- BIODATA FORM ACADEMY NO ENTRY) ~~~ PHOTO AME IN FULL ‘COURSE a) FIRST NAME SRLNO- DATE OF b) MIDDLE NAME REPORTING ¢) SURNAME DATE OF BIRTH RELIGION PLACE OF BIRTH MARRIED. QHINDU = AMUSLIM —ASIKH AYES ANO ACHRISTIAN QBUDDHIST SOTHERS NO OF CHILDREN commuUNITY CATEGORY 4 GENERAL ASC AST a08C NATIONALITY MEDICAL CATEGORY INDIAN p IDENTIFICATION MARK a) b) FATHER’S NAME MONTHLY INCOME a) FIRST NAME b) MIDDLE NAME PROFESSION ) SURNAME PERMANENT HOME ADDRESS a) HNO/VILL b) STREET/COLONY/PO cirv/oisTr d) STATE yeariinicu wir uw Ee“NAME OF GUARDIAN a) FIRST NAME b) MIDDLE NATE c) SURNAME ‘ANY RELATIVE SERVING IN BSF NEXTOFKIN ea a NO NAME 4 YES RELATION RANI ‘ADDRESS NAME unit RELATION MEMBER OF NCC MEMBER OF SCOUTS ARE YOU A SWIMMER? ANO | AYES QNO AYES BNO | AYES PREVIOUS SERVICE INTHE ARMED FORCES COURSES DONE UNIT/ BASIC PAY EDUCATIONAL QUALIFICATION STANDARD DATEOF DATEOF — EDUSTD_—_SUBIECTS DIVISION BOARD/ ENTERING LEAVING ACHIEVED UNIVERSITY a) 10™ b) ' ¢) a) 22" b) a a) GRADUATION b) a Post C lt a) GRADUATION b) OTHERS a) ») VeEaINicu witht uwSTANDARD -DATEOF -DATEOF -EDUSTD SUBJECTS, DIVISION BOARD/ ENTERING LEAVING ACHIEVED university a) b) a) b) a) ») CERTIFICATE 1, CERTIFY THAT THE ABOVE MENTIONED INFORMATION iS CORRECT AND COMPLETE ‘TO THE BEST OF MY KNOWLEDGE AND BELIEF. | SHALL BEAR FULL RESPONSIBILITY IN CASE ANY ENTRY IS FOUND FALSE LATER AT ANY STAGE. SIGNATURE OF THE CANDIDATE COUNTER SIGNATURE vuainicu wily- PARTICULARS FOR RELEASE OF PAY & ALLOWANCES OF GO’S OF BSF 1. NAME FIRST MIDDLE DATE OF SURNAME BIRTH 2. DESIGNATION 3, DESIGNATION OF AUDIT OFFICE PAD(8SF) 4, PRESENT DEPT ‘BSF 5. PRESENT STATION BSF ACADEMY TEKANPUR 6. PAY SCALE 9. CAPACITY IN WHICH LAST POST HELD DATE OF CHARGE ASSUMPTION Lec suBMITTED 10, BANKERS DETAILS SUBSTANTIVE 4 oFFiciaTiING 4, (———_ESIGANTION OF AUTHORITY _ A ves A NO “ly provisionat payment DésineD 4 YES ANO 4.3 MONTHS ‘4 6 MONTHS {SUBMIT ANNEX-III} NAME OF BANK ADDRESS ACCOUNT NO vearnicu vw11, WHETHER IN OCCUPATION OF GOVT ACCOMODATION ano A Laas DESIGNATION OF {ENT DEMAND AUTH 42. MARITAL STATUS ANo Aves, No OF CHILDREN 13, DECLARATION OF HOME TOWNS 14, MISC(IF ANY) 125, SPECIMEN SIGNATURES L 2 3 NOTE: Attach Attested Photocopy of Latest Pay slip ee SIGNATURE NAME DESIGNATION BN/UNIT/HO STS, BSF ACADEMY TEKANPUR ATTESTED vvueainicu witthy1 hereby declare that duty pay last drawn by me at the rate of Rs in the scale of from . Lalso declare that deduction and recoveries to be made from my pay till as per details below: DEDUCTION: PROVIDENT FUND Subscription i F Account No Maintained by Pu Premium O—Monthly Schedule O-itaif Yearly O-vearly RECOVERIES: Motor Cycle/Car Advance Any Other : House Building Advance Total Amount Monthly’ Recovery House Building Advance (GP Fund) Total Amount Monthly Recovery Signature Designation : Ha, BSF ACADEMY ‘Tekanpur vvarinrcu witht yuDeclaration: | declare as under a) That | am unmarried /widower. b) That | am married and have only one wife (living). c) That | am married and have more than one wife (living). Application for grant of exemption is enclosed. d) That | am married and during the life time of my spouse have contracted another marriage. 7 e) That | am married and my husband has no other living wife, to the best of my knowledge. f) That | have. contracted marriage with a person who has already one or more wife living. Application for grant of exemption is enclosed. 2. | solemnly affirm that the above declaration is true and | understood that in event of the declaration being found'to be incorrect after appointment, | shall be liable to be dismissed from service. Date: Signature of Officer Name veainicu wtNomination Form For Financial Assistance from BSF Benevolent Fund IRLA NO RANK Date of Joining BSF__ | Date of Appointment Name First Nominee Name Relationship Address Second Nominee Name Relationship Address Ld Signature yvuarmicu with UeFORM OF OATH Lf SWEAR BY ALMIGHTY GOD THAT | SHALL BE FAITHFUL AND BEAR TRUE ALLEGIANCE TO INDIA AND TO THE CONSTITUTION OF INDIA AS PER LAW ESTABLISHED AND THAT | SHALL BE DUTY BOUND, TO HONESTLY AND FAITHFULLY SERVE IN BORDER SECURITY FORCE AND GO WHERE EVER | MAY BE ORDERED BY AIR, LAND OR SEA AND THAT | SHALL OBSERVE AND OBEY ALL COMMANDS OF ANY OFFICER SET OVER ME EVEN TO THE PERIL OF MY LIFE. PLACE: BSF ACADEMY DATE: SIGNATURE NAME “OCamiea wireNOMINATION FOR BENEFITS UNDER GOLDEN JUBLEE SEEMA PRAHARI KALYAN KAWACH (When the Govt Servant has a family and wishes to nominate one member or more than one-members thereof) > 5 7 5 v Tominate the persons mentioned below who Is /are member(s) of my family and confer on him/them the right to receive to the extent specified below and amount that may be sanctioned by the Central Govt under the GISPKK in the event of my attalning the age of superannuation may remain upon at my death : NAME AND RELATIONSHIP SHARE TO BE PAID | CONTINGENCIES | NAME, ADDRESS AND RELATIONSHIP OF THE PERSON TO ! ADDRESS OF WITH GOVT TO EACH ON THE WHOM THE RIGHT OF THE NOMINATION SHALL PASS IN i NOMINEE SERVANT HAPPENING OF | THE EVENT OF HIS PERMANENT DECEASING THE GOVT ) WHICH THE — | SERVANT. 1 ROM ty NAME ‘ADDRESS — RELATIONSHIP. SHALL BECOME INVALID NOTE: The Govt Servant should draw a line across the blank space after his/her last entry to prevent insertion after he/she has signed: | Date ie day of lat BSF Academy Tekanpur. WITNESS: Signature 1 NAME: 2. | NAME: Name of Govt ServantNOMINATION FOR BENEFITS UNDER CGEGIS (When the Govt Servant has a family and wishes to nominate one member or more than one members thereof) sttelning the age of superannuation may real upon at my deat: Traminate the persons mentioned below who Is /are mambera) of my familly and confer on him/thom the right to receive to the extent specified below ‘nd amount that may be sanctioned by the Central Govt under the Cantal Government Employees Group Insurance Scheme 1996 Inthe event of my THAMEAND ADDRESSOF RELATIONSHIP SHARE TOBEPAID | CONTINGENCIES | WAME, ADDRESS AND RELATIONSHIP OF THE PERSON TO Nominee want cov TOEACH ONTHE | WHOM THE RIGHTR OF THE NOMINATION SHALL PASS IN THE SERVANT HaPPENINGOF | EVENTOF His PERMANENT DECEASING THE GOVT SERVANT. WHICH THE NownaTioN haut accome | NAME ADDRESS TECATIONSHP VAUD NOTE: The Govt Servant should draw alin across the blank space after his/her last entry to prevent insertion after he/she has ilgned. Date: ] ret BSF Academy Tekanpur. warniess: Signature 1 NAME: ‘| 2 NAME: Name of Govt Servant Scanned with C:STATEMENT OF MOVABLE PROPERTY YEAR: NAME Present pay Service To Which Belong BORDER SECURITY FORCE Date of Next Increment Present Place of Posting ‘STS, BSF ACADEMY TEKANPUR Present Post held ‘Name of Property having value | Name of Property | Detalls Registration Acquisition Actual Price & L/no & date of GREATER THAN RS 20000 (Regd No, Make, Details Details Source Of Permission of Model etc) Purchase Gol Present Value Ovehicle (O-0wn name O-Purchase ow O-Dependent O-Fitted O-Computer Name: : O-Other Relation Specify: ‘O-vehicte (0-0wn name O-Purchase o-v O-Dependent O-Fitted O-Computer O-other eee Specify: Relation: Place: STS, BSF ACADEMY TEKANPUR Date: [| Signature of Officer Name: Rank: uw cu wit 3 > ?TATEMENT OF IMMOVABLE PROPERTY YEAR: ARERR Treat “SRS TE WHT | SORT SEIRTT FORTE Date ot Nea eeart Sian Fase Rang |STE BF READE TEANGA resent t GTBSTSURON | Kame ofPopeny | —Detala | Prseatvalue | —Regsvalion | —Aequltion —] Actual income | Uno & date of ‘were propery held | Details Details from Property | Permission of cor Oniouse D-danname | Purchase aflease COstesient Ovependene | Morenee | Plot a Other jensen a spear, Oaioue Cownane | Purchase oflease O-nesdentt O-oependent | Morteree | Pet oe other \ O- Agta ee sped: | | | Oviouse COmname | Parca ofa ‘ O-esidenta Orvopendone | Morenge Pot m other Ong and on spect. 5, BSF ACADEMY TEXANPUR Signature of Officer Name: Rank: Scanned with C:NOMINATION FOR CONTRIBUTORY PENSION FUND 1. IRLANO 2. NAME 3. SEX 4, PERMANENT ADDRESS 5. cry 6. STATE RESIDENTIAL PHONE NO 8. E-MAIL ADDRESS 9. FAXKO 10. NOMINATION LETTER NO 11. NOMINATION DATE 12. A- NOMINEE SRL NO 2 - NOMINEE SRLNO 13. A-NOMINEE 1 NAME 13, B-NOMINEE 2 NAME 14, RELATIONSHIP 04. B RELATIONSHIP 75, A-NOMINEE 1 ADDRESS 15. 8-NOMINEE 2 ADDRESS 76, A-NOMINEE 1 DATE OF BIRTH 76, NOMINEE 2 DATE OF BIRTH 17, A NOMINEE 1 PERCENT 17. B-NONINEE 2 PERCENT 18. A-NAME OF GUARDIAN OF MINOR NOMINEE | 18. B-NAME OF GUARDIAN OF MINOR 1 NOMINEE 2 “yueaiiicu wir Ui TTZ 9, A-NOMINEE 1 INVALID CONDITION 19, ANOMINEE 2 INVALID CONDITION 20, REMARKS (If any) 21, FORM CODE c SIGNATURE OF OFFICER SIGNATURE OF AO NAME NAME su wiul & a vealCERTIFICATE OF CHARGE ASSUMPTION (Treasury Rule-24) Certified that | have on the FORENOON / AFTERNOON this day assumed the charge of — att BSF Academy Tekanpur Gwalior (MP). | Place: BSF Academy | Date: Signature of Officer | Name IRLA NO: Rank COUNTER SIGNATURE veaiinicu wit u EEPARTICULARS FOR RELEASE OF PAY & ALLOWANCES OF GO’S OF BSF 1. MAME FIRST MIDDLE DATE OF SURNAME BIRTH 2. DESIGNATION 3. DESIGNATION OF AUDIT OFFICE PAD(BSF) 4. PRESENT DEPT BSF 5. PRESENT STATION BSF ACADEMY TEKANPUR 6 PAYSCALE 7. CAPACITY IN WHICH LAST POST HELD SUBSTANTIVE A oFFIcATING 7, (————_DESIGANTION OF AUTHORITY _ 8, DATE OF CHARGE ASSUMPTION | 9, LPCSUBMITTED ies (Aino “Te provisionat pavaent oesineD ‘A YES 4NO ‘4 3 MONTHS 4 6 MONTHS {SUBMIT ANNEX-III) 10. BANKERS DETAILS NAME OF BANK ‘ADDRESS ‘ACCOUNT NO vua GU vil ESANNO A YEST], DESIGNATIONOF: +, 12. WHETHER IN OCCUPATION OF GOVT RENT DEMAND AUTH ACCOMODATION 32, MARITALSTATUS Ano Aves, No OF CHILDREN, 13, DECLARATION OF HOME TOWN 14, MISCIIF ANY) 15, SPECIMEN SIGNATURES L 2 3, NOTE: Attach Attested Photocopy of Latest Pay slip SIGNATURE NAME DESIGNATION BN/UNIT/HQ STS, BSF ACADEMY TEKANPUR ATTESTED poe veanmncavwiu Vihereby declare that duty pay last drawn by me at the rate of Rs in the scale of from . Lalso declare that deduction and recoveries to be made from my pay till as per details below: DEDUCTION: PROVIDENT FUND, Subscription Account No Maintained by pu Premium Schedule O--Yearly RECOVERIES: Motor Cycle/Car Advance ‘Any Other House Building Advance Total Amount Monthly Recovery House Building Advance * (GP Fund) Total Amount Monthly eee Signature Designation : HO BSF ACADEMY Tekanpur vearnicu witthu eeeNOMINATION FOR BENEFITS UNDER CGEGIS (When the Govt Servant has a family and wishes to nominate one member or more than one members thereof } TTrominate the parsons mentioned below who is/are memberla] f my faly and confer on m/ther the right wo recsive tothe extent seid below | | and amount chat may be sanctioned by the Central Govt under the Contra Government Emaloyees Group Insurance Scheme 1986 In the event of my |_stalelag the age of superannuatlon may main upon at my death NAME ANDADDRESS OF | RELATIONSHIP | SHARE TO BEPAID | CONTINGENCIES | WAME, ADDRESS AND RELATIONSHIP OF THE PERSON TO NOMINEE wintcovr ToEACH TONTHE | WHOM THE RIGHTR OF THE NOMINATION SHALL PASS IN THE | SERVANT HAPPENING OF _| EVENT OF HS PERMANENT DECEASING THE GOV" SERVANT. | WHICH THE | NOMINATION HALL ezcome [NAME ADDRES EATON | wvauo. NOTE: The Govt Servant should drawa line across the blank space after his/her last entry to prevent insertion after he/she has signed. Date Jere" at BSF Academy Tekanpur. ‘wrTness: ‘Signature 3, NAME: 2 NAME: Name of Govt Servant Scanned with C