FORM – I

CHARACTER AND ANTECEDENT CERTIFICATE

Certified that Shri / Smt. / Kumari …………………………

………………………………………………………………………………….............
…………………………………………………………… son / wife / daughter of
……………………… …………….. …………. who is known to me for the last
…..………………years, possess good moral character and has no
antecedents which should render him/her unsuitable for Government
employment.

Certified that Shri / Smt. / Kumari ……………………………… ….…….is not

related to me.

Signature

Name in Block letters

Place:

Designation and Seal

Office Telephone No.

INSTRUCTIONS

1. To be signed or countersigned by a Gazetted Officer of the

Government of India or a State Government or magistrate 1st Class or
a Member of the Parliament or State Legislature.
2. Signatory's designation may also be given in block letters.
3. Period, for which the vouching officer should have known the
candidates, should be at least one Year.
4. The certificate should be of recent data.