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Application Form For Recruitment To Bs-16 & Above Posts: Aga Khan Road, Sector F-5/1, ISLAMABAD
Application Form For Recruitment To Bs-16 & Above Posts: Aga Khan Road, Sector F-5/1, ISLAMABAD
Batch No.
Diary No.
F.4-
-R
3)
d
Date of Birth (exact as per Matric certificate)
4) Computerized (NADRA) National Identity Card (CNIC) No. of Applicant 5) Encircle the relevant Code:
6) a) Gender Male Female M F b) Religion Muslim Non-Muslim
M
NM
District of Domicile:
Punjab (Including ICT) Azad Kashmir Gilgit Baltistan (GB) FATA
Domicile Code
7)
10
20
30
31
40
60
Multan
61
Peshawar Quetta
90
Sukkur
Encircle the relevant Code separately for Test and Interview Centre. D.I.Khan Gilgit Islamabad Karachi Lahore Test Centre D G I Karachi K Lahore L
Buddhist Community
P Peshawar P
S Quetta Q
Islamabad
Age Relaxation
Azad
Kashmir
CODE
00
01
02
03
04
05
06
07
- 2 11). ACADEMIC QUALIFICATIONS: Do you possess the minimum educational qualification as mentioned in the advertisement as on the closing Date?
Yes
No
Board/ University
Sr. No.
Result Declaration Date (Certificate issued only by the Controller of Examination of Board/University will be accepted)
Day
Month
Year
Principal Subjects
1 2 3 4 5 6 7
12)
COURSES/TRAINING (Certificate, Diploma, Post-Graduate Diploma, on job training etc.) STARTING DATE ENDING DATE Nature of Training Intern On ee Job
GRADE
Sr. No.
NAME OF COURSE
Day
Month
Year
Day
Month
Year
1 2 3 4 5
13) RESEARCH/PUBLICATIONS/PAPERS/ARTICLES:
Mark R in the last column of the research report/paper/article/publication, if required in the advertisement. Sl. No. 1 2 3 4 5
Title
Publisher
Day
DISABILITY
Physically Impaired
CODE
Computer Writer If you need any assistance for attempting the question paper in the examination/ test, then Mark the relevant Box
V
Computer Audio Recorder Braille Writer
P
Computer Audio Recorder Writer
H
Audio Recorder AR
Code
AR
AR
Weeks
15)
EXPERIENCE: (i) Start from first employment in ascending order (ii) Do you possess relevant Post-Qualification experience for the post as mentioned in the advertisement. Experience (each) claimed here must be authenticated by providing experience certificate/valid proof of that period with exact dates, job description/specification issued by the Competent Authority.
PERIOD Fed. Govt. From To
(Write to-date if you are still in service)
Armed Forces
Semi Govt.
Daily Wages
Sl No
BS
Prov. Govt.
Permanent
Temporary
Day
1 2 3 4 5
Month
6
Year
7
Day
8
Month
9
Year
10
Year
11
Month
12
Day
13
14
15
16
17
18
19
20
21
22
23
24
25
26
Apprentice
Officiating
Part Time
Honorary
Contract
Private
Adhoc
27
28
-3-
- 4 -
16) Check List: Have you filled/attached attested copies of all required documents as per following sequence?
Yes / No 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Correct Case No. / Name of post/Department as per Advertisement. Original Treasury Challan with application form. Latest Three (3) Photographs Mentioning your name on backside. Copy of Computerized National Identity Card (CNIC). Copy of Matric/Secondary School Certificate (Proof of Age). Copy of required Degrees/Diplomas/Certificates. Proof of Post-Qualification experience. Copy of self Domicile Certificate. Departmental Permission Certificate (For Govt. Servants) In Case of Disabled Candidates, certificate of Disability from the Competent Authority.
17) Declaration (i): I hereby solemnly declare that I am not in possession of any domicile certificate other than District _______________________ claimed / submitted alongwith this application form for the instant case. I further declare that if I am found in possession of any domicile certificate other than the one mentioned above, I will be liable to dismissal from service any time with costs or any other penalty. Declaration (ii): I certify that the statements made by me in the answers to the foregoing questions 1-17 are true, complete and correct to the best of my knowledge and belief. Submission of fake/forged documents and any misrepresentation or omission discovered even after appointment may render my appointment liable to termination in addition to the action decided by the Commission. I have also carefully read the General Instructions to the candidates and I am bound by the terms and conditions contained therein.
Note:- Attested copies of all the documents should be attached in above order and numbered in continuation of page number of Application Form.
- 5 ANNEX-A SPECIMEN OF EXPERIENCE CERTIFICATE (To be typed/printed on Letter Head of Ministry/Division/Department/Organization/Firm) Certified that Mr./Miss/Mrs.................................................................................................................................... has been/is employed in this Ministry/Division /Department / Firm/Organization as.......................................................... from......................................to.................................(dates) whole time/part time/honorary basis/contract basis/daily wages. The work of Mr./Miss/Mrs....................................................while employed in this Ministry/Division/ Department/Firm/Organization was/is satisfactory. The duties/job specifications are/were as follows:(1) (2) (3) (4) (5) ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................. ................................................................................................................................................................ ................................................................................................................................................................
Date of Issue.............................. Signature.. Name of Issuing Authority.................. FOR PRIVATE ORGANIZATION ........................................................... Designation....................................... BPS (or Equivalent)........................... Office Stamp/Seal............................. Phone No...
CNIC No.
(Issuing Authority)
Name:
Note : (i)
Experience certificate must be issued under the signature of an officer at least one step higher than the post applied for. For example in case of a candidate for a post of BS-17, the experience certificate must be issued under the signature of head of the department/an officer of BPS-18 or equivalent as the case may be.
(ii)
In case of a candidate who served/is serving in a private Firm/Organization, experience certificate must be issued under the signature of Chief Executive/Head of Private Firm/Organization with CNIC No. address, Phone Nos.
(iii)
Experience certificate must be issued on the official letter pad with reference/file No. and date of issue and it should be duly stamped with full address. Telephone No. should also be indicated, failing which the experience certificate will not be acceptable.
(iv)
In case of more than one employer each experience certificate must be on the pattern as given above to derive the authentication/period of relevancy/irrelevancy of the job.
- 6 ANNEX-B CERTIFICATE TO BE PRODUCED BY CANDIDATES BELONGING TO THE TRIBAL AREAS This is to certify that Mr./Miss/Mrs........................................................................................................................... Son/Daughter of....................................................................................................................................................... belongs to the recognized tribe of............................................................................................................................ and is a permanent resident of Village/Town........................................................................................................... of District/Trible Area............................................................................................................................................... and his/her family have been living in that area since............................................................................................. belongs to a Gilgit Baltistan,* Federally Administered Tribal Area* Provincially Administered Tribal Area*. Note :Tribal Area as defined vide Article 246 of the Constitution of the Islamic Republic of Pakistan. *Strike out whichever is not applicable.
Dated.............................................
ANNEX-C CERTIFICATE TO BE PRODUCED BY THE CANDIDATE FROM THE KASHMIR AFFAIRS DIVISION, GOVERNMENT OF PAKISTAN, ISLAMABAD This is to certify that Mr./Miss/Mrs........................................................................................................................... Son/Daughter of...................................................................................................................................................... is a permanent resident of Village/Town..................................................................... of District............................. of Azad Jammu & Kashmir Territory and has been living in the aforesaid areas or any other part of Pakistan.
Dated.............................................
(iii) Designation________________________________________________BS _________________ (iv) Present department with complete address___________________________________________ _____________________________________________________________________________ (3) I have applied for the above post on the prescribed form separately to the Commission. Departmental permission certificate may kindly be forwarded to the Secretary, Federal Public Service Commission, F-5/1, Aga Khan Road, Islamabad, Closing Date for receipt of application by the Commission is _______________. Date_______________________ Signature of the candidate___________________ __________________________________________________________________________________________ FOR USE BY THE DEPARTMENT (EMPLOYER OF THE CANDIDATE) Attention :
Division/Department concerned must forward this certificate or communicate the refusal to F.P.S.C. within 60 days from the closing date for receipt of applications or before interviews whichever is earlier, failing which the head of the organization will have to account for its non-submission or delay to the Government. On selection, the department will have to relieve the official for joining the post.
No.____________________ Date___________________ (4) Forwarded: Mr./Miss/Mrs___________________________________________________is employed in this department since _________________he/she/holds a temporary/permanent/adhoc/contract/daily wages post under the Federal/Provincial/Semi-Government/Government/Autonomous/Corporation(Strike out not applicable). His/her total continuous government service Federal/Provincial______years_____months_____ days. (5) The candidate has availed extraordinary leave for __________years_________Months_________days and or has availed study leave for__________years__________months__________days. (6) The place of domicile as declared by him/her and accepted at the time of first entry into Government/ SemiGovernment/ Autonomous/Corporation service was___________________Province/Area. In case of Sindh, indicate Sindh (Rural) or Sindh (Urban). (7) There is nothing adverse in his/her performance evaluation report (PER)/annual confidential reports/records, antecedents/character, which may render him/her ineligible/unsuitable for the post applied for. (8) In case it is decided by the department to forward a case where adverse entries do exist in an officers/Officials record, extracts of the adverse entries from the relevant ACRs should be sent alongwith the departmental permission certificate for information of the Commission. Also confirming that the adverse remarks were communicated to the candidate and no appeal petition is pending for decision thereon. Signature_________________________ Secretary, Federal Public Service Commission, F-5/1, Aga Khan Road, Islamabad. Name____________________________ Designation and department with complete address (to be signed by head of the Department/Division/Ministry (Official stamp must be affixed)
Banks Name Banks Code District of Bank Branch.. Bank Details Must be filled by the candidate
T.R-6
Important
(Treasury Rule 29) Chalan No. (BANKS COPY) Treasury/Sub-Treasury Cash paid into the National Bank of Pakistan State Bank of Pakistan
Date
Name of Candidate . Secretary, Federal Public Service Commission, Islamabad Case No. F. 4 Examination Fee for the post of Rs. (Rupees .only) /20 -R Full particulars of the remittance and of authority (if any) Name (or designation) & address of the person on whose behalf money is paid
By whom tendered
CENTRAL QUARDUPLICATE
Amount
Head of Account
T.R-6
Important
(Treasury Rule 29) Chalan No. (TREASURYS COPY) Treasury/Sub-Treasury Cash paid into the National Bank of Pakistan
Date
Name of Candidate . Secretary, Federal Public Service Commission, Islamabad Case No. F. 4 /20 -R Examination Fee for the post of Rs. (Rupees .only)
By whom tendered Name (or designation) & address of the person on whose behalf money is paid Full particulars of the remittance and of authority (if any)
CENTRAL TRIPLICATE
Amount
Head of Account
T.R-6
CENTRAL
Name of Candidate . Secretary, Federal Public Service Commission, Islamabad Case No. F. 4 /20 -R Examination Fee for the post of Rs. (Rupees .only)
By whom tendered
Name (or designation) & address of the person on whose behalf money is paid Full particulars of the remittance and of authority (if any)
DUPLICATE
(Treasury Rule 29) Chalan No. CANDIDATES COPY) Treasury/Sub-Treasury Cash paid into the National Bank of Pakistan
Signature Treasury Officer/Bank Officer with Stamp Date Signature Treasury Officer/Bank Officer with Stamp
Amount
C 02101 Organs of States - Exam Fee Realized by FPSC
Head of Account
Important
Date
For Bank use only
T.R-6
Important
By whom tendered Bank Details Must be filled by the candidate
CENTRAL
Name of Candidate . Secretary, Federal Public Service Commission, Islamabad Case No. F. 4 /20 -R Examination Fee for the post of Rs. (Rupees .only)
Name (or designation) & address of the person on whose behalf money is paid Full particulars of the remittance and of authority (if any)
(Treasury Rule 29) Chalan No. Treasury/Sub-Treasury Cash paid into the National Bank of Pakistan
ORIGINAL
Amount
C 02101 Organs of States - Exam Fee Realized by FPSC
(FPSCS COPY)
Head of Account