Appendix A
SELF CERTIFICATION CERTIFICATE (ONE FOR EACH TATTOO) BY CANDIDATES
FROM TRIBAL COMMUNITIES WITH PERMANENT BODY TATTOO(S)
1.
I, _______________________ (Name of Candidate), Son/Daughter of
_____________________ (Name of Father/Mother/Guardian as applicable
___________(Date of Birth) hereby give an undertaking that I belong to
____________________Tribe from ___________ area of _____________State and I do
not have any permanent body tattoo on my body/I have one/two/three/four/more than
four * permanent body tattoo(s) inked on my body as follows (one for each tattoo) :Photograph of Tattoo
Details of Tattoo
(Post card size to be pasted here duly Size of Tattoo
signed by the candidate with name please (In Cms)
do not use staple pins/clips)
Language
(If Applicable)
Significance of Tattoo
(IF Applicable)
(* Delete whichever is not applicable)
2.
I am enclosing Certificate(s) as per Appendix B, in original, for permanent body
tattoo(s) on my body, duly signed as per instructions.
3.
I hereby declare that besides the tattoo(s) as referred in Para 1 of Appendix A
above, I will not have any other permanent body tattoo(s) in future if I am selected to
undergo pre-commission training.
4.
The above information given by me is true and correct to the best of my
knowledge and belief.
5.
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 :
Date :
______________________
(Signature of the Candidate)
Name, Entry & SSB Batch No
Appendix B
CERTIFICATE (ONE CERTIFICATE FOR EACH TATTOO) FOR PERMANENT BODY
TATTOO IN RESPECT OF CANDIDATES FROM TRIBAL COMMUNITIES
1.
This is to certify that ________________ (Name of Candidate) whose date of
birth is ____________ is the Son/Daughter of _____________ (Name of
Father/Mother/Guardian as applicable) and belongs to _____________ (Name of the
Tribe) Community of ______________ (Name of the District) in the State of
________________ (Name of the State).
2.
It is certified that the permanent body tattoo(s) inked at the following parts of the
body of ____________ (Name of the candidate) is as per existing customs and
traditions of) ________________Tribe and is in practice as on date :(a)
(b)
(c)
(d)
(Total No of Tattoos both in figures and words)
3.
Post card size photograph of each of the tattoo as given in Paragraph 2 of
Appendix B above is correct and placed as under for any future reference / record
hereafter :
Photograph of Tattoo
(Post card size to be pasted here duly
signed by the candidate and official
issuing this certificate with their respective
names.
Please do not use staple
pins/clips)
Details of Tattoo
Size of Tattoo
(In Cms)
Language
(If Applicable)
Significance of Tattoo
(IF Applicable)
Note :- Each tattoo will have a separate photograph with details and will be described
separately in additional pages will be used for the purpose and each page will attested
separately.
Place :
________________________________
(Signature with Name Designation and
Stamp of DC/DM or SDM of the
District/Tehsil) OR (Signature with Name
Designation if any and Address of
Chairman/Secretary or Senior Member
of the Tribe to which the candidate
belongs to with their Stamp)
Appendix D
SELF CERTIFICATION CERTIFICATE (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/Daughter 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) at Paragraph 2 below
(*strike out whichever is not applicable :Photograph of Tattoo
Details of Tattoo
(Post card size to be pasted here duly Size of Tattoo
signed by the candidate with name please (In Cms)
do not use staple pins/clips)
Language
(If Applicable)
Significance of Tattoo
(IF Applicable)
2.
I hereby declare that besides the tattoos as declared by me in Paragraph 1 of
Appendix D 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 belief.
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 :
Date :
______________________
(Signature of the Candidate)
Name, Entry & SSB Batch No
Note 1.
Each tattoo will have a separate photograph and will be described
separately additional pages will be used for the purpose and each gage 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).
