TV 5200 1340954926152PWD 2012

1

GOVERNMENT OF INDIA

MINISTRY OF RAILWAYS

SOUTHERN RAILWAY

www.sr.indianrailways.gov.in

RECRUITMENT TO POSTS IN SOUTHERN RAILWAY FOR THE 3% OF VACANCIES RESERVED FOR PERSONS WITH

DISABILITIES (PHYSICALLY HANDICAPPED QUOTA) UNDER SPECIAL RECRUITMENT DRIVE

Employment Notification No. SR/SRD/PWD/01 / 2012 dated 01.07.2012

Closing Date & Time for receipt of applications

01-08-2012 at

18.00 hrs.

Closing Date & Time for residents of Assam, Meghalaya, Arunachal Pradesh,

Mizoram, Nagaland, Tripura, Sikkim, Jammu & Kashmir, Lahaul & Spiti Districts

and Pangi sub-division of Chamba district of Himachal Pradesh, Andaman &

Nicobar and Lakshadweep islands and candidates residing abroad.

16-08-2012 at

18.00 hrs.

Applications are invited in the prescribed format from the Persons With Disabilities (PWD)

(Physically challenged/handicapped) Citizens of India and from such other persons declared eligible

by Ministry of Home Affairs, Government of India to fill up 195 vacancies from Open Market to the

post listed at Para 2 in Southern Railway (S.Rly.), Chennai.

Abbreviations used in this notification:

SR

Southern Railway

Rly.

Railway

S&T

Signal & Telecommunication

SC

Scheduled Caste

OBC

Other Backward Class

ST

Scheduled Tribe

PWD

Persons with Disabilities

SRD

Special Recruitment Drive

OA

One Arm

OL

One Leg

BL

Both Legs

OAL

One Arm and One Leg

MW

Muscular Weakness

VH

Visually Handicapped

HH

Hearing Handicapped

LV

Low Vision

OH

Orthopaedically Handicapped

B

Blind

1

PERSONS WITH DISABILITIES

1.1

DEFINITIONS OF DISABILITIES: Definitions of categories of disabilities for the purpose of

recruitment are given below.

1.2

VISUALLY HANDICAPPED

(a) Blindness: “Blindness” refers to a condition where a person suffers from any of the following

conditions, namely:- (i) total absence of sight, or (ii) visual acuity not exceeding 6/60 or 20/200

(snellen) in the better eye with correcting lenses; or (iii) limitation of the field of vision subtending an

angle of 20 degrees or worse;

(b) Low vision: “Persons with low vision” means a person with impairment of visual functioning

even after treatment or standard refractive correction but who uses or is potentially capable of using

vision for the planning or execution or a task with appropriate assistive device.

1.3

HEARING HANDICAPPED

Hearing Impairment: “Hearing Impairment” means loss of 60 decibels or more in the better ear in

the conversational range of frequencies.

1.4

ORTHOPAEDICALLY HANDICAPPED

(a) Locomotor disability: “Locomotor disability” means disability of the bones, joints or muscles

leading to substantial restriction of the movement of the limbs or any form of cerebral palsy.

(b) Cerebral Palsy: “Cerebral Palsy” means a group of non-progressive conditions of a person

characterised by abnormal motor control posture resulting from brain insult or injuries occurring in

the pre-natal, peri-natal or infant period of development.

(c) All the cases of orthopedically handicapped persons would be covered under the category of

“Locomotor disability” or “Cerebral Palsy”.

1.5

DEGREE OF DISABILITY FOR RESERVATION: Only such persons would be eligible for

reservation in services/posts who suffer from not less than 40 percent of relevant disability.

Candidates should submit a Disability Certificate in the prescribed format (Annexure–V)

(‘Proforma’ is available in the web site also) issued by the competent authority and submit a copy

of the same along with the Application Form.

2

1.6

COMPETENT AUTHORITY TO ISSUE DISABILITY CERTIFICATE: The competent authority to

issue Disability Certificate shall be a MEDICAL BOARD duly constituted by the Central or State

Government. The Medical Board shall consist of at least three members out of which at least one

shall be a Specialist in the particular field for assessing locomotor / cerebral / visual / hearing

disability, as the case may be.

1.7

SCRIBE FOR VISUALLY HANDICAPPED CANDIDATES: Visually Impaired Candidates / those

candidates whose writing speed is affected by Cerebral palsy can avail the assistance of SCRIBE

for writing answers on their behalf. For engaging the SCRIBE, the candidate will have to suitably

inform along with the application as per Annexure-VI (‘Proforma’ is available in the web site also).

The engagement of SCRIBE will be subject to the following conditions.

(a) The candidates will have to arrange their own SCRIBES at their own cost during the

examination. Separate Admit cards will be issued to the SCRIBES accompanying the Visually

Handicapped candidates. Admit card should contain the particulars and photograph of the

SCRIBE duly signed by him/her.

(b) The academic qualification of the SCRIBE should be one grade below the qualification

prescribed for the post for which recruitment is being made.

(c) The SCRIBE can be from any academic discipline if the recruitment is for general post. If the

recruitment is for a specialist post, he/she should be from a discipline different from that of the

candidate.

(d) The candidates as well as the SCRIBE will have to give a suitable undertaking (Annexure-VI)

(‘Proforma’ is available in the web site also) confirming that the SCRIBE fulfils all the stipulated

eligibility criteria for a scribe as mentioned above. In case, it transpires later that he / she did

not fulfil any of the laid down eligibility criteria, there has been suppression of material facts, the

candidature of the applicant will stand cancelled irrespective of the result of the examination.

The visually handicapped candidates shall be responsible for any misconduct on the part of

SCRIBE brought by him/her.

The undertaking, as given in the Annexure-VI, should be submitted by the visually

handicapped candidates / candidate whose writing speed is affected by Cerebral palsy, along

with his / her Application Form.

(e) Candidates availing the assistance of a SCRIBE shall be eligible for extra time of 20 minutes

for every hour of the examination.

1.8

All one eyed candidates and VH candidates whose visual degree of disability is less than 40% shall

not be considered as visually handicapped person and the provision of engaging SCRIBE shall not

be applicable to them.

1.9

The disability certificate should be valid for a period of 5 years for those whose disabilities is

“Temporary”. The Medical Board should indicate the period of validity of the certificate, where there

are chances of variation in the degree of disability. For those with permanent disability, the

disability can be shown as “Permanent”.

1.10

After qualifying in the Written Examination, candidates will have to pass the Medical Examination

prescribed for Persons with Disabilities before empanelment.

2. VACANCY POSITION:

Cat.

No.

Category

nos.

Name of the category

Examination Day – 1

Examination Day -4

A

2

JUNIOR ENGINEER /ELECTRICAL

I

13

TECHNICIAN / Grade III/ ELECTRICAL

6

JUNIOR ENGINEER / DRAWING

/ELECTRICAL

14

TECHNICIAN / Grade III/ C&W /FITTER

3

JUNIOR ENGINEER /WORK SHOPS

15

TECHNICIAN / Grade III/ DIESAL/ MECHANIC

4

JUNIOR ENGINEER /CARRIAGE &WAGON

16

TECHNICIAN / Grade III/DIESAL / ELECTRICAL

5

JUNIOR ENGINEER /DEISAL MECHANIC

17

TECHNICIAN / Grade III/ CARPENTER

7

JUNIOR ENGINEER /P.WAY

18

TECHNICIAN / Grade III/WELDER

8

JUNIOR ENGINEER / DRAWING /Engg.

19

TECHNICIAN / Grade III/ MECHINIST

9

JUNIOR ENGINEER /WORKS/Engg.

20

TECHNICIAN / Grade III/PAINTER

10

JUNIOR ENGINEER / TRACK MECHINE

21

TECHNICIAN / Grade III/ELE/FIT/ ELECTRICAL

Examination Day -2

22

TECHNICIAN / Grade III /MECHANICAL /FITTER

B

1

SECTION EENGINEER/DRAWING /ENGG

23

TECHNICIAN / Grade III/TURNER

C

30

TEACHER/ Grade I / PHYSICS

24

TECHNICIAN / Grade III/FITTER / WORK SHOP

D

31

CHEMICAL & METALLURGICAL

ASSISTANT/ Grade I

26

TECHNICIAN /Signal / Grade III

E

33

STAFF NURSE

27

TECHNICIAN /Telecommunication / Grade III

F

34

HEALTH & MALARIA INSPECTOR

J

25

TECHNICIAN /Signal / Grade II

G

35

PHARMACIST / Grade III

Examination Day -5

Examination Day -3

K

29

TICKET COLECTOR

H

11

ASSISTANT STATION MASTER

36

JUNIOR STENO

12

GOODS GUARD

37

JUNIOR CLERK

28

ENQUIRY-CUM-RESERVATION CLERK

39

ACCOUNTS CLERK

32

JUNIOR ACCOUNTS ASSISTANT

38

SENIOR CLERK

Note: - Candidates please refer to instructions in Para 17.2 with regard to Grouping and

submission of applications

3

ELIGIBILITY CRITERIA

3.1

EDUCATIONAL QUALIFICATION:

a) For Technician categories, no other qualifications including Diploma in Engineering will

be accepted as an alternative qualification.

b) Act apprenticeship/ITI certificate must be approved by SCVT/NCVT.

3.2

Age shall be reckoned as on 01-07-2012

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3.3

AGE RELAXATION : OBC : 3 YEARS AND SC/ST : 5 YEARS in addition to the age

limitation fixed under para 2 above against each category.

3.4

Proof of Age: The candidate shall enclose a copy of any of the following documents in support

of Date of Birth which shall contain the Date of Birth, along with the Application Form.

(i) Birth Certificate issued by Municipal authorities.

(ii) Transfer Certificate issued by School/College authorities.

(iii) Matric / SSLC / Senior Secondary/HSC Mark sheet

4

PROCEDURE FOR RECRUITMENT:

4.1

The recruitment procedure consists of Written Examination, Verification of Records and

Medical Examination.

a) For Assistant Station Master (Cat. No.11), there will be an Aptitude Test after written

examination.

b) For Teacher Gr.I (Cat. No.30) there will be an interview after the written examination.

4.2

WRITTEN EXAMINATION: The Duration of the Written Examination shall be 2 (TWO) Hours.

The Question Paper for the Written Examination shall be based on appropriate level of

Educational Qualification prescribed against each post consisting of 150 Multiple Choice

(four) objective type questions aimed to assess the General Knowledge / Awareness, General

Arithmetic, Reasoning and common technical questions pertaining to the group concerned.

4.3

The question paper shall be printed in Hindi, Urdu & English and also in the Regional

Language(s).Tamil, Malayalam, Telugu and Kannada.

4.4

Negative marking: There will be negative marking for wrong answers. 1/3rd mark shall be

deducted for each wrong answer i.e. one mark shall be deducted for every 3 wrong answers.

4.5

Among the qualified candidates, the candidates who submit the original Certificates /

Documents in support of their eligibility during Document Verification shall alone be called for

Medical Examination.

5

MEDICAL EXAMINATION:

5.1

a) Clearing the Medical Examination is mandatory. Only those who have cleared the Medical

Examination successfully will be considered for inclusion in the Final Merit List to the extent of

vacancies available.

b) Candidates applying for Assistant Station Master (Cat. No. 11) will be required to submit a

medical certificate obtained from an eye specialist as per proforma given in Annexure-VII along

with application. (‘Proforma’ is available in the web site also)

5.2

MEDICAL CLASSIFICATION STANDARDS:

A – 2

Physically fit in all respects. Visual Standards – Distant Vision: 6/9, 6/9 without glasses

(no Fogging Test). Near Vision: Sn. 0.6, 0.6 without glasses.

A - 3

Physically fit in all respects. Visual Standards – Distant vision: 6/9, 6/9 with or without

glasses. Power of lenses not to exceed 2D. Near vision: Sn.0.6, 0.6 with or

without glasses.

B – 1

Physically fit in all respects. Visual Standards – Distant Vision: 6/9, 6/12 with or

without glasses. Power of lenses not to exceed 4D. Near Vision: Sn. 0.6, 0.6 with or

without glasses when reading or close work is required.

C – 1

Physically fit in all respects. Visual Standards – Distant vision: 6/12, 6/18 with or

without glasses. Near vision: Sn. 0.6, 0.6 with or without glasses when reading or

close work is required.

C – 2

Physically fit in all respects. Visual Standards – Distant vision: 6/12, Nil with or

without glasses. Near vision: Sn. 0.6 combined with or without glasses when reading or

close work is required.

Note: Details and criteria given above are indicative and not exhaustive. Other Medical Tests as required will also

be included / conducted. The above medical standards will be applied for PWD with conditions specified in

Para 1 above.

6

EXAMINATION FEE: NO EXAMINATION FEE IS REQUIRED

7

COMMUNITY CERTIFICATE :

7.1

SC/ST Candidates: Candidates claiming to belong to SC/ST communities are required to

submit Community Certificates from the competent authority in the prescribed format

(Annexure–II) (‘Proforma’ is available in the web site also) and enclose a copy of the same

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with the Application Form.

7.2

OBC Candidates: Candidates claiming to belong to Other Backward Classes are required to

submit Community Certificates from the competent authority in the prescribed format

(Annexure–III) (‘Proforma’ is available in the web site also) and submit a copy of the same

with the Application Form.

In addition, candidates belonging to OBC communities should specifically submit a declaration

of Non-Creamy Layer as in the format of Annexure–IV.

7.3

While there is no community reservation for the candidates in this Special Recruitment Drive, all

selected SC/ST & OBC candidates shall be charged only against relevant SC/ST & OBC

community Roster points of the concerned cadre Post Based Roster.

8

SERVING EMPLOYEES OF GOVERNMENT/ PUBLIC SECTOR UNDERTAKING:

8.1

A candidate serving under any Government or Public Sector Enterprise/Undertaking, including

Railways should either apply through proper channel or directly duly enclosing the “NO

OBJECTION CERTIFICATE” from the employer.

8.2

An advance copy of such application, complete in all respects may also be sent super-scribing

on the top of the envelope & application “ADVANCE COPY” so as to reach the address

mentioned below before the closing date and time specified. However, the application ‘Through

Proper channel’ should reach within 15 days from the closing date, for which the entire

responsibility rests with the candidate.

9

CANDIDATES BELONGING TO ANDAMAN & NICOBAR and LAKSHADWEEP ISLANDS.

9.1

Candidates belonging to Andaman & Nicobar and Lakshadweep Islands may be allotted

Examination Centre in these Islands provided sufficient number of eligible candidates have

applied.

10

GENERAL INSTRUCTIONS:

10.1

The candidates should carefully read all the instructions before applying for the post.

10.2

The candidates applying in response to this Notification shall ensure that he / she fulfil all eligibility

conditions at the time of submission of application including the eligible disabilities to the post

concerned as mentioned in Para 2.

10.3

The number of vacancies shown in this Notification is provisional and the same is liable to

increase or decrease or even become NIL, depending upon the actual needs of the

administration.

10.4

The candidates’ admission at all stages of recruitment will be purely provisional, subject to satisfying the

prescribed eligibility conditions to the post concerned.

10.5

The Railway working involves working near moving of trains/Machineries which requires safety of

Personnel/Persons/Passengers. Therefore in some categories like Assistant Station Master/

Goods Guard, the PWD candidates when recruited can be assigned jobs only in such places/

Cadre duly taking into account of safety aspects.

10.6

Certificates in languages other than English or Hindi should be accompanied by an attested

translation in English/Hindi.

10.7

Mere issue of Call Letter / Hall Ticket to the candidate will not imply that his or her candidature

has been finally cleared by the recruitment process of Southern Railway, Chennai.

10.8

The Southern Railway, Chennai, is free to reject any application not fulfilling the requisite

eligibility conditions and criteria, at any stage of recruitment. If appointed erroneously, such

candidate’s services shall be summarily terminated without any notice.

10.9

Southern Railway, Chennai, reserves the right to alter the stages of examinations / Re-

Examination or cancel part or whole of any recruitment process at any stage, without assigning

any reason.

11

Travel Expenses: SC/ST candidates alone will be issued with II-Class Free Pass for their

journey from their nearest Railway Station to the venue of Written Examination. Others will have

to make their own arrangements for coming to the venue of Written Examination and

Verification of Certificates. No reimbursement of travel expenses will be made on any account.

12

Accommodation: All the candidates will have to make their own arrangements for their

accommodation while attending Written Examination and other stages of recruitment process.

13

Change of address: If there is any change in address of the candidate, the candidate should

ensure in his / her own interest to arrange with Post Office concerned for re-direction of the

communications from old to new address at the address given in the Application.

14

In the interest of Administrative exigencies, selected candidates will be posted

9

anywhere, in any Post / Category of Southern Railway to which selected, after successful

completion of training, wherever prescribed. The decision of the Southern Railway

administration is final.

15

Candidates who have been debarred from appearing in any of the Railway Recruitment Board /

Railway Recruitment Cell exams should not apply unless the debarment period expires before

the closing date.

16

MISCONDUCT:

16.1

Candidates are warned that they should not furnish any particulars that are false or suppress

any material information while filling up the Application Form.

16.2

Candidates shall not bring or attempt to bring any political or other influence to further his/her

interest in respect of recruitment.

16.3

Misconduct on the part of the candidate at any part of the recruitment process is strictly

prohibited.

16.4

Indulgence in any such practice will be viewed very seriously and their candidature shall

be rejected without any notice.

16.5

Candidates may note that if they are found guilty of any one of the following during /

after the recruitment process, his / her candidature / appointment is liable to be

cancelled / terminated without any notice at any stage. Further, such candidates are

liable for criminal prosecution. a) .

a) Submitting fabricated / forged certificates or documents which have been tampered for

getting selected or to avail free travel facilities

b) Using unfair means during the recruitment process.

c) Impersonating or resorting to impersonation by any person.

d) Misbehaving with the officials during the recruitment process

e) Taking away the Question Paper or Answer Sheet from the Examination hall.

f) Obtaining support / help for his / her candidature by any means.

16.6

It will not be possible to entertain any enquiry or correspondence while the recruitment process

is going on.

16.7

Decision of Southern Railway, Chennai, in all matters relating to recruitment will be final

and binding on the candidates.

16.8

All the candidates should send their application well in advance before the closing date. The

Southern Railway, Chennai, will not be responsible for any postal delay/wrong delivery for

whatsoever reason, at any stage of the recruitment process.

17

HOW TO APPLY:

17.1

Application Format in Annexure-I published along with this Employment Notification alone

should be used. Application Format can also be downloaded from the website of this

office.

17.2

ONLY ONE APPLICATION: Each candidate should send only one Application for one group of

posts mentioned in Para 2.1. and indication shall be made to which post he/she applies in the

relevant columns in the Application. Candidates desirous of applying for more than

one group should submit separate application.

a) Candidates applying for more than one group in a single application will not be considered

and will be rejected.

b) Candidates sending multiple applications for each posts in a group also will not be

considered will be rejected.

c) Even if such a candidate gets selected inadvertently, he/she will not be offered appointment

later on.

17.3

ENCLOSURES: Photo copies of the certificates / documents are to be enclosed along with

the Application Form, in the order specified below. Original certificates should not be

enclosed.

(i) Application Form and applicable Annexures

(ii) Copy in proof for Date of Birth

(iii) Copy of Educational Qualifications

(iv) Copy of Community Certificate, in case of SC or ST or OBC.

(v) Copy of Physical Disability Certificate.

10

(vi) Filled in proforma for engaging Scribe, in case of Visually Handicapped persons.

(vii) Government Servants and staff of Quasi administrative offices of Railway organisations –

Bonafide Certificate from the authority giving the length of regular service, etc

(viii) ‘No Objection Certificate’ from the employer, if already employed.

17.4

Thumb impression is must. Applicants must sign in the application except in capital letters and

affix their left hand thumb impression (right hand thump impression for those not having left

thumb). Thumb impression must be clear and complete. Thumb impression is not blurred or

smudged. Application without thumb impression will be rejected.

17.5

Application complete in all respects along with all the enclosures in a sealed/closed cover super

scribed as under:

“APPLICATION FOR RECRUITMENT TO POSTS IN SOUTHERN RAILWAY AGAINST

3% VACANCIES RESERVED FOR PERSONS WITH DISABILITIES

(PHYSICALLY HANDICAPPED QUOTA) UNDER SPECIAL RECRUITMENT DRIVE”

shall be sent by Ordinary Post, so as to reach at the following address on or before the date

indicated in the Notification.

“The Deputy Chief Personnel Officer / Recruitment,

Railway Recruitment Cell, Southern Railway,

No.5, 3rd Floor, Dr. P.V. Cherian Crescent Road,

Egmore, Chennai – 600 008.”

17.6

One cover should contain only one Application Form with enclosures.

17.7

Filled in applications can also be directly dropped in the box kept in the above premises on or

before the closing date.

17.8

Invalid applications: Candidates must ensure that their application is complete in all respects.

Applications which suffer from the following deficiencies will be summarily rejected.

(a) Application not in the prescribed Format / missing columns.

(b) Incomplete or illegible applications.

(c) Unsigned applications or with signatures with capital letters or with different

signatures at different places.

(d) Applications without Left or right hand Thumb Impression.

(e) Applications of under-aged or over-aged candidates.

(f) Applications without copy of Proof for Date of Birth.

(g) Applications without copies of Educational Qualifications.

(h) Submitting more than one Application for one group or one application with more

than one group mentioned or applying for each post in a group.

(i) Applications received after the closing date & time.

(j) Application without recent colour photo

(k) Application affixed with xerox photo

(l) Application without declaration in the appropriate place as directed.

(m) Application without applicable Annexures.

(n) Application without proof of community certificate in case of SC/ST/OBCs

17.9

For any legal action arising out of this Employment Notice, the jurisdiction shall be under the

Honourable Central Administrative Tribunal/ Madras Bench or Honourable Central

Administrative Tribunal/ Ernakulam Bench.

17.10

In case of dispute, English version of the Employment Notification will be treated as valid.

17.11

Candidates are advised to periodically check the website www.sr.indianrailways.gov.in for

the latest information about this Recruitment.

18

BEWARE OF JOB RACKETEERS.

1. All recruitments by Southern Railway are made purely on merit.

2. Candidates attempting to use influence or unfair means shall be disqualified.

3. Southern Railway neither conduct any coaching classes nor recommend any books for

reference nor have authorised any persons / agencies to recruit or train on its behalf.

DEPUTY CHIEF PERSONNEL OFFICER/WELFARE

SOUTHERN RAILWAY ANNEXURE - 1

APPLICATION FOR RECRUITMENT UNDER SPECIAL RECRUITMENT DRIVE

FOR PERSONS WITH DISABILITIES

EMPLOYMENT NOTICE NO. SR/SRD/PWD/1/2012

PLEASE FILLUP THE APPLICATION IN CAPITAL LETTERS IN OWN HAND

WRITING

All application must be submitted in A4 size 80 GSM paper(Bond paper)

For Office use only

Control No.

Roll No.

1.Application for:

Group Code

Category No.(s)

Name of the post(s)

2. Name of the Candidate:

3. Fathers’ Name

4. Date of Birth (DD/MM/YYYY)

5. Community (Tick )

SC

ST

OBC

UR

7. Contact Telephone with STD code/ Mobile No.

8. Address for communication

P

I

N

9. Nationality

10. Religion

11. Sex (Tick )

12. Marital status

MALE

FEMALE

13. Nearest Railway Station

(in English only for issue of Free Railway pass for SC/ST candidates)

14. Visible Marks of Identifications( Moles etc. on your body)

a)…………………………………………………………………………………………………………………

b)…………………………………………………………………………………………………………………

15. Educational Qualifications:

a) Academic

Qualification

University/Board

Year of passing

subjects

% of Marks

SSC/10th Clas

Higher Secondary/XII

Degree

b) Technical

Diploma

Degree

Others

16. Regional language Question Paper required in(Tick)

17. Declaration by the Candidate: (Copy the passage in the box below in your own hand writing)

I hereby declare that all the particulars given above by me are true and to the best of my knowledge. I am aware that in the event

of any information furnished by me is found false/incorrect at any stage, my candidature will be rejected summarily and I am also

liable for criminal action

……………………………………………………………………………………………………………………………

Place:

Left or Right Hand Thumb Impression

Signature of the Applicant

Date:

Note:-Candidates desirous of applying for more than one group should submit separate application

Paste (do not pin or

staple) here your recent

colour passport size photo

of size 3.5 x 3.5 CM (the

colour photo should not

be more than 3 months

old)

Not to be attested

Signature of Candidate

6. Type of Physical Disability (Tick )

OH

VH

HH

OA

OL

BL

OAL

MW

LV

B

Tamil

Telugu

Malayalam

Kannada

ANNEXURE - II

FORM OF CASTE CERTIFICATE FOR SC/ST

(The Form of the certificate to be produced by Scheduled Castes & Scheduled Tribes candidates applying for

appointment to posts under the Govt. of India)

This is to certify that Shri/Smt./Kum* ……………………………………………………………………………………

Son/Daughter* of ………………………………………………….of Village/Town*…..………………………………

in District /Division *…………………………………………… of State/ Union Territory*……….…………….

belongs to the ………………………………………………………….…………Caste / Tribe* which is recognized

as a Scheduled Caste / Scheduled Tribe * under :

• The Constitution (Scheduled Castes) Order 1950*.

• The Constitution (Scheduled Tribes) Order 1950*.

• The Constitution (Scheduled Castes) (Union Territories) Order1951*

• The Constitution (Scheduled Tribes) (Union Territories) Order 1951*

(As amended by the Scheduled Castes and Scheduled Tribes Lists (Modification) Order, 1956, the Bombay Re-

organization Act 1960, the Punjab Re-organization Act, 1966, the State of Himachal Pradesh Act,1970, and the North

Eastern Area Re-organization Act, 1971, and Scheduled castes & the Scheduled Tribes Order (Amendment Act,

1976).

• The Constitution (Jammu and Kashmir) Scheduled Caste Order 1956@.

• The Constitution (Andaman and Nicobar Island) Scheduled Tribes Order 1959@ as amended by the Scheduled

Castes and Scheduled Tribes order (Amendment Act.) 1976@

• The Constitution (Dadra and Nagar Haveli) Scheduled Castes Order, 1962.

• The Constitution (Dadra and Nagar Haveli) Scheduled Tribes Order, 1962@.

• The Constitution (Pondicherry) Scheduled Castes Order, 1964@.

• The Constitution Scheduled Tribes (Uttar Pradesh) Order, 1967@

• The Constitution (Goa, Daman and Diu) Scheduled Castes Order,1968@.

• The Constitution (Goa, Daman and Diu) Scheduled Tribes Order, 1968@.

• The Constitution (Nagaland) Scheduled Tribes Order, 1970@.

• The Constitution (Sikkim) Scheduled Castes Order, 1978@.

• The Constitution (Sikkim) Scheduled Tribes Order, 1978@.

Shri/Smt/Kum*..………………………………. And / or his/her* family ordinarily reside(s) in village/town* ……………….

of*……………. ………………………………District/Division* of the State/Union Territory* of ……………………………

… Signature …………..……………………

** Designation *…………………………………

(with seal of office) State /Union Territory**

Place…………………

Date: ………………….

(*) Please delete the words which are not applicable.

@ Please quote specific Presidential Order.

Note : i) The term *Ordinarily reside(s)** used will have the same meaning as in section 20 of the Representation of

the Peoples Act, 1950.

**Officers competent to issue Caste/Tribe Certificates :

**District Magistrate/ Additional District Magistrate / Collector / Deputy Commissioner / Additional Deputy

Commissioner / Deputy Collector/ 1st Class Stipendiary Magistrate / City Magistrate / Sub Divisional Magistrate /

Taluka Magistrate / Executive Magistrate / Extra Assistant Commissioner. (Not below the rank of 1st class

Stipendiary Magistrate)./ Chief Presidency Magistrate / Additional Chief Presidency Magistrate/Presidency

Magistrate/Revenue Officers not below the rank of Tahsildar. / Sub Divisional Officer of the area where the candidate

and / or his /her family normally reside(s).

Note: ST candidates belong to Tamilnadu State should submit caste certificate ONLY from the REVENUE

DIVISIONAL OFFICER.

Annexure - III

OBC CERTIFICATE FORMAT

FORM OF CERTIFICATE TO BE PRODUCED BY OTHER BACKWARD CLASSES

APPLYING FOR APPOINTMENT TO POST UNDER THE GOVERNMENT OF INDIA.

This is to certify that Shri/Smt/Kum* .......................................................................................

Son/Daughter* of Shri…………………………………………………... .................................................... of

Village /Town .................................................................... District ............................... in

.............................

State belongs to .................................................. community which is recognized as backward class

under ………………………

(indicate the Sub Caste above)

1. Resolution No. 12011/68/93-BCC@dtd 10th September 1993, published in the Gazette of India-

Extraordinary Part-I, Section 1. No. 186 dated 13th September 1993.

2. Resolution No. 12011/9/94-BCC dated 19th October 1994, published in the Gazette of India-

Extraordinary Part-I, Section I. No. 163, dated 20th October 1994.

3. Resolution No. 12011/7/95-BCC dtd 24th May 1995, Published in the Gazette of India-

Extraordinary Part-I, Section I. No. 88 dtd 25th May 1995.

4. Resolution No. 12011/44/96-BCC dtd 6th December 1996, published in the Gazette of India-

Extraordinary Part-I, Section I. No. 210, dated 11th December 1996.

5. Resolution No. 12011/68/93-BCC, Published in Gazette of India – Extra Ordinary – No. 129,

dated the 8th July 1997.

6. Resolution No. 12011/12/96-BCC, Published in Gazette of India – Extra Ordinary – No. 164

dated the 1st Sept. 1997.

7. Resolution No. 12011/99/94-BCC, Published in Gazette of India – Extra Ordinary – No. 236

dated the 11th Dec. 1997.

8. Resolution No. 12011/13/97-BCC, Published in Gazette of India – Extra Ordinary – No. 239

dated the 3rd Dec. 1997.

9. Resolution No. 12011/12/96-BCC, Published in Gazette of India – Extra Ordinary – No. 166

dated the 3rd August 1998.

10. Resolution No. 12011/68/93-BCC, Published in Gazette of India – Extra Ordinary – No. 171

dated the 6th August 1998.

11. Resolution No. 12011/68/98-BCC, Published in Gazette of India – Extra Ordinary – No. 241

dated the 27th Oct. 1999.

12. Resolution No. 12011/88/98-BCC, Published in Gazette of India – Extra Ordinary – No. 270

dated the 6th Dec. 1999.

13. Resolution No. 12011/36/99-BCC, Published in Gazette of India – Extra Ordinary – No. 71

dated the 4th April 2000.

Shri/Smt/Kum*............................................................................................. and / or his/her family ordinarily

reside(s) in the ........................................ District of the .......................................................................State.

This is also to certify that he/she does not belong to the persons / sections (Creamy Layer) mentioned in

Column 3 (of the Schedule to the Government of India, Department of Personnel and Training O.M. No.

36012/22/93/Estt. (SCT) dated 08.09.1993) and modified vide Government of India, Department of

Personnel and Training O.M. No. 36033/3/2004/Estt.(RES). dated 09.03.2004.

Place:

Date: (with seal of office)

ANNEXURE -IV

Proforma for declaration to be submitted by Other Backward Class Candidates along with the

application while applying for the posts against Employment Notice

No……………………….………………………………of RRB ….………………………………………

DECLARATION

“I ……………………………..………son/daughter of Shri………..………………….. resident of

village/town/city ……………………… .district…………………… State…………………………

hereby declare that I belong to the ………………………………………(indicate your sub-caste)

community which is recognized as a backward class by the Government of India for the purpose

of reservation in services as per orders contained in Department of Personnel and Training

Office Memorandum No.36012/22/93-Estt.(SCT) dated 08.09.1993. It is also declared that I do

not belong to persons/sections (Creamy Layer) mentioned in column 3 of the Schedule to the

above referred Office Memorandum dated 08.09.1993 and its subsequent through O.M.

No.36033/3/2004-Estt.(Res.) dated 09.03.2004”

Place: Signature of the Candidate

Date: Name of the candidate

Annexure-V

FORM OF MEDICAL CERTIFICATE FOR PERSONS WITH DISABILITIES (PWD)

NAME AND ADDRESS OF THE INSTITUTE/HOSPITAL

Certificate No. ………………………… …………… Date : …………………..…………

DISABILITY CERTIFICATE

1. This is certified that Smt/Shri/Kum ……………….………………..…………………

son/daughter of Shri …………………………………………….…………………………

age ……….., sex Male/Female having identification marks as below

…………………………………………….…………………………………………………

is suffering from permanent disability of following category :

A. Locomotor or cerebral palsy:

(i) BL- Both legs affected but not arms.

(ii) BA- Both arms affected (a) Impaired reach

(b) Weakness of grip.

(iii) OL- One leg affected (right or left) (a) Impaired reach

(b) Weakness of grip Signature of candidate

(c) Ataxic in the above box below

(iv) OA- One arm affected (right or left) (a) Impaired reach the photograph

(b) Weakness of grip

(c) Ataxic

(v) BH- Stiff Back and hips (cannot sit or stoop)

(vi) MW- Muscular Weakness and limited physical endurance.

B. Blindness or Low Vision: (C) Hearing Impairment:

(i) B- Blind (ii) PB- Partially Blind (i) D- Deaf (ii) PD - Partially Deaf.

(Delete the category whichever is not applicable)

2. This condition is progressive/non-progressive/likely to improve/not likely to improve.

Re- assessment of this case is not recommended / is recommended after a period

of ………….. year …………. Months.

3. Percentage of disability in his / her case is ……. Percent.

4. Smt./Shri/Kum………………. meets the following physical requirement for discharge of

his/her duties.

(i) F-can perform work by manipulating with fingers Yes No

(ii) PP-can perform work by pulling and pushing Yes No

(iii) L--can perform work by lifting Yes No

(iv) KC-can perform work by kneeling and crouching Yes No

(v) B-can perform work by bending Yes No

(vi) S-can perform work by sitting Yes No

(vii) ST-can perform work by standing Yes No

(viii) W-can perform work by walking Yes No

(ix) SE-can perform work by seeing Yes No

(x) H-can perform work by hearing/speaking Yes No

(xi) RW-can perform work by reading and writing Yes No

(Signature of Doctor) (Signature of Doctor) (Signature of Doctor)

Name: Name: Name:

Registration No.: Registration No.: Registration No.:

Member Medical Board Member Medical Board Member Chairperson,

Medical Board

* Please delete the words which are not applicable

Place :

Date :

Counter Signature of the Medical Superintendent/CMO/

Head of Hospital (with seal)

Note : (i) According to the Persons with Disabilities (Equal Opportunities, Protection of Rights and Full participation)

Rules, 1996 notified on 31.12.1996 by the Central Government in exercise of the powers conferred by sub-section

(1) and (2) of Section 73 of the Persons with Disabilities (Equal Opportunities, Protection of Rights and Full

Participation) Act, 1995 (1 of 1996), authorities to give disability Certificate will be a Medical Board duly constituted by

the Central or the State Government. The State Government may constitute a Medical Board consisting of at least

three members out of which at least one shall be a specialist in the particular field for assessing locomotor/hearing &

speech disability, mental retardation and leprosy cured, as the case may be.

(ii) The certificate would be valid for a period of 5 years for those whose disability is temporary. For those who acquired

permanent disability, the validity can be shown as permanent.

Paste here your recent colour

photograph showing the

disability (The photograph

should be attested by the

Chairperson of the Medical

Board)

ANNEXURE - VI

DECLARATION TO BE SUBMITTED BY VISUALLY HANDICAPPED CANDIDATES /THOSE

CANDIDATES WHOSE WRITING SPEED IS AFFECTED BY CEREBRAL PALSY.

PARTICULARS OF THE SCRIBE PROPOSED TO BE ENGAGED BY THE CANDIDATE.

1 Name of the Candidate ...............................................................................

2. Date of Birth of the Candidate ...................................................................

3. Name of the Scribe ....................................................................................

4. Father’s Name of the Scribe ......................................................................

5. Address of the Scribe

(a) Permanent Address : .................................................................

....................................................................................................

(b) Present Address : ………………………………...................

..................................................................................................

6. Educational qualification of the scribe ……………………………..……............. Signature of scribe in

................................................................................................................................. above Box below the

……………………………………………………………………………………………… photograph

7. Relationship, if any, of the scribe to the candidate ...............................................

8. DECLARATION

We hereby declare that the particulars furnished above are true and correct to the best of our knowledge

and belief. We have read/been read out the instructions of the Railway Recruitment Board regarding

conduct of the visually challenged candidates /scribes at this examination and hereby undertake to abide

by them. We also declare that:

(a) The academic qualification of the Scribe is below the qualification prescribed for the post applied for.

(b) The academic discipline of the scribe is same as of the candidate since the application is for the

General post/the academic discipline of the scribe is different from that of the candidate as the

application is for a specialist post.(Delete the portion not applicable).

*Strike out which is not applicable.

......................................... ....................................

(Signature of the candidate) (Signature of the Scribe)

Left Thumb impression Left thumb impression

of the candidate in the box given above. of the Scribe in the box given above.

Control No.(for office use)

Paste here recent colour

passport size photograph

of the scribe of size 4 cm x

5 cm (The colour

photograph should not be

more than 3 months old)

Proforma for Medical Certificate to be obtained from

an

eye specialist by candidates applying for the

posts of Assistant Station Master

I have checked up SmtJShri/Kum

.............................

who

has applied for the post of Assistant Station Master in

Railways. Acuity of vision/colour vision

of

Shri/Smt.lKum

.....................

'"

.........

'"

..... has been tested

in

view of the following standard required for appointment on

the Railways.

Annexure -VII

Paste here your recent

colour passport size

photograph of size 4 cm X

5 cm (the colour

photograph should not be

more than 3 months old)

The photograph should be

attested by the eye

specialist

i

I

Signature

of

candidate

in

the

above box below the photograph

Post Class Distant Vision Near Vision Colour Vision

on Ishihara

Assistant

Station Master A-2 6/6,616 without glasses

with fogging test (must

NOT accept

+20)

Sn 0.6/0.6

without glasses Normal

Shri/Smt.lKumari

............................................................................................

.

fully confirms to the above vision standards.

Name

of

the Eye Specialist.

...............

,

...................

(Signature

of

the Eye Specialist)

Registration

No.

of

the Eye Specialist.

...........

'"

...........................

.

(Seal

of

Eye Specialist)

Place :

Date:

TV 5200 1340954926152PWD 2012

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