APPLICATION LOGISTICS), (rwAr) FOR THE POST OF INLAND WATERWAYS MEMBER (TRAFFIC & AUTHORITY OF INDIA 1. Name 2. Desiqnation with Organization 3. Date of Birth 4. Pay Band and Grade PaY 5. Service to which belong/Rank 6. Q u a I ifi cati o n s/ Ex pe ri e n celAch i elyg4 e nlq 7. Post held in chronological order in the last 10 years Post and Pay Sca le Organization Brief Job Description Date Other Remarks (Including whether the post held on regular/ ad- hoc/deputation etc. From To B. Other matters, if anY 1. 2. 3. 4. (Signature of Candidate) CERTIFICATE BY HEAD OF OFFICE OF THE APPLICANT It is certified that all the particulars furnished by the officer are correct. It is certified that no disciplinary/vigilance case is either pending or contemplated against the applicant and he/she is clear from the vigilance angle. His/her integritY is certified It is certified that no major/minor penalties have been imposed on the officer during the last 10 years. Attested copies of the lasts 5 years' APARs (all pages) are attached SIGNATURE OF THE HEAD OF THE OFFICE ALONG WITH THE OFFICE SEAL 5,