MEDICAL CERTIFICATE

I hereby certify that I have examined Shri / Ms ………………………

………………..………………………….. a candidate for employment in the Intelligence
Bureau, Government of India and cannot discover that he / she has any disease
(communicable or otherwise), constitutional weakness or bodily infirmity except
……………………………………. and do not consider that a disqualification for employment
in the Office of the Director, Intelligence Bureau, New Delhi.

2. Shri / Ms ………………………………………… is fit / unfit for outdoor work at high

altitude and has passed all the tests prescribed in the standard of fitness required for
appointment to the rank of ACIO-II/Exe in the Intelligence Bureau.

3. Shri / Ms ……………………………………………’s age according to his statement is

……………….years and appears about ………………… years.

4. Shri / Ms ……………………………………. has been examined as per the standard of

fitness prescribed by the Intelligence Bureau (MHA) (given overleaf).

----------------------------
(Signature of Medical Authority)
Designation
(Rubber Stamp)

-----------------------------
(Signature of Candidate/Examinee)

Place :
Date :
Encl. : Candidate’s statement and declaration about standard of fitness (over-leaf)

Photograph of the Candidate to be

attested by the Medical Authority
STANDARD OF FITNESS REQUIRED FOR APPOINTMENT TO THE RANK OF ACIO-
II/Exe IN THE IB

(A) A candidate must be in a good mental and bodily health and free from any physical
defect likely to interfere with the efficiency performance of the duties of his
appointment. He should have the required standard of health to enable him to work
in the harsh climate at places of high altitude.

Standard of distant and near vision with or without glasses.

i) Distant Vision Near vision
Better Eye Worse Eye Better Eye Worse Eye
6/9 6/9 0.6 0.8
OR
6/6 6/12
ii) When the age of the candidate at the time of first appointment is 25 years or
more the corrected visual acuity is reduced by one step i.e.
6/12 6/12
OR
6/9 6/18

iii) Colour vision normal.

iv) Any organic disease or a progressive refractive error which is likely to result in
lowering the visual acuity should be considered a disqualification.

v) One eyed persons are regarded as Unfit.

(B) Blood Pressure: 15-25 years of age 100 plus the age is average. Over 25 years of
age 110 plus half the age is satisfactory

(C) Urine Examination should conform to the standard for Medical fitness.

(D) Candidate’s hearing in each ear should be good and there should not be any sign of
disease of the ear.

(E) Candidate’s speech, teeth should be in order, chest well formed and expansion
sufficient, heart and lungs, limbs hand and foot well formed.

(F) Candidate must not suffer from any inveterate skin disease or have any congenital
defect.

(G) Candidate must not bear traces of acute or chronic disease pointing to an impaired
constitution.

(H) Candidate must be free from communicable disease.

(I) Candidate must clear following test which are required for high altitude training

i) HB, TCL, DCL, ESR

ii) Blood Sugar fasting- post prandial

iii) Blood urea

iv) X-Ray Chest PAV view

v) ECG
 CANDIDATE’S STATEMENT AND DECLARATION

The candidate must make the statement required below prior to his medical examination and must sign the
declaration appended hereto. His attention is specially directed to the warning contained in the Note below :-
State your name in full _______________________________________________________
(in Block letters)
State your age & place of birth_________________________________________________

(a) Have your ever had smallpox, intermittent or any other fever, enlargement of
suppuration of glands, asthma, heart disease, lung disease, fainting attacks,
rheumatism, appendicitis, spitting of blood.

(b) Any other disease or accident requiring confinement to bed and medical and
surgical treatment

When were you last vaccinated _________________

Have you or any of your near relations been afflicted with consumption, scrofull,
gout, asthma, fits, epilepsy or insanity?

Have you suffered from any form of nervousness due to overwork or any other
cause?

Have you been examined and declared unfit for Govt. service by a Medical
Officer/Medical Board within the last 3 years?

Furnish the following particulars concerning your family

Father’s age if living Father’s age at death and Mother’s age if living Mother’s age at death
and state of health cause of death and state of health and cause of death

No of Brother living, Nos. of Brothers dead, No of Sister living, the Nos. of Sister dead, their
the state of health their ages at death and state of health ages at death and cause
cause of death of death

I declare that all the above answers are true and correct to the best of my knowledge and belief;
I also solemnly affirm that I have not received a disability certificate pension on account of any disease or
any other condition.

Candidate’s Signature

Signed in my presence

Signature of Medical Officer (with Stamp)

Note: The candidate will be held responsible for accuracy of above statements. Willful suppression of
any information will incur the risk of losing appointment or forfeiting all claims to superannuation
allowances and gratuity.
 DECLARATION

Under Para 3(ii) of the appointment letter,

I, Shri ______________________________ declare as under :-

i) That I am a bachelor/widower/widow

ii) That I am married and have only one wife/husband living

iii) That I am married and have more than one wife/husband.

I request that in view of the reasons stated below I may be granted exemption from
the operation of restriction on the recruitment to service of a person having more than one
wife living.

I solemnly affirm that the above declaration is true and understood that in the event
of the declaration found to be incorrect after my appointment, I shall be liable to be
dismissed from service.

Signature and name _____________________

(Name in Block Letters)

Reasons :

Dated :

Form of Oath of allegiance for Indian Nationals

I,
___________________________________________________________________ to
swear that I will be faithful and bear true allegiance to India and to the Constitution of India
as by law established and that I will carry out the duties of my office loyally, honestly and
with impartially.

Signature of the candidate

Dated :
CERTIFICATE OF CHARACTER
 Certified that I know Shri/Ms ____________________________________________
s/o
__________________________________________________r/o_____________________
_________________________________________________________________________
________________________________________for the last ______________ years
_________ months and to the best of my knowledge and belief he/she bears reputable
character and has no antecedents which render him/her unsuitable for Govt. employment.

2. Shri/Ms ______________________________________________ is not related to

me.

Signature

Name :

Designation :
(Office address with rubber stamp)
Place :
Dated :

CERTIFICATE OF CHARACTER

Certified that I know Shri/Ms ____________________________________________

s/o
__________________________________________________r/o_____________________
_________________________________________________________________________
________________________________________for the last ______________ years
_________ months and to the best of my knowledge and belief he/she bears reputable
character and has no antecedents which render him/her unsuitable for Govt. employment.

2. Shri/Ms ______________________________________________ is not related to

me.

Signature

Name :

Designation :
(Office address with rubber stamp)
Place :
Dated :
 SURETY BOND

KNOW ALL MEN BY THESE PERSONS THAT WE (1) Shri

_______________________________s/o
Shri_____________________________________________ resident
of_______________________________________________________________________
______________________________________________________(give full and complete
address) (hereinafter called the ‘CANDIDATE’) and (2)Shri
____________________________________ s/o Shri__________________________
r/o__________________________________________________-_ (give complete and full
address) (Hereinafter called the Surety on his behalf) and do hereby jointly and severely
bind ourselves and our respective heirs, executors and administrators to pay to the
PRESIDENT OF INDIA (Hereinafter call the ‘GOVERNMENT’ which expression shall include
his successor in office and assignment) on demand the sum equal to three months pay and
allowances or the cost of training imparted to him/her in the IB which ever is higher on
account of the candidate having been placed on training as (3) ACIO-II/Exe from (4)
__________________ (the date of training) to _____________________ (5) with service
liability for a period of five years at the cost of GOVERNMENT OF INDIA.

Dated this __________ day of ____________ two thousand _____________.

Whereas the candidate has been selected by the Joint Deputy Director, Intelligence
Bureau on behalf of the Government for appointment to the post of ACIO-II/Exe (Group-C
service) in the ‘INTELLIGENCE BUREAU’ and has been placed on training in consideration
of the candidate and the SURETY agreeing (which they have done verbally and hereby
confirmed by signing before those present) to the executing of this BOND.

Now the condition of the above written obligation is that in the event of the candidate
Shri__________________ not observing and not performing the terms of service as laid
down in Memo No.56/Estt(G-1)/2018-_________dated ________ (enclosed hereto) which
the candidate hereby accepts and not observing and not performing the regulations for the
time being in force for Group-C service officers of the INTELLIGENCE BUREAU (the
decision of the Government in that behalf shall be final), and the candidate resigning or
leaving the service during the period he is undergoing training except with the approval of
the DIRECTOR, INTELLIGENCE BUREAU on account of resignation/any other reason,
he/she and or the Surety shall forth refund on demand to the Govt. of India a sum equivalent
to his/her 3 months’ salary (pay plus DP plus dearness allowance) or at any time within a
period of the FIVE YEARS after completion of the training, the candidate and/or the Surety
shall forthwith refund on demand to the Govt. of India the sum of Rs.1,50,000/- (Rupees One
Lakh & Fifty Thousand) only on account of the candidate having been placed on training at
cost of the Govt. of India. (the decision of the DIB as to
whether the candidate has or has not performed and observed or not observed the
obligation, stipulations provisions and conditions herein before recited in the agreement shall
be final and binding on the candidate and his Surety).
And upon the bounded candidate Shri (6)
____________________________________ and/or Shri (7)
__________________________ surety aforesaid making such refund, the above written
obligation shall be void and no effect, otherwise it shall be and remain in force and virtue.
Provided always that the liability of the Surety hereunder shall not be impaired or
discharged by reasons of the Govt. or of any person authorized by them (whether with or
without the consent or knowledge of the Surety) nor shall it be necessary for the
Government to sue the said candidate before suing the above bounded surety Shri (8)
_______________________________ for the amount due hereunder.

The Government of India have agreed to bear the stamp duty payable on this Bond.

(Signature of the Candidate)

(9) Signed and delivered by the above Candidate in the presence of (signature, Names
and addresses of two witnesses for the candidate).

1. ______________________

2. ______________________

Signed and delivered by the Surety above named person in the presence of
(signatures, names and addresses of two witnesses for the surety).

1. _______________________

2. _______________________

_______________

(Signature of Surety)

Accepted (for and on behalf of the PRESIDENT OF INDIA)

 Guidelines for filling up the Surety Bond

(1) & (6) write the name of the candidate.

(2), (7) & (8) write the name of the person who is standing as Surety of the Candidate.

(4) write the date of training.

(9) write the names of signatures of two persons who stood witnesses to signatures of the candidate and two
persons of his surety. Four persons who will stand witness (2 for the candidate and 2 for surety) should be
different persons. Their names and residential addresses should also be given on the Surety Bond in the space
provided for it.
 INSTRUCTIONS FOR CANDIDATES JOINING IB AS ACIO-II/Exe

A. ARRIVAL AND REPORTING

The trainees must report their arrival at the Training Centre on the date mentioned in the offer
of appointment.
After their arrival at the Training Centre, they should report to the Course officer who will give
them further information and instructions about their boarding and lodging etc.

1. All the trainees must bring with them one of the following Identification documents :

(i) Citizen I/Card (Aadhar Card) (ii) Passport

(iii) Voter I/Card (iv) Photo I/Card of employer, if any.

2. Candidate should come alone as no family member(s) minor/major would be allowed entry
inside the campus with the candidate.

3. The training involves strenuous physical exercise including Mountaineering, hence, he/she must
ensure that he/she is able to do these exercise without any risk.

B. ACCOMMODATION
Every trainee will be allotted accommodation in the Hostel by the Course Officer and they will
occupy the rooms allotted to them. Subject to the number of trainees and availability of space, the
trainees will be given single seated or multi seated rooms. Each trainee will be provided with a cot, a
chair, a writing table and a wardrobe. No trainee will be allowed to bring any furniture, electric
gadgets etc. with him/her.

C. MESS
A cooperative Mess is run in the Training Centre on no profit-no-loss basis by the trainees
themselves. All the trainees will compulsorily dine in the Mess and will share the cost of food service
boys etc. The trainees will be required to pay for their personal expenditure, charges for washer man,
cobbler and other miscellaneous pocket expenses.

D. PAY & ALLOWANCES

No advance pay, travelling allowance or any other allowances will be paid by the Training
Centre. All the trainees are advised to bring at least Rs.13000/- with them in cash to meet their initial
personal expenditure and Mess charges till the pay and allowances admissible are disbursed to them.
They should also open SB A/C in SBI and submit their A/C No. on arrival at the training centre. They
should also bring with them cheque book of their SBI bank account.

E. CLOTHING & EQUIPMENT

(A) All the trainees must bring with them the following articles of clothing at the Time of their
reporting at the training centre:-
(i) Mosquito Net : One number
(ii) White Bed Sheet : Two number

(B) The trainees should also bring with them the following items:-
(i) Two full sleeves white shirts and one white full pant/trouser;
(ii) A plain tie, preferable of navy blue colour or any other tie in their possession;
(iii) A pair of black leather shoes with lace and 5 eyes (‘Oxford’ model of Bata) and
(iv) Swimming costumes

(C) (i) No arms will be brought by the candidates.

(ii) Simple mobile phone without having Camera facility and blue tooth would be allowed in
the hostel. Trainees should not bring laptop and valuable items along with them.