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Format of

GAP CERTIFICATE
(for candidates who were not studying in any institution after completion of the qualifying Examination)

This is to certify that Shri/Smti_____________________________________________________

Son/daughter of Shri/Smti/Late ____________________________________________________

An inhabitant of village/town____________________________ Mouza____________________

P.O.___________________ P.S.________________________ District_____________________

State_____________________ is not involved in any unlawful activities since completion of his

HS/ 12th Standard, i.e, w.e.f.____/____/____ till date. This certificate shall be applicable for
educational purpose only.

Date: ……………………………………..

Signature: ___________________________

(Office Seal) Name: ……………………………………………....

Notary/Ward Member of Municipality


Or GP/ Officer In-Charge of PS
(Officer’s Seal)

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