NOC For Passport From Govt
NOC For Passport From Govt
NOC For Passport From Govt
1.
2.
Home address
3.
4.
5.
6.
7.
8.
9.
10
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11
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12
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13
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14
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15
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16
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17
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18
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19
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20
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21
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22
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Date of Birth
Date of entry in service
Whether Provisional or Not
Pay & Scale of Pay
Date of commencement of Continuous service
Purpose of NOC
Place of Visit
Purpose of visit
:
:
:
:
:
:
:
:
Duration of Visit
Signature of applicant
Place
Date
:
:
:
Counter signed
Head office
PROFORMA REPORT
(To be filled by the head of office)
No
No
No
Certified that the information given above and that given in the application as Sl. No.1 to 22 are
verified and found correct.
Place :
Date :
Signature:
Name & designation
of head of office:
CERTIFICATE
Certified that the incumbent Sri/smt. of this office has,
1)
2)
3)
No bonded objection.
4)
Place:
Date:
DECLARATION
I, hereby
declare that:
1)
2)
I agree to abide by the conditions laid in the Appendix XIIA, Part I KSR
3)
I will not accept any remuneration through Government channel while in abroad
4)
5)
6)
7)
I will resign this job or will take prior permission before accepting job abroad.
Place:
Date:
Countersigned
s/d Name and address of Head of office
PROFORMA REPORT
Details of family members of Sri/Smt..
Sl.
No.
1
2
3
4
Place
Date
Name
Address
Age
Relationship
Occupation
Three recent Passport type photos one is attested by Head office in the filled annexure B and attested copy
of the Voter ID Card must be forwarded along with the application
No
Office of the .
..
Station
Pin Code.Ph. No.
Date
From
To
Sir,
ANNEXURE B
NO OBJETION CERTIFICATE
Sub:
(Al Central Government Employees, State Government Employees, Employees of Statutory Bodies and
Public Sector Undertakings are required to produce and Identity certificate) (Strike out portion not
applicable)
(To be given in Duplicate on Original Stationary)
Certified that Sri/Smt/Kum..
Son/Wife of Sri.. of is a
Temporary/permanent employee of this (office address) .
from
..(date)...and is at present holding the post of
.Sri./Smt/Miss/Mst.
..is/are dependent family
member(s) of Sri./Smt.and
his/her identity is certified.
Indian Passport. The undersigned is duly authorized to sign this Identity Certificate. I have read the
provisions of Section 6(2) of the Passports Act, 1967 and certify that these are not attracted in case of
this applicant. I recommend issue of an Indian Passport to him/her. It is certified that this Organization
is a Central/State Government/Public Sector Undertakings/Statutory Body. The identity Card Number of
Shri./Smt. (employee)..........................is.