ENGAGEMENT OF PERSONNEL UNDER TENURE BASIS

Hindustan Aeronautics Ltd (HAL), a Navratna Central Public Sector Undertaking, is a premier
Aeronautical Industry of South East Asia, with 20 Production / Overhaul / Service Divisions and
11 co-located R&D Centres spread across the Country. HAL's spectrum of expertise encompasses hi-tech
programmes involving a number of state-of-the-art technology, design, development, manufacture, repair,
overhaul and upgrade of Aircraft, Helicopters, A e r o -engines, Industrial & Marine Gas Turbines,
Accessories, Avionics & Systems and structural components for Satellites & Launch Vehicles.

2. Applications are invited from eligible candidates in the prescribed Performa for the following posts
on Tenure Basis for a period of 4 years in the Non-Executive cadre, for posting to HAL – Helicopter Factory,
Tumakuru(Karnataka). The tenure will come to an end automatically on completion of four years from the
date of joining / or may be extended at the discretion of the Management.

1. DETAILS OF POST/DISCIPLINE/RESERVATION/QUALIFICATION

Sl. Post, No. of Vacancies and Reservations

Total Qualification
No Channel/Scale UR OBC SC ST EWS PwBD
NAC (3 years) OR
Fitter
1 7 7 -- -- 3 -- 17 ITI (2 years) + NAC/NCTVT
(Scale - C5)
(1 year)
NAC (3 years) OR
Electrician
2 3 2 -- -- -- -- 05 ITI (2 years) + NAC/NCTVT
(Scale - C5)
(1 year)
University Degree (BA/
B.Com/B.Sc/BBA/BBM/
BCA/BSW etc.) under
Stores Clerical /
10+2+3 pattern from a
Commercial Asst/ 1
3 1 1 1 -- -- 04 recognized University AND
Admin Asst (VI)
Professional Certificate in
(Scale - C5)
typing / stenography / PC
Operations etc. (minimum 3
months)
B.Com from a recognized
University under 10+2+3
Accounts 1
4 1 -- -- -- -- 02 pattern AND Professional
(Scale - C5) (HI)
Certificate PC Operations
etc. (minimum 3 months)
Civil 3 years regular Diploma in
5 1 -- -- -- -- -- 01
(Scale - D6) Engg (Civil)

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 3 years regular Diploma in
Engg (Electrical / Electronics
Technician / Telecommunication /
6 (Electrical) 3 3 -- -- 1 -- 07 Electronics &
(Scale - D6) Communication /
Instrumentation / Electrical
& Telecommunication)

Technician
3 years regular Diploma in
7 (Mechanical) 1 1 -- -- -- -- 02
Engg (Mechanical)
(Scale - D6)
3 years regular Diploma in
Assistant (IT) Engg / Technology –
8 -- -- 1 1 -- -- 02
(Scale - D6) (Computer / Computer
Science)

UR=Unreserved, OBC=Other Backward Caste, SC=Scheduled Caste, ST=Scheduled Tribe,

EWS=Economically Weaker Section, PwBD – Persons with benchmark disabilities,
VI – Visual Impairment, HI – Hearing Impairment

2. QUALIFICATION & EXPERIENCE REQUIREMENT:

 Candidates applying for the above mentioned posts should possess the qualification as mentioned
against each post.

 Candidates with Part Time/Correspondence/Distance Education/E-learning qualification will not be

eligible to apply.

 Candidates possessing higher qualifications than the required qualification indicated in the
Notification need not apply. Candidature of such personnel who possess higher qualification than
the required qualification indicated in the Notification and who apply for the post, will be rejected at
any stage of the Recruitment or Selection.

 Candidate pursuing / enrolled for any other qualifications should mandatorily indicate the same in
the application format. All the qualifications possessed by the candidates and qualifications/ courses
being pursued by them at the time of submitting the application for employment, are to be clearly
indicated in the application. In other words, all the qualifications already possessed and
qualifications / courses , which are being pursued / currently undergoing are to be indicated in the
application while submitting the same for notified posts in HAL

3. AGE LIMIT / RELAXATION/ CONCESSION:

 The upper age limit shall be 28 years as on 01.08.2023 for Unreserved Category and EWS
category.

 Relaxation upto 5 years in age is admissible for the candidates belonging to SC/ ST category.

 Relaxation upto 3 years in age is admissible for the candidates belonging to OBC (Non Creamy
Layer) category.

 The Upper age limit for Persons with Benchmark Disabilities (PWBD) is relaxable upto 10 years.
Relaxation in Age limit shall be applicable irrespective of the fact whether the post is reserved or
not, provided the post is identified suitable for persons with disabilities.

 Upper Age Limit is relaxable by 5 years in respect of the candidates who had ordinarily
been domiciled in the State of Jammu & Kashmir during the period of 01.01.1980 to 31.12.1989.

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 The Upper Age limit with all relaxations shall not exceed 55 years. For PWBD candidates, the upper
Age limit with all relaxations shall not exceed 56 years.

4. PLACE OF POSTING:

The selected candidates will be posted at HAL - Helicopter Factory, Tumakuru (Karnataka). However,
they are liable to be transferred / posted / assigned to any place where HAL has the Divisions / Offices /
Bases depending upon organizational requirements.

5. TENURE OF ENGAGEMENT:

The selected candidates will be engaged on tenure basis for a period of four years from the date of
engagement. The engagement is not against permanent vacancy and will not entitle any candidate to
claim for regular / permanent employment in future. The tenure will come to an end automatically on
completion of four years period from the date of joining, without any further notice. However, based on
Organization requirement and performance of the candidates, the tenure of engagement can be
extended by a further period of four years. The employment can be terminated, at any time, during the
period of tenure engagement, by giving one month’s notice by either party or payment of the Basic Pay
+ DA components in the Consolidated Remuneration in lieu of the Notice. The Tenure Based Engagement
will not confer any right on the Personnel to claim the status of a regular employee of the Company.
Selected Personnel on Tenure Basis will undergo Induction Training. The personnel selected will be
deployed in shifts.

6. REMUNERATION:

 During the period of tenure engagement the candidates will be paid following remuneration:

Entitlement Scale-C5 in Rs per month Scale-D6 in Rs per month

Basic Pay 22,000/- 23,000/-

DA At applicable rates At applicable rates

HRA At applicable rates At applicable rates

Perks @ 25% on Basic Pay @ 25% on Basic Pay

Lumpsum amount 1500/- 1500/-

towards Medical Expenses
Other benefits & As per rules As per rules
Allowances

 The components of benefits and allowance are as follows:-

i) Dearness Allowance (revised quarterly) on the Basic Pay.
ii) House Rent Allowance as per classification of Cities (when Company quarter is not provided).
iii) Provident Fund contributions will be calculated taking into account the Basic Pay + Dearness
Allowance components of the Consolidated Emoluments.
iv) Allowance towards medical reimbursement a Lump sum amount of Rs.1500/- per month will be
admissible to meet the medical expenses (both in- patient and outpatient), based on self-
certification. This amount shall be paid on monthly basis along with the Consolidated
Remuneration. These personnel will not be entitled for any other medical benefits in any of the
HAL hospitals / Dispensaries or elsewhere.
v) Monthly Incentive and Annual Incentive
vi) Quarterly Performance Pay.
vii) TA/DA for joining duty and for Temporary Duty as per relevant Rules applicable to Workmen in the
appropriate Scale of Pay.
viii) Group Insurance in lieu of EDLI.
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 ix) Night Shift Allowance, wherever applicable.

 An annual increase of 3% during the tenure shall be admissible on the Basic Pay, subject to
satisfactory performance.

 Personnel engaged on Tenure Basis will be entitled for one day casual leave for each remaining
complete month in the calendar year as per Rules.

 Tenure Based personnel will be entitled to 2.5 days Vacation Leave (VL) with pay, for every
calendar month of service as per Rules.

 4 sets of Uniforms once in 2 years. Stitching charges & shoe allowance (safety shoes, where ever
applicable in place of shoe allowance) will be issued/provided.

 Female personnel will be entitled to Maternity Benefits as per the provisions under the Maternity
Benefit Act, 1961.

 The tenure based engagement will not confer any right on the personnel to claim the status of a
regular employee of the Company.

 They will abide by the various company rules and regulations governing carrying out the assigned
tasks and their conduct, like standing orders, transferability to other departments or Divisions or
Places, Termination of contract for reasons of non-performance or poor performance or without
assigning any reason.

 The tenure based personnel will not be entitled for any allowance or benefits other than those
indicated in the scheme for Engagement of Personnel on Tenure Basis in the Company.

6. SELECTION PROCEDURE:

 The selection will be done through Written Test.

 The minimum percentage of marks scored by the candidates in the qualifying examination i.e,
Diploma or ITI & NAC as the case may be in the respective trades / disciplines is mentioned as;

Category Qualifying Percentage (%)

of marks

UR / OBC 60% & above

SC / ST / PWBD 50% & above

 If the number of candidates with the above percentage (%) of marks are large in number, the
company reserves the right to decide the cut off percentage for calling the candidates for the
written test, based on the marks secured in the qualifying examination (Diploma or ITI & NAC)
prescribed for a particular trade / discipline.

 The date, time and venue of the Written Test will be intimated to the shortlisted eligible candidates
by email / HAL website (in the email id provided in the Application Format by the candidate). The
same will also be hosted on the HAL Website (www.hal-india.co.in).

 The Written Test will be of 2 ½ hours duration. The test will be in 3 parts, comprising of Multiple
Choice Questions (MCQs). Part-I will consist of 20 questions on General Awareness, Part-II will
consist of 40 questions on English & Reasoning. Part-III will consist of 100 questions on the
concerned Discipline. Each question carries 1 mark each and there is no negative Mark.

 Candidates will have to appear for Written Test at their own cost, on the date, time & venue, which
will be mentioned in their Admit Card. The candidates have to download Admit Card from HAL
Website (www.hal-india.co.in).

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 Candidates are required to bring Admit Card & One of the Original Photo Identity Card viz. Voters
ID Card , Driving License , Aadhar Card, Passport, PAN Card, ID Card (by Central / State Govt. /
PSU for their employees), ID Cards (by Govt. Agencies authorised ), ID Cards (by College/Institute
where last studied) along with Xerox copy of the Photo ID Card self-attested , to prove their
identity before the Invigilator, failing which they will not be allowed to appear for the
Physical/Written Test.

 Selection of the candidates will be done based on the Marks scored in the Written Test only, in the
order of Merit.

 Candidates who qualify in the Written Test will be called for Document Verification in order of merit.
Final selection will be made on the basis of performance in the Written Test. The number of
candidates called for Document Verification will be limited to the number of Posts notified
(Discipline/Category wise). Inability of the candidates to produce the requisite documents at the
time of document verification shall render them liable for non-consideration of their candidature. No
undertaking for production of documents in respect of eligibility criteria with regard to age,
qualification & experience on a later date will be allowed.

 Engagement of selected candidates is subject to Verification of Caste (wherever applicable)

and Character & Antecedents from the concerned Authorities, as per the Rules of the Company
. The candidates should bring all the relevant original certificates / testimonials etc., along with one
set of self-attested photo copies in support of educational qualifications. experience, date of
birth, caste certificate (In Central Govt. format) etc . All the relevant and required documents
as per the advertised criteria will be scrutinized during document verification stage and those
candidates who are found to be meeting the advertised criteria will only be considered for
selection. Additional candidates will be called for Document Verification in the order of merit
till such time the number of candidates qualifying in Document Verification process is equal to
the posts advertised.

 The date, time & place of document verification will be informed through email. Candidates who
qualify document verification stage would be reimbursed Travelling Allowance (TA), i.e. Sleeper
Class / II Class Train fare / Bus fare by the shortest route, subject to production of proof of travel
(Original onward journey ticket and Photostat / xerox copy of return journey ticket), failing which
TA will not be paid. In case the candidate travel by other modes of transport, he /she will be
reimbursed the fare limited to the shortest route by train or actual expenses, whichever is less, on
production of proof.

 Candidates qualified in the Document Verification will be issued Provisional Offer and they are
required to undergo Pre- employment Medical examination. No relaxation in Health Standards will
be allowed. On satisfactory receipt of Medical Report from the Company’s Doctor as per the medical
standards prescribed by HAL Verification of Character and Antecedents from the concerned
Authorities, Final Offer of Engagement will be issued as per the rules of the Company.

7. MEDICAL EXAMINATION:

Candidates provisionally selected will have to undergo a Pre-Employment Medical Examination at HAL
Hospital before joining HAL. Applicants should meet the Medical Standards as prescribed by the
Company (Concerned authority in respect of PWD candidates). No relaxation in Health Standards will
be allowed. Appointment of selected candidates is subject to receipt of satisfactory Medical Report from
the Company’s Doctor as per the Medical Standards of the Company. No relaxation in Health
Standards will be allowed.

8. HOW TO APPLY:

 The candidates sponsored by the concerned Employment Exchanges who have received
communication from HAL are only eligible to apply Online for the advertised posts.

 Eligible and interested candidates are required to log-in to HAL Website (www.hal-india.co.in)
and submit the filled-in application.

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 A candidate is eligible to apply for one post only for which he/ she is most eligible.

 Candidates are allowed to apply only once and applications once submitted cannot be altered under
any circumstances. Candidates are required to possess a valid e-mail id and Mobile Number which
is to be entered in the application blank, so that intimation regarding the Written Test, Document
Verification, Medical Test etc. can be sent. HAL will not be responsible for bouncing of e-mail sent
to the candidates. They are also advised to retain this e-mail ID active as any important intimation
to them shall be provided by HAL through e-mail.

 On submission and acceptance of the application, system will generate the Registration /
Acknowledgement form along with the application reference number allotted, which will be used for
future reference.

 Request for change of mailing address, Category, Discipline etc. as declared in the Online
Application will not be entertained.

 If the information / certificates furnished by the candidates at any stage are found to be false or
incomplete or are not found to be in conformity with eligibility criteria mentioned in the
advertisement, the candidature/ appointment will be considered as revoked/terminated at any
stage of recruitment process or after recruitment or joining, without any reference given to the
candidate.

 Any further Information/Corrigendum/Addendum would be uploaded only on HAL website

(www.hal-india.co.in).

 The last date for submission of the Online Application is 24.09.2023.

 No application will be accepted in person or by post.

10. GENERAL CONDITIONS:

 Only Indian Nationals are eligible to apply.

 Candidates employed in Central / State Government/ Public Sector Undertakings etc. (including
candidates engaged on Contract basis therein) who are provisionally selected should produce "No
Objection Certificate (NOC)" at the time of the document verification from their employer failing
which their candidature will be cancelled.

 Candidates belonging to SC/ST /OBC Category and applying through the reservation quota are
required to produce valid Caste Certificate issued by the Competent Authority at the time of
Document Verification. The Date, Time & venue for Document Verification will be
intimated to the candidates who are provisionally selected in the Written Test via email (in the
email id provided in the Application Format by the candidate). The same will also be hosted on the
HAL Website (www.hal-india.co.in);

 All qualifications should be from Indian Universities/ Institutes recognized by

appropriate statutory Authorities in the Country.

 Persons with 40% or more relevant disability only are eligible to apply for the posts reserved for
PWBD. Candidates are required to produce Disability certificate issued by the Competent Authority
at the time of document verification.

 While applying for the post, the applicant should ensure that he/she fulfils the eligibility and other
norms as mentioned above as on the specified dates and that the particulars furnished by him/her
are correct in all respect.

 Furnishing wrong / incorrect information or suppression of relevant information will lead to rejection
of candidate and the application will be out-rightly rejected.

 Screening and short listing for the Written Test will be based on the details provided by the
candidate in the online Application Form. Hence it is necessary that applicants should furnish only
accurate, full and correct information.
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 Appearance of the shortlisted candidates in the Written Test is provisional and it does not entitle
them for any claim for the post. They will be treated as debarred ab-initio at any stage of the
selection process in case they do not fulfil essential eligibility criteria. Admission to the Written Test
will be purely provisional without verification of Age, qualification, SC/ST/ OBC/PWD category etc.
of the candidates.

 The decision of HAL in all matters relating to eligibility, acceptance or rejection of applications,
mode of selection, conduct of Physical test/ Written Test/ Document Verification etc. will be final
and binding on the candidates. Further, HAL reserves the right to fill up or otherwise any or all the
notified posts and also to fill up the future vacancies if any from the valid panel of selected
candidates as per the rules of the Company.

 HAL reserves all the right to cancel/restrict/modify the notification criteria/ Recruitment process
and / or the Selection Process thereunder, without issuing any further notice whatsoever. The
number of vacancies can be modified as per the discretion of the Management.

 Shortlisting of candidates for the Written Test will be purely provisional without verification of Age,
Qualification, Category (SC/ST/OBC- Non Creamy Layer/ PWBD / XSM etc.) of the candidates.

 Mere meeting the conditions of the Notification by the candidate(s) will not automatically entail
them to be called for Physical Test / Written Test/ Document verification/ Selection and
Engagement.

 Candidates should clearly mention all the details sought in the Application Format. In case of no
clarity/ discrepancy in the information provided, Application will be summarily rejected. No
communication will be sent to the candidates.

 Furnishing wrong / incorrect information or suppression of relevant information will lead to rejection
of candidate and the application will be out-rightly rejected.

 Applicants having work experience in Private Sector Organizations are required to submit an
Experience Certificate on the letterhead of the Company. The letterhead of the Company should
have details of the Company. Candidate having age relaxation will not be issued the Provisional
Offer without producing Experience Certificate in the letterhead of the Company.

 These vacancies are identified to be filled up by external candidates only, through Direct
Recruitment. Therefore, Applications of internal candidates, if any, will not be considered.

 Any sort of Canvassing or influencing of the Officials related to Recruitment / Selection Process
would result in immediate disqualification of the candidates.

 Engagement of selected candidates is subject to receipt of satisfactory Medical Report from the
Company's Doctor as per the standards prescribed by HAL and verification of Caste, Character and
Antecedents from the concerned Authorities as per the rules of the company and Vigilance
Clearance (as applicable ).

 Necessary information regarding the selection, written test etc. will be hosted on HAL Website
www.hal-india.co.in from time to time. All correspondences to the candidates will be made via e-
mail on the e-mail id provided by the candidate at the time of online application. No other method
of communication will be adopted.

 In case of any particular clarification, the candidates can write to HAL, Helicopter Division,
Bangalore at [email protected] or contact us at 080- 22323744 / 22322964. No
other method of Communication will be entertained.

 Any sort of canvassing or Influencing of the Officers related to Recruitment / Selection

process would result in immediate disqualification of the candidates.

 Court of jurisdiction for any dispute/ cause will be Bangalore.

-o0o-
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 IMPORTANT DATES:

Sl.
Description/Particulars Date (Tentative)
No.

1. Date of commencement of online applications 10.09.2023 (00.00 AM)

2. Last date for receipt of online applications 24.09.2023 (23.59 PM)

Online downloading from

3. Downloading of admit card
28.09.2023 onwards

4. Date of Written Test 08.10.2023

5. Announcement of Written test result 10.10.2023

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 Annexure C

FORM OF CERTIFICATE TO BE PRODUCED BY THE CANDIDATES

BELONGING TO SCHEDULED CASTE/SCHEDULED TRIBE

This is to certify that Shri/ Shrimathi*/ Kumari* _________________Son/daughter* of

__________________ of Village/town*_________________ in District/Division*____________ of
the 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) order 1950
*The Constitution (Scheduled Tribes) (Union Territories) order 1951

{As amended by the Scheduled Castes and Scheduled Tribes lists( Modification Order, 1956, the
Bombay Reorganization act, 1960, the Punjab Reorganization Act, 1966, the state of Himachal
Pradesh Act 1970, the North-Eastern areas ( Reorganization) Act, 1971 and the Scheduled
Castes and Scheduled Tribes orders (Amendment) Act 1976}

*The Constitution ( Jammu and Kashmir) Scheduled Castes order 1956

*The Constitution (Andaman and Nicobar Islands) Scheduled Tribes order 1959 as
amended by the Scheduled Castes and Scheduled Tribes Orders (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

2. Shri / Shrimathi / Kumari*____________________________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)

Place _____________ State / Union Territory

Date _____________

* Please delete the words, which are not applicable

Note : The term “ Ordinarily resides” used here will have the same meaning as in section 20 of
the Representation of the People Act 1950.
 Annexure D
FORM OF CERTIFICATE TO BE PRODUCED BY OTHER BACKWARD
CLASSES APPLYING FOR APPOINTMENT TO POSTS UNDER THE
GOVERNMENT OF INDIA

This to certify that Shri / Smt / Kumari , son /

daughter of _,of Village / Town __ in District / Division
in the State / Union Territory __________________
belongs to the Community which is recognized as a Backward Class under
the Government of India, Ministry of Social Justice and Empowerment’s
Resolution No. ________________, dated __________*. S hri / Smt / Kumari
_____ and / or his / her family ordinarily reside(s)
in the ___________________ District / Division of the State / Union
Territory. 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 8-9-1993**.

District Magistrate,
Deputy Commissioner, etc.

Dated :

Seal

* The authority issuing the certificate may have to mention the details of
Resolution of Government of India, in which the caste of the candidate is
mentioned as OBC.
** As amended from time to time
Note: The term ‘Ordinarily’ used here will have the same meaning as in Section
20 of the Representation of the people’s Act, 1950
 Annexure H

Government of..............
(Name & Address of the authority issuing the certificate)

INCOME & ASSET CERTIFICATE TO · BE PRODUCED BY ECONOMICALLY

WEAKER SECTIONS

Certificate No. ---------- Date:___________

VALID FOR THE YEAR_____________.

This is to certify that Shri/Smt./Kumari ___________________son /

daughter/wife permanent resident
of Village /Street Post
Office District in the State/Union Territory
Pin Code whose phot ograph
is attested below belongs to Economically Weaker Sections, since the gross annual
income* of his/her 'family"* is below Rs.8 lakh (Rupees Eight Lakh only) for the financial
year . His/her family does not own or possess any of the following assets*** :

I. 5 acres of agricultural land and above;

II. Residential flat of 1000 sq. ft. and above;
Ill. Residential plot of 100 sq. yards and above in notified municipalities;
IV. Residential plot of 200 sq. yards and above in areas other than the notified
municipalities.

2. Shri/Smt./Kumari belongs to the caste

which is not recognized as a Scheduled Caste, Scheduled Tribe and Other Backward
Classes (Central List)

Signature with seal of Office _

Name _
Designation________________________

Recent Passport
size attested
photograph of the
applicant

*Note1 :.Income covered all sources i.e. salary, agriculture, business, profession, etc.
**Note 2:The term "Family" for this purpose include the person, who seeks benefit of
reservation, his/her parents and s iblings below the age of 18 y ears as also his/her
spouse and children below the age of 18 years
***Note 3: The property held by a " Family" in di fferent l ocations or different
places/cities hav e been clubbed while applying the land or property holding test to
determine EWS status.
 Annexure H

Government of..............
(Name & Address of the authority issuing the certificate)

INCOME & ASSET CERTIFICATE TO · BE PRODUCED BY ECONOMICALLY

WEAKER SECTIONS

Certificate No. ---------- Date:___________

VALID FOR THE YEAR_____________.

This is to certify that Shri/Smt./Kumari ___________________son /

daughter/wife permanent resident
of Village /Street Post
Office District in the State/Union Territory
Pin Code whose phot ograph
is attested below belongs to Economically Weaker Sections, since the gross annual
income* of his/her 'family"* is below Rs.8 lakh (Rupees Eight Lakh only) for the financial
year . His/her family does not own or possess any of the following assets*** :

I. 5 acres of agricultural land and above;

II. Residential flat of 1000 sq. ft. and above;
Ill. Residential plot of 100 sq. yards and above in notified municipalities;
IV. Residential plot of 200 sq. yards and above in areas other than the notified
municipalities.

2. Shri/Smt./Kumari belongs to the caste

which is not recognized as a Scheduled Caste, Scheduled Tribe and Other Backward
Classes (Central List)

Signature with seal of Office _

Name _
Designation________________________

Recent Passport
size attested
photograph of the
applicant

*Note1 :.Income covered all sources i.e. salary, agriculture, business, profession, etc.
**Note 2:The term "Family" for this purpose include the person, who seeks benefit of
reservation, his/her parents and s iblings below the age of 18 y ears as also his/her
spouse and children below the age of 18 years
***Note 3: The property held by a " Family" in di fferent l ocations or different
places/cities hav e been clubbed while applying the land or property holding test to
determine EWS status.
 Annexure – E1
Disability Certificate (FORM –V)
(In cases of amputation or complete permanent paralysis of limbs or dwarfism
and in case of blindness)
[See rule 18(1)]
(Name and Address of the Medical Authority issuing the Certificate)
Recent passport size
attested photograph
(Showing face only)
of the person with
disability.

Certificate No. Date:

This is to certify that I have carefully examined Shri / S mt. /Kum.

____________________ son /wife /daughter of Shri _________________ Date
of Birth (DD/MM/YYYY) ____________ Age ______ years, male/ female
__________________ registration No. ______________ Permanent resident of
House No. ________ Ward/Village/Street _____________ Post Office ______
District __________ State ________________, whose photograph is affixed
above, and am satisfied that:
(A) he/she is a case of:
• locomotor disability
• dwarfism
• blindness
(Please tick as applicable)

(B) the diagnosis in his/her case is __________________

(A) he/she has ________ % (in figure) __________________ percent (in

words) permanent locomotor disability/dwarfism/blindness in relation to
his/her ______ (part of body) as per guidelines (……………number and
date of issue of the guidelines to be specified).

2. The applicant has submitted the following document as proof of

residence:-

Details of authority issuing

Nature of Document Date of Issue
certificate

(Signature and Seal of Authorised Signatory of

notified Medical Authority)
Signature/thumb
impression of the person
in whose favour certificate
of disability is issued
 Annexure – E2
Disability Certificate (Form – VI)
(In case of Multiple Disabilities)

[See rule 18(1)]

(Name and Address of the Medical Authority issuing the Certificate)

Recent passport
size attested
photograph
(Showing face
only) of the person
with disability.

Certificate No. Date:

This is to certify that I have carefully examined Shri/ Smt./ Kum.

____________________ son /wife /daughter of Shri _________________ Date
of Birth (DD/MM/YYYY) ____________ Age ______ years, male/ female
__________________ .

Registration No. ______________ permanent resident of House No. ________

Ward/Village/Street _____________ Post Office ______ District __________
State ________________, whose photograph is affixed above, and am satisfied
that:
(A) he/she is a case of Multiple Disability. His/her extent of permanent
physical impairment/ disability has been ev aluated as per guidelines
(……………number and date of issue of the guidelines to be specified) for the
disabilities ticked below, and is shown against the relevant disability in the table
below:

Affected Permanent physical

Sl.
Disability part of Diagnosis impairment/mental
No.
body disability (in %)
1. Locomotor disability @
2. Muscular Dystrophy
3. Leprosy cured
4. Dwarfism
5. Cerebral Palsy
6. Acid attack Victim
7. Low vision #
 8. Blindness #
9. Deaf £
10. Hard of Hearing £
11. Speech and Language
disability
12. Intellectual Disability
13. Specific Learning
Disability
14. Autism Spectrum
Disorder
15. Mental illness
16. Chronic Neurological
Conditions
17. Multiple sclerosis
18. Parkinson’s disease
19. Haemophilia
20. Thalassemia
21. Sickle Cell disease

(B) In the light of the above, his/her over all permanent physical impairment
as per guidelines (……….number and date of issue of the guidelines to be
specified), is as follows : -

In figures : - ------------------ percent

In words :- --------------------------------------------------------------------------- percent

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

improve.

3. Reassessment of disability is :
1) Not necessary, or
2) Is recommended /after…… year…… months and therefore this
certificate shall be valid till ----- ----- ------
(DD) (MM) (YYYY)
@ e.g. Left/right/both arms/legs
# e.g. Single eye
£ e.g. Left/Right/both ears
4. The applicant has submitted the following document as proof of
residence:-

Nature of Date of issue Details of authority issuing

document certificate

5. Signature and seal of the Medical Authority.

Name and Seal of Name and Seal Name and Seal of the Chairperson
Member of Member

Signature/thumb impression
of the person in whose
favour certificate of disability
is issued
 Annexure – E3

Disability Certificate (Form – VII)

(In cases other than those mentioned in Forms V and VI)
(Name and Address of the Medical Authority issuing the Certificate)
(See rule 18(1))
Recent passport
size attested
photograph
(Showing face
only) of the person
with disability.

Certificate No. Date:

This is to certify that I have carefully examined Shri / Smt / Kum

__________________________________________ Son / wife / daughter of
Shri __________________________________________ Date of Birth
(DD/MM/YYYY)_____ _____ ____ Age ______ years, male/female _________
Registration No. __________________ permanent resident of House No.
___________ Ward/Village/Street _____________________ Post Office
_________________ District ________________ State
____________________, whose photograph is affixed above, and am satisfied
that he/she is a case of ______________________________ disability. His/her
extent of percentage physical impairment/disability has been ev aluated as per
guidelines (……..number and date of issue of the guidelines to be specified) and
is shown against the relevant disability in the table below:-
Affected Permanent physical
Sl.
Disability part of Diagnosis impairment/mental disability
No.
body (in %)
1. Locomotor @
disability
2. Muscular
Dystrophy
3. Leprosy cured
4. Cerebral Palsy
5. Acid attack Victim
6. Low vision #
7. Deaf €
8. Hard of Hearing €
9. Speech and
Language
disability
10. Intellectual
Disability
11. Specific Learning
Disability
 12. Autism Spectrum
Disorder
13. Mental illness
14. Chronic
Neurological
Conditions
15. Multiple sclerosis
16. Parkinson’s
disease
17. Haemophilia
18. Thalassemia
19. Sickle Cell
disease
(Please strike out the disabilities which are not applicable)
2. The above condition is progressive / non-progressive / likely to improve /
not likely to improve.
3. Reassessment of Disability is
(i) Not Necessary, Or
(ii) Is recommended / after_______ years__________ months and
therefore this certificate shall be valid till _____________ (DD/MM/YYYY).
@ e.g. Left / Right / Both arms / Legs
# e.g. Single eye / Both eyes
£ e.g. Left / Right / Both ears
4. The applicant has submitted the following documents as proof of residence:
Nature of Date of Details of authority
Document issue issuing Certificate

(Authorised Signatory of notified Medical Authority)

(Name and Seal)

Signature/thumb Countersigned
impression of the {Countersignature and seal of the Chief Medical
person in whose Officer/Medical Superintendent/
favour certificate of
Head of Government Hospital, in case the
disability is issued
Certificate is issued by a medical authority who is not
a Government servant (with seal)}

Note- In case this certificate is issued by a m edical authority who is not a

Government servant, it shall be valid only if countersigned by the Chief Medical
Officer of the District.