
NIPER-Raebareli in all matters relating to eligibility, acceptance or rejection of applications, mode of
selection, conduct of examination/ interview will be final and no query or correspondence will be entertained
in this connection from any individual or his/her agency.
33. No person shall be recruited unless he/she is in good mental and physical health and free from any physical
defect that is likely to interfere with the efficient performance of his official duties. Candidates, who are
finally approved for the appointment to the institute, shall produce Medical Certificate from an authorized
Government Medical Officer at the time of joining the Institute.
34. Candidates are advised to visit the website: www.niperraebareli.edu.in regularly. Only Email communication
will be sent. No separate call letter will be sent.
35. A Candidate’s admission to the Written Test/Interview and subsequent process is strictly provisional. The
mere fact that the call letter has been issued to the candidate does not imply that his/her candidature has been
finally cleared by the NIPER-Raebareli. The NIPER- Raebareli would be free to reject any application, at
any stage of the process, cancel the candidature of the candidate in case it is detected at any stage that a
candidate does not fulfill the eligibility norms and/or that he/she has furnished any incorrect/false
information/Certificate/documents or has suppressed any material fact(s). If any of these shortcoming(s) is/are
detected after appointment in the NIPER- Raebareli, their services are liable to be summarily terminated.

36. In case any dispute arises on account of interpretation of clauses in any version of this Advertisement in
language other than English, the English version available on the NIPER- Raebareli Website shall prevail.
37. Errors and omissions in notification and selection process are subject to corrections as per rules and
regulations. Moreover, the guidelines relating to recruitment rules shall be followed as per NIPER Act, 1998
and as amended from time to time.
38 In case of universities/institute awarding CGPA/SGPA/OGPA grades etc., candidates are requested to convert
the same into percentage based on the formula as per their university/institute guidelines.

39 (a) The application is to be submitted in four distinct steps, as below:

(i) Registration (online)

(ii) Fee Submission (online/offline)
(iii) Application Submission (online)
(iv) Dispatch of physical copy of online application with original signature (manual)

(b) The datelines for the above-mentioned stages of application is as follows:

Commencement of Online Registration October 01, 2019

(11:00 AM)
Last date of Online Application & Payment of November 01, 2019
Fees (up to 6:00 PM)
Last date of receipt of hard copy of online November 11, 2019
application at NIPER-R along with all relevant (up to 5:00 PM)
enclosures.
40 Mode of Selection:

The selection process for teaching staff consists of two phases (a) Seminar Presentation (b) Interview.
The shortlisted candidates will be invited to give seminar presentation before a duly constituted
Committee. Only the candidates recommended by the Committee based on their performance in the
seminar presentation shall attend the Interview before the Selection Panel.

Page 8 of 24
 ANNEXURE - I
FORMAT FOR SC/ST CERTIFICATE
A candidate who claims to belong to one of the Scheduled Caste or the Scheduled Tribes should submit
in support of his claim an attested/certified copy of a certificate in the form given below, from the District
Officer or the sub-Divisional Officer or any other officer as indicated below of the District in which his
parents (or surviving parent) ordinarily reside who has been designated by the State Government
concerned as competent to issue such a certificate. If both his parents are dead, the officer signing the
certificate should be of the district in which the candidate himself ordinarily resides otherwise than for
the purpose of his own education. Wherever photograph is an integral part of the certificate, the
Corporation would accept only attested photocopies of such certificates and not any other attested or true
copy.
(The format of the certificate to be produced by Scheduled Castes and Scheduled Tribes candidates
applying for appointment to posts under Government of India.)
This is to certify that Shri/Shrimati/Kumari* son / daughter
of of Village/Town/*
in District/Division * of the State/Union Territory*
belongs to the Caste/Tribes which is recognized as a Scheduled Castes/Scheduled
Tribes* under:
@The Constitution (Scheduled Castes) order, 1950
@The Constitution (Scheduled Tribes) order, 1950
@The Constitution (Scheduled Castes) Union Territories order, 1951 *
@The Constitution (Scheduled Tribes) Union Territories Order, 1951*
[As amended by the Scheduled Castes and Scheduled Tribes Lists (Modification) order, 1956, the
Bombay Reorganization Act, 1960 & the Punjab Reorganization Act, 1966, the State of Himachal
Pradesh Act 1970, the North-Eastern Area(Reorganization) Act, 1971 and the Scheduled Castes and
Scheduled Tribes Order(Amendment) Act, 1976.]
@The Constitution (Jammu & Kashmir) Scheduled Castes Order, 1956
@The Constitution (Andaman and Nicobar Islands) Scheduled Tribes Order, 1959 as amended by the
Scheduled Castes and Scheduled Tribes Order (Amendment Act), 1976
@The Constitution (Dadra and Nagar Haveli) Scheduled Castes Order 1962
@The Constitution (Dadra and Nagar Haveli) Scheduled Tribes Order 1962
@The Constitution (Pondicherry) Scheduled Castes Order 1964
@The Constitution (Scheduled Tribes) (Uttar Pradesh) Order, 1967
@The Constitution (Goa, Daman & Diu) Scheduled Castes Order, 1968
@The Constitution (Goa, Daman & Diu) Scheduled Tribes Order 1968
@The Constitution (Nagaland) Scheduled Tribes Order, 1970
@The Constitution (Sikkim) Scheduled Castes Order 1978
@The Constitution (Sikkim) Scheduled Tribes Order 1978
@The Constitution (Jammu & Kashmir) Scheduled Tribes Order1989
@The Constitution (SC) orders (Amendment) Act, 1990
@The Constitution (ST) orders (Amendment) Ordinance 1991
@The Constitution (ST) orders (Second Amendment) Act, 1991
@The Constitution (ST) orders (Amendment) Ordinance 1996
@The Scheduled Caste and Scheduled Tribes Orders (Amendment) Act, 2002
@The Constitution (Scheduled Caste) Orders (Amendment) Act, 2002
@The Constitution (Scheduled Caste and Scheduled Tribes) Orders (Amendment) Act, 2002

Page 13 of 24
% 2. Applicable in the case of Scheduled Castes, Scheduled Tribes persons who have migrated from
one State/Union Territory Administration to other.
This certificate is issued on the basis of the Scheduled Castes/ Scheduled Tribes certificate issued to
Shri/Shrimati Father/Mother of Shri/Shrimati/Kumari*
of village/ town*_
in District/Division* of the State/Union Territory* who
belong to the Caste/Tribe* which is recognized as a Scheduled
Caste/Scheduled Tribe in the State/Union Territory* issued by the
dated .
%3. Shri/Shrimati/Kumari and/or* his/her family ordinarily reside(s) in village/town*
of District/Division* of the
State/Union Territory of .

Signature
**Designation
With a Seal of Office
State/Union Territory
Place:
Date:

* Please delete the words which are not applicable @ Please quote specific presidential order % Delete
the paragraph which is not applicable.

NOTE: The term ordinarily reside(s) used here will have the same meaning as in section 20 of the
Representation of the People Act, 1950.

** List of authorities empowered to issue Caste/Tribe Certificates:

(i) District Magistrate / Additional District Magistrate / Collector / Deputy Commissioner /

Additional Deputy Commissioner / Dy. Collector/Ist Class Stipendiary Magistrate/Sub-
Divisional Magistrate / Extra-Assistant Commissioner / Taluka Magistrate / Executive
Magistrate.
(ii) Chief Presidency Magistrate / Additional Chief Presidency Magistrate / Presidency
Magistrate.
(iii) Revenue Officers not below the rank of Tehsildar.
(iv) Sub-Divisional Officers of the area where the candidate and/or his family normallyresides.

NOTE: ST candidates belonging to Tamil Nadu state should submit caste certificate ONLY FROM
THE REVENUE DIVISIONAL OFFICER.

Page 14 of 24
 ANNEXURE - II

FORMAT OF CERTIFICATE TO BE PRODUCED BY OTHER BACKWARD CLASSES

APPLYING FOR APPOINTMENT TO POSTS UNDER THE GOVERNMENT OF INDIA

This is to certify that son/daughter of

of village District/Division In the
State belongs to the
Community which is recognized as a backward class under:

i) Resolution No. 12011/68/93-BCC dated the 10th September, 1993, published in the Gazette
of India Extraordinary – Part I, Section I, No. 186 dated 13th September, 1993.
ii) Resolution No. 12011/9/94-BCC, dated 19.10.1994 published in Gazette of India
extraordinary Part I Section I No. 163, dated 20th October, 1994.
iii) Resolution No. 12011/7/95-BCC dated the 24th May 1995 Published in the Gazette of
India extraordinary Part-I Section I No. 88 dated 25th May, 1995.
iv) Resolution No.12011/96/94-BCC dated 9th March, 1996.
v) Resolution No. 12011/44/96-BCC, dated the 6th December, 1996, published in the Gazette
of India – Extraordinary-part I, Section-I, No. 210, dated the 11th December, 1996.
vi) Resolution No.12011/13/97-BCC dated 3rd December, 1997. vii) Resolution No.12011/99/94-
BCC dated 11th December, 1997. viii) Resolution No.12011/68/98-BCC dated 27th October,
1999.
vii) Resolution No.12011/88/98-BCC dated 6th December, 1999, published in the Gazette of
India, Extra Ordinary Part-I, Section-I No.270, 6th December, 1999.
viii) Resolution No.12011/36/99-BCC dated 4th April, 2000, published in the Gazette of India, Extra
Ordinary Part-I, Section-I, No.71 dated 4thApril, 2000.
ix) Resolution No.12011/44/99-BCC dated 21.9.2000, published in the Gazette of India, Extra
Ordinary Part-I, Section-I, No.210 dated 21.9.2000.
x) Resolution No.12015/9/2000-BCC dated 6th September, 2001, published in the Gazette of
India, Extra Ordinary Part-I, Section-1, No.246 dated 6th September, 2001.
xi) Resolution No.12011/1/2001-BCC dated 19th June,2003, published in the Gazette of India,
Extra Ordinary Part-I, Section-1, No.151 dated 20th June, 2003.
xii) Resolution No.12011/42002-BCC dated 13th January, 2004, published in the Gazette of India,
Extra Ordinary Part-I, Section-1, No.9 dated 13th January, 2004.
xiii) Resolution No.12011/142004-BCC dated 12th March, 2007, published in the Gazette of
India, Extra Ordinary Part-I, Section-1, No.67 dated 12th March, 2007.

Shri and/or his family ordinarily reside(s) in

the District/Division of the State.

This is also to certify that he/she does not belong to the persons/sections (Creamy Layer) mentioned in
column 3 of the Schedule to the Government of India, Department of Personnel & Training OM No.
36012/22/93-Estt. (SCT) dated 08.09.1993 and modified vide Govt. of India Dept. of Personnel and
Training OM No. 36033/3/2004-Estt(Res) dated 09.03.2004 & 14.10.2008.

Dated:

Seal: District Magistrate or Deputy Commissioner etc.

Page 15 of 24
Note - I:
a) The term 'Ordinarily' used here will have the same meaning as in Section 20 of
theRepresentation of the People Act, 1950.
b) The authorities competent to issue Caste Certificate are indicated below:-
i) District Magistrate / Additional Magistrate / Collector / Dy. Commissioner / Additional Deputy
Commissioner / Deputy Collector / Ist Class Stipendary Magistrate / Sub-Divisional Magistrate
/ Taluka Magistrate / Executive Magistrate/Extra Assistant Commissioner (not below the rank
of 1st Class Stipendiary Magistrate).
ii) Chief Presidency Magistrate /Additional Chief Presidency Magistrate/ Presidency Magistrate.
iii) Revenue Officer not below the rank of Tehsildar
iv) Sub -Divisional Officer of the area where the candidate and/or his family resides.

Note - II:
The closing date for receipt of application will be treated as the date of reckoning for OBC status of
the candidate and also, for assuming that the candidate does not fall in the creamy layer.

Page 16 of 24
 ANNEXURE - III-(a)
Form-V
CERTIFICATE OF DISABILITY
(In cases of amputation or complete permanent paralysis of limbs or dwarfism
and in case of blindness)
[See rule 18(1)]
(Name and Address of the Medical Authority issuing the Certificate)

Recent passport
size attested
photograph
(Showing face
only) of the person
with disability.

Certificate No. Date:

This is to certify that I have carefullyexamined Shri/Smt./Kum.

son/wife/daughter of Shri Date of Birth _(DD/MM/YYYY)_
Age years, male/female registration No. _ permanent
resident of House No. _ Ward/Village/Street Post Office
District State , whose photograph
is affixed above, and am satisfied that:

(A) he/she is a case of:

□ Locomotor disability
□ Dwarfism
□ Blindness
(Please tick as applicable)
(B) the diagnosis in his/her case is .
(A) he/she has % (in figure) percent (in words) permanent
locomotor disability/dwarfism/blindness in relation to his/her (part of body) as
per guidelines ( number and date of issue of the guidelines to be specified).
1. The applicant has submitted the following document as proof of residence:-

Details of authority issuing

Nature of Document Date of Issue
certificate

(Signature and Seal of Authorized Signatory of

Notified Medical Authority)
Signature/thumb
impression of the
person in whose
favour certificate
of disability is Page 17 of 24
 ANNEXURE – III (b)
Form-VI
CERTIFICATE OF DISABILITY
(In cases of multiple disabilities)
[See rule 18(1)]
(Name and Address of the Medical Authority issuing the Certificate)

Recent passport
size attested
photograph
(Showing face
only) of the person
with disability.

Certificate No. Date:

This is to certify that we have carefully examined Shri/Smt./Kum.

son/wife/daughter of Shri Date of Birth _(DD/MM/YYYY)_
Age years, male/female registration No. _ permanent
resident of House No. _ Ward/Village/Street Post Office
District State , whose photograph
is affixed above, and am satisfied that:
(A) he/she is a case of Multiple Disability. His/her extent of permanent physical
impairment/disability has been evaluated as per guidelines (… .............. number and date of issue
of the guidelines to be specified) for the disabilities ticked below, and is shown against the
relevant disability in the table below:
Affected Permanent physical
Sl.
Disability part of Diagnosis impairment/mental disability
No.
body (in %)
1 Locomotor disability @
2 Muscular Dystrophy
3 Leprosy cured
4 Dwarfism
5 Cerebral Palsy
6 Acid attack Victim
7 Low vision #
8 Blindness #
9 Deaf £
10 Hard of Hearing £
11 Speech and Language disability
12 Intellectual Disability
13 Specific Learning Disability
14 Autism Spectrum Disorder

Page 20 of 24
 15 Mental illness
16 Chronic Neurological Conditions
17 Multiple sclerosis
18 Parkinson’s disease
19 Haemophilia
20 Thalassemia
21 Sickle Cell disease
(B) In the light of the above, his/her over all permanent physical impairment as per
guidelines ( number and date of issue of the guidelines to be specified), is as follows: -
In figures: - percent.
In words: - percent.
2. This condition is progressive/non-progressive/likely to improve/not likely to improve.
3. Reassessment of disability is:
i) not necessary, or
ii) is recommended/after years months, and therefore this certificate shall
be valid till _DD/MM/YYYY_.

@ e.g. Left/right/both arms/legs

# e.g. Single eye
£ e.g. Left/Right/both ears
4. The applicant has submitted the following document as proof of residence:-
Details of authority issuing
Nature of Document Date of Issue
certificate

5. Signature and seal of the Medical Authority.

Name and Seal of Member Name and Seal of Member Name and Seal of the Chairperson

Signature/thumb
impression of the
person in whose
favour certificate of
disability is issued

Page 21 of 24
 ANNEXURE – III (c)
Form-VII
CERTIFICATE OF DISABILITY
(In cases other than those mentioned in Forms V and VI)
[See rule 18(1)]
(Name and Address of the Medical Authority issuing the Certificate)

Recent passport
size attested
photograph
(Showing face
only) of the person
with disability.

Certificate No. Date:

This is to certify that I have carefullyexamined Shri/Smt./Kum.

son/wife/daughter of Shri Date of Birth _(DD/MM/YYYY)_
Age years, male/female registration No. _ permanent
resident of House No. _ Ward/Village/Street Post Office
District State , whose photograph
is affixed above, and am satisfied that he/she is a case of
disability. His/her extent of percentage physical impairment/disability has been evaluated as per
guidelines (… number and date of issue of the guidelines to be specified) and is shown against the
relevant disability in the table below:-
Affected Permanent physical
Sl.
Disability part of Diagnosis impairment/mental disability
No.
body (in %)
1 Locomotor disability @
2 Muscular Dystrophy
3 Leprosy cured
4 Cerebral Palsy
5 Acid attack Victim
6 Low vision #
7 Deaf €
8 Hard of Hearing €
9 Speech and Language disability
10 Intellectual Disability
11 Specific Learning Disability
12 Autism Spectrum Disorder
13 Mental illness
14 Chronic Neurological Conditions

Page 22 of 24
 15 Multiple sclerosis
16 Parkinson’s disease
17 Haemophilia
18 Thalassemia
19 Sickle Cell disease
(Please strike out the disabilities which are not applicable)
2. The above condition is progressive/non-progressive/likely to improve/not likely to improve.
3. Reassessment of disability is:
i) not necessary, or
ii) is recommended/after years months, and therefore this certificate shall
be valid till _DD/MM/YYYY_.

@ eg. Left/Right/both arms/legs

# eg. Single eye/both eyes
€ eg. Left/Right/both ears

4. The applicant has submitted the following document as proof of residence:-

Nature of Document Date of Issue Details of authority issuing

certificate

5. Signature and seal of the Medical Authority.

Name and Seal of Member Name and Seal of Member Name and Seal of the Chairperson

(Authorized Signatory of Notified MedicalAuthority)

(Name & Seal)
Countersigned
{Countersignature and seal of the
Chief Medical Officer/Medical Superintendent/
Head of Government Hospital, in case the
Certificate is issued by a medical authority who
is not a Government servant (with seal)}

Signature/thum
b impression of
the person in
whose favour
certificate of
disability is
issued

Note: - In case this certificate is issued by a medical authority who is not a Government servant, it
shall be valid only if countersigned by the Chief Medical Officer of the District.

Page 23 of 24
 Annexure – IV

Certificate to be furnished by the employer/Head of Office/forwarding authority, if in

service and applying through Proper Channel.

Employer’s Certificate/ Recommendation

Shri/Smt./Dr. is a
Permanent/Temporary/Contractual employee of the organization holding the
post which carries the pay scale of (Grade
Pay) and his/her application is forwarded for consideration and
necessary action.

Certified that the particulars furnished b y are correct and he/she

possesses educational qualifications and experience mentioned in the advertisement.

Further certified that:

(i) No objection certificate, from present employer.
(ii) There is no vigilance case pending/contemplated against him/her.
(iii) His/her integrity is beyond doubt.
(iv) No major/minor penalties have been imposed on him/her
during the last 10 years. Please enclose list of major/minor
penalties imposed during the last 10 years, if any.
(v) A cadre clearance certificate is appended herewith.

Please mark ( ) for which certificates are enclosed

Signature Name
of the Officer:
Designation:
Department:
Office Seal:

Place Date:

(Signature of candidate)