LIST OF DOCUMENTS TO BE DOWNLOADED BY THE CANDIDATES SELECTED

FOR THE POST OF JUNIOR EXECUTIVE (ATC)

Documents to be submitted by the candidates on Receipt ANNEXURE

1. of Offer :

i) Acceptance letter - to be sent through SPEED POST to ‘A’

DGM(HR)-ANS on receipt of offer

2. Documents to be retained by the candidates :

i) Terms and Conditions of offer of appointment to the post ‘B’

of Junior Executive (ATC).

3. Documents to be submitted at the time of Medical

Examination :

i) Letter for Chief Medical Officer for medical examination ‘C’

by Medical Board.
(sent with offer of appointment)
ii) Candidate’s statement and declaration ‘D’

4. Documents to be submitted at the time of joining/

reporting for training at Training Centre :

i) Surety Bond ‘E’

ii) Attestation forms in triplicate as per Annexure – I. ‘F’
iii) Four passport size photographs duly attested by a -
Gazetted Officer
iv) Certificate (in original alongwith a copy each duly -
attested by Gazetted Officer) of :
v) Educational/ Professional Qualifications/ Date of Birth/ -
Caste (in case of SC/ST/OBC) Category (in case of PH)
vi) Release certificate from the last employer, if serving or -
undergoing training in a Govt. Department/ PSUs etc.
vii) Character Certificate ‘G’
vii) Marital Status undertaking ‘H’
ix) Candidate is required to take an Oath of Allegiance of ‘I’
faithfulness to the Constitution of India in the prescribed
format
x) Declaration regarding Home Town ‘J’

The above documents are required to be downloaded by all the candidates who have been selected for the post
of Jr. Executive (ATC). The selected candidates must fill his/ her name and also Distt. Hqrs. particulars in the relevant
space of the letter for medical examination downloaded from website (Annex-C). They may also tick mark ( ) their
training centre (as per AAI’s website) where the Medical Report is to be sent by CMO.
........................................
 A
To be sent through Speed Post

To

The Dy. General Manager (HR)-ANS

Directorate of HRM (ANS Wing)
Airports Authority of India,
Rajiv Gandhi Bhawan,
Safdarjung Airport,
New Delhi-110003.

Sub: Willingness for appointment to the post of Jr. Executive (ATC)

Sir,

Please refer to your letter No.12024/1/2011-EA dated 21.06.2011 offering me the

post of Jr. Executive (ATC) in Airports Authority of India.

*2. I hereby accept the offer of appointment for the post of Jr. Executive (ATC). The
terms and conditions of the offer are acceptable to me. All the required documents such
as medical certificate, attestation form etc. will be submitted at the time of my reporting
for training at the respective Training Centre.

*3. I hereby state that I will not be joining the post offered to me and as such the offer
sent to me may be cancelled.

*Strike out whichever is not applicable.

Yours faithfully,

ROLL NO.______________ Signature________________________

Name___________________________

Address__________________________

Date:
 B
AIRPORTS AUTHORITY OF INDIA
RAJIV GANDHI BHAVAN, SAFDARJUNG AIRPORT, NEW DELHI- 110003

THE TERMS & CONDITIONS FOR OFFER OF APPOINTMENT TO

THE POST OF JR. EXECUTIVE (ATC)
1. TRAINING

The period of training will be minimum 24 weeks at Airports Authority of India Civil Aviation Training
College, [CATC] Bamrauli, Allahabad-211012 and also at any other airport/place as decided by the
Management. The duration of the training may be extended based on the performance and conduct of
the Trainee during the training period. Also, subject to performance, the training can be discontinued
and thus terminating the service of the candidate as a result of non suitability and poor performance.

2. SERVICE CONDITION DURING TRAINING

(a) STIPEND

The trainee will be given a stipend equivalent to Basic Pay along with other admissible
allowances (as are being disbursed at E-I Grade) in the pay scale of Rs.16400-40500/-
during the period of training.
(b) TRAVELLING ALLOWANCE
No traveling allowance and daily allowance will be paid to the appointee for the
journeys performed for joining the training.

(c) LEAVE

Casual Leave at the rate of one day for every month’s training may be granted at the
discretion of the Principal/Authorized Officer. Leave without stipend may also be
sanctioned on medical grounds on production of appropriate medical certificate from
the Medical officer of the College or any other Medical Officer so designated by the
Principal. No leave for a total period of more than 3 days on any ground shall be
granted and the training may be terminated in the event of a Trainee remaining
absent for more than 3 days and the Trainee shall have no claim for continuance of
training or for appointment as Junior Executive (ATC).

(d) MEDICAL FACILITIES

Medical Facilities as available at the Training Centre will be extended to the Trainee.
However no re-imbursement of medical expenses will be admissible to the Trainee
during the training period.

(e) ACCOMMODATION

The trainee will be provided hostel accommodation subject to availability and on

payment of prescribed charges during the training period. Wherever hostel
accommodation is provided, the trainee shall not be entitled for HRA.
(f) FORWARDING OF APPLICATIONS FOR EMPLOYMENT OUTSIDE
AIRPORTS AUTHORITY OF INDIA

The trainee shall not apply to any organization for employment outside AAI during
his/her training period and no application will be forwarded for outside employment
before completion of one-year service as Junior Executive [ATC] in AAI on
completion of the training. The above condition will not be applicable to the SC/ST
Trainees.

3. AGREEMENT BOND

The Trainee will be required to execute an agreement bond of Rs.3,00,000/- (Rupees

Three lacs only) on non-judicial stamp paper of Rs.100/-(Rupees One Hundred only)
as per specimen enclosed. The person standing surety to the above agreement shall
be:-

(a) A permanent Government Servant/Officer of the Central Govt., Public Sector

Undertakings holding group ‘A’ post or equivalent and this fact shall be duly
certified and authenticated by the surety’s employer under official seal.
OR

A person of means possessing immovable property valued at not less than

Rs.10,00,000/-(Rupees Ten lacs only) and this should be duly certified and
authenticated by the Revenue Authorities under the official seal.

(b) Full particulars and address of the surety and the witnesses should be clearly given in
the bond.

(c) The agreement bond should be neatly and clearly typed without any cuttings or
mutilations. The date on which, it is being executed by the candidate, should not be
filled in by the candidate

4 OFFER OF TRAINING AT TRAINING CENTRE

The offer of training/joining as a trainee at the Training Centre is provisional and

subject to verification of the candidate’s character and antecedents by the police
authorities and subject to his medical fitness.

5. TERMINATION OF TRAINING/PENALTIES ETC.

a. The trainee after training is liable to be terminated without assigning any reason if the
competent authority is satisfied that the Trainee has not shown satisfactory progress (in
learning, discipline & conduct), during the period of training. No compensation
whatsoever shall be paid on such termination of training.

b. If the competent authority is satisfied that the failure to attain the satisfactory progress is
due to the negligence of the trainee of his/her failure to apply himself/herself earnestly to
his/her training, the trainee shall have to repay all amounts paid to him/her as stipend
and any other amount spent on trainee during his/her training period.
 c. The trainee shall have to serve the AAI for a period of 3 years after appointment as
Junior Executive (ATC). In case, he/she quits the training during the course of the
training or before completion of the period of 3 years as stated earlier, the AAI shall
have the right to recover an amount not exceeding Rs.3,00,000/- (Rupees Three lacs
only) as compensation in addition to the recovery of the amounts paid as stipend during
the period of training.

6. SERVICE CONDITION ON REGULAR APPOINTMENT

On successful completion of the training, trainee will be posted as Junior Executive

(ATC) in the Airports Authority of India in the scale of Rs.16400-40500/- (IDA pattern)
plus other allowances as admissible from time to time at that level.

a) NATURE OF THE POST

The newly appointed Junior Executive (ATC) may be posted anywhere in India or
abroad as may be determined by the management.

The candidates selected for the post of Junior Executive (ATC) shall not be allowed
to switch over to any other discipline in the equivalent post in AAI.

b) PERIOD OF PROBATION

On appointment as Junior Executive (ATC) the appointee will be under probation for
a period of two years which may be extended, if necessary. The probationary
appointment may also be terminated if the work and conduct of the appointee during
the period of probation is found unsatisfactory.

c) EFFICIENCY TEST

The trainee on completion of the initial period of training at the Training Centre will
be required to appear at the qualifying test. If the trainee does not successfully pass
the qualifying test in three attempts i.e.(One Main exam and Repeat two chances), no
further chance to appear at the qualifying test will be given and the training will be
terminated. This, however, is to be read with clause no. 5(b). The successful
completion of training will further depend upon the over all assessment of the
trainee’s work and conduct during the period of training.

It is further stipulated that the trainee will be required to pass all the examination
given to him/her at the end of each course determined by the Training Centre.

d) LEAVE

On regular appointment as Junior Executive (ATC), the appointee will be entitled to

leave with pay as per AAI rules as amended from time to time. For the present,
during each calendar year it is 30 days Earned Leave, 12 days Casual Leave and 20
days Half Pay Leave subject to the conditions prescribed under the rules. The
female employees are entitled to Maternity Leave as per rules.

e) PROVIDENT FUND

The Junior Executive (ATC) will also be entitled to join the contributory provident
Fund scheme in accordance with the rules.
f) MEDICAL ATTENDANCE

On appointment as Junior Executive (ATC), the employee and his/her declared

dependents will be entitled to Medical attendance in accordance with the applicable
rules in AAI

g) RESIDENTIAL ACCOMMODATION

Subject to availability of residential accommodation at the stations the Junior

Executive (ATC) is posted, he/she may be allotted accommodation as per rules in
his/her seniority at the station. The license fee for such allotment of accommodation
is 10% of the basic pay or the license fee as determined by the Management from
time to time. Where no accommodation is provided, the Junior Executive (ATC)
will be entitled to House Rent allowance as per applicable rules in force from time to
time.

h) OATH OF ALLEGIANCE

On appointment, the incumbent will be required to take a written oath of allegiance

to the constitution of India before he/she assumes duty.

i) MARITAL STATUS

He/She will be required to give declaration in writing in the enclosed form that, if
married he/she has only one wife/husband living. In the event of his/her statement
being found incorrect after his/her appointment, he/she will be liable to be dismissed
from service. Except with the prior permission of the Chairman, Airports Authority
of India, he/she will not contract another marriage during the life time of his/her first
wife/husband, not-withstanding the fact that such subsequent marriage may be
permissible under his/her personal law for the time being applicable to him/her.

j) DECLARATION OF HOME TOWN

On his/her appointment as Junior Executive (ATC) he/she shall furnish a declaration

as regards his/her hometown for the purpose of grant of Leave Travel Concession
during leave, etc. etc.

k) COUNTING OF TRAINING PERIOD

The training period will be treated as under:

i) For the Purpose of Increment

The date of joining at Civil Aviation Training College, Allahabad/other Centres for
training will be treated as duty for the purpose of drawing increments after
completion of training.

ii) For the Purpose of Promotion

The service for promotion to the higher grade will be counted from the date of
successful completion of training at Training Centre, Allahabad/other Centres.
 l) GROUP INSURANCE SCHEME OF LIC AND AAI EMPLOYEES
BENEVOLENT FUND SCHEME

On appointment as Junior Executive (ATC), he/she will be entitled to be covered

under the Group Saving-Linked Insurance Scheme of LIC and also the benevolent
fund Scheme of AAI as per the relevant rules of the scheme.

7. The appointment is provisional and is subject to the caste/tribe certificates being

verified through the proper channel and if the verification reveals that the claim that
he/she belongs to Other Backward Classes, Scheduled Caste or Scheduled Tribe, as
the case may be, is false, the services will be terminated forthwith without assigning
any further reasons and without prejudice to such further action as may be taken
under the provisions of the Indian Penal Code for production of false certificates.

8. SENIORITY

The Seniority of the Junior Executive [ATC] will be determined as per rank in merit
list which includes marks of written test plus interview.

9. MISCELLANEOUS

(a) He/She is required to undergo an initial medical examination from the Medical
Board of Govt. Hospital or the Medical Authority prescribed by AAI and
produce Medical fitness Certificate in the enclosed format. The Medical
Certificate should be submitted to In-Charge, Training Centre before joining.

(b) He/She should submit to the Incharge, Training Centre, the original certificates
regarding Date of Birth, Educational Qualification, OBC/SC/ST/EX-Servicemen
Certificate, if any, and also the Agreement Bond and Medical Fitness Certificate
from the Medical Board before joining the training.

(c) The joining date at the Training Centre will not be extended under any
circumstances.

(d) If at any time it is found that he/she has suppressed any factual information,
the appointment will be terminated forthwith without any reason.

(e)The terms and conditions mentioned earlier may be modified if required at any
time during the period of training/appointment as Junior Executive (ATC).

__________
 D
CANDIDATE’S STATEMENT AND DECLARATION

The candidate must make the statement required below prior to his medical examination and
must sign the declaration appended thereto. His/her attention is specially directed to the warning
containing in the note below:-

1. State your name in full ________________________________

(in BLOCK LETTERS)

2. State your age and place of birth ________________________________

3. (a) Have you ever had small pox

intermittent or any other fever,
enlargement or suppression of glands,asthma,
heart disease, long disease, fainting attacks,
regeumatism, appendicitis?

OR
(b) any other disease or accident
requiring confinement to bed and
medical or surgical treatment. ________________________________

4. When were you last vaccinated? ________________________________

5. Have you or any of your near relations

been afflicted with Consumption, Scrofula,
Gout, Asthma, Fits, Epilepsy or Insanity ________________________________

6. Have you suffered from any form of nervousness

due to over-work or any other cause? ________________________________

7. Have you been examined and declared unfit

For Govt. service by a Medical Officer/Medical
Board within the last 3 years. ________________________________
 8. Furnish the following particulars concerning your family.

Father’s age if living Father’s age at death No. of brothers living, No. of brothers dead,
and state of health and cause of death their age and state of their age at death and
health cause of death

Mother’s age if living Mother’s age at death No. of sisters living, No. of sisters dead,
and state of health and cause of death their age and state of their age at death and
health cause of death

I declare all the above answers to be, to the best of my belief, true and correct.

I also solemnly affirm that I have not received a disability certificate/pension on account of
any disease or other conditions.

____________________
Candidate’s signature

FIT/UNFIT

Signed in presence of

_________________
Signature of Medical Officer

NOTE: The candidate shall be held responsible for the accuracy of the above statement. By
willfully suppressing any information he/she will incur the rise of losing the appointment,
and if appointed, of forfeiting all claim to superannuation allowance or gratuity.
 E

BOND

Know all men that by these presents

we______________________________son/daughter_____________________________of resident
of ________________________________________________________________ (hereinafter
referred to as Trainee (Junior Executive (ATC) employee) and
__________________________son/daughter_____________________________________ resident
of_______________________________________________(hereinafter referred to as Surety) do
hereby firmly bind ourselves and out respective heirs, executions, administrators up to Airports
Authority of India, Rajiv Gandhi Bhavan, Safdarjung Airport, New Delhi-110003 having its offices
in different parts of the country (hereinafter called Authority) in terms of this Bond.

WHEREAS the Trainee employee has been selected by the Authority as

_______________________________________________ vide its offer of appointment
_____________________________ dated ________________ for imparting training to him/her
with a view to utilize his/her services in the Authority, which offer has been unequivocally accepted
by the Trainee employee.

AND WHEREAS in terms of clause 1 of the terms and conditions of the said offer of
appointment the trainee-employee is required to undergo training for a period as decided by the
management and thereafter will serve the authority for a period of 3 years as stipulated in the offer
of appointment.

AND WHEREAS in terms of the clause 3 of the terms and conditions of the said offer of
appointment, the trainee-employee and his Surety are required to execute a Service Agreement
Bond on non-judicial stamp paper of value of Rs./-100(Rupees Hundred only) in favour of the
Airports Authority of India, undertaking to complete the training and thereafter to serve the
authority for a period of 3 years failing which the trainee-employee and the surety shall be jointly
and severally bound to pay the Authority a sum of Rs.3,00,000/-(Rupees Three lacs only) in terms
of this Bond.

(Signature of Trainee)

Signature of Surety:
Name: __________________
Address: __________________
__________________
 NOW, THEREFORE this Bond witnesses as under:-

1. That the trainee-employee shall undergo the training provided by the authority for a period
as decided by the management which may be extended at the discretion of the Authority during
which period the Trainee-employee shall diligently, faithfully and to the best of his/her ability
undergo the training and conduct and behave himself/herself honestly, orderly and obediently
towards his/her whole time duties assigned by the authority and will not engage directly or
indirectly in any trade, business or occupation till the end of the period for which he/she is bound to
serve the Authority and the decision of the Authority shall be conclusive and binding.

2. That the Trainee-Employee shall not leave the Authority during the prescribed training
period of 24 weeks (which may be extended at the discretion of the Authority) or during the period
of service of the authority for the stipulated period of 3 years after completion of the training,
except for reasons of continued serious ill-health/incapacitating him/her to work provided that such
ill-health has not been brought about by his/her own neglect, carelessness, design or misconduct
about which the decision of the authority shall be conclusive and binding.

3 That the trainee-employee shall promptly obey him/her superiors and comply with their
orders, instructions issued from time to time and at all times and in all respect shall faithfully
observe all the Rules and Regulations of the Authority.

4. That the trainee-employee shall observe secrecy and in no way divulge or disclose to any
person or persons whatsoever, the secrets entrusted to him/her or coming to his/her knowledge in
the course of his/her training and service with the authority either in relation to its work business or
its customers.

5. That the trainee-employee shall not commit or cause to be committed any waste, damage or
other injury to the property and/or goods of the Authority not shall he/she lend any such property or
goods to any person without the permission of the management of the Authority.

6. The Trainee-employee shall not participate in political activities nor shall become a member
of political organizations.

(Signature of Trainee)

Signature of Surety:
Name: __________________
Address: __________________
__________________
7. That if the Trainee-employee voluntarily quits at any time during the period of training or fails
to complete his/her training successfully and/or does not serve the Authority for the stipulated
period of 3 years thereafter, the trainee-employee and the surety shall jointly and severally
compensate the authority for all the expenses incurred by it on account of and in connection with
his/her training. The expenditure incurred by the authority on account of and in connection with the
training of the Trainee-employee shall include the stipend, T.A. etc. paid to the Trainee-employee
during the training period, the cost of supervision, overhead and other direct and indirect expenses
incurred by the authority on the training. The decision of the Chairman or an Officer nominated by
the Chairman of the authority shall be final and binding as to the total amount of expenditure
incurred by the authority on account of and in connection with the training of the trainee employee.
However, the total amount recoverable under this clause shall not exceed Rs.3,00,000/-
[Rupees Three lacs only]. Further the trainee employee shall on the termination of his/her
training/service by the Authority or on his/her leaving the said training/service whenever it may
happen shall account, documents papers and effects then in his/her possession and custody and
belonging or relating to the Authority.

8. That at the end of the stipulated and extended period of training, as the case may be, the
suitability of the above Trainee-employee for employment in the service of the Authority will be
evaluated by the Competent authority of the Authority on the basis of his/her performance during
the period of training and the decision of the Competent Authority in this regard shall be final and
binding on Trainee-employee and the surety. In case the trainee-employee despite giving due
opportunity to improve himself/herself during the initial or extended period of training fails to
complete the training successfully, he/she would be liable to reimburse to the Authority the
expenses incurred by it as detailed in para 7 above.

9. That if in the opinion of the competent Authority the Trainee-employee has successfully
completed the training, the Trainee-employee shall be bound to accept the employment of the
authority and shall continue to be in the employment of the Authority at its direction, in any
subsidiary of the Authority or in any department of any undertaking of the Government of India, for
a period of 3 years thereafter, unless his/her service are duly terminated by the authority before that
period.

(Signature of Trainee)
Signature of Surety:
Name: __________________
Address: __________________
__________________
10. That the Authority shall have the right to suspend or dismiss the Trainee-employee for any
breach on his/her part to comply with any of the terms and conditions of the offer of appointment or
this Bond or those of the Training scheme and/or any of the rules and Regulations of the Authority
for the time being in force and/or any concealment of any disease or disability from which the
trainee-employee and the surety aforesaid shall jointly and severally be liable to reimburse to the
Authority the expenditure incurred on account of and in connection with the training to the Trainee-
employee as provided herein before under this bond. The said surety in his individual and personal
capacity hereby undertakes and guarantees to pay to the Authority, on demand, the expenditure
incurred on account of and in connection with the training of the Trainee-employee as detailed in
para 7 above in case the Trainee-employee commits breach of any of the terms and conditions of
this Bond or the training Scheme of the Authority. The said surety further agrees that the Authority
at its discretion shall be entitled to enforce this Bond against the surety as Principle Debtor in first
instance, without proceedings against the trainee-employee and not-withstanding any amounts
which may be payable by the Authority to the Trainee-employee.

11. That for matters not provided for in this service Agreement Bond, the trainee-employee
shall be governed by the offer of appointment and rules and Regulations of the Authority in force
from time to time.

12. That the Authority, however may at its discretion interrupt, or terminate the training in the
event of adverse reports regarding the progress of trainee or health of the Trainee-employee
without, thereby, incurring any liability to the trainee-employee.

13. That the above Trainee-employee and surety further agree that if the trainee-employee
leaves training or service of the authority before the expiry of the stipulated period of training and
service thereafter, he/she and the surety will not only be liable to reimburse to the Authority the
expenses incurred by it on account of and in connection with the training but will also be required
to give one month advance notice while on training and on probation after absorption and after
completion of probation period or pay further amount equivalent to one months salary last drawn in
lieu of notice in terms of the offer of appointment.

14. That after completion of 3 years service if the trainee-employee wants to leave service of the
Authority then he/she shall give one months advance notice to the Authority failing which he/she
will also be liable to pay to the authority compensation equivalent to one months salary.

(Signature of Trainee)

Signature of Surety:
Name: __________________
Address: __________________
__________________
15. That in the event of insolvency, lunacy or death of the surety the above trainee-employee
undertakes to intimate the Authority of the event with satisfactory proof thereof within 15 days of
occurrence, and shall execute a fresh bond with a fresh surety or sureties as may be acceptable to
the Authority, without prejudice to the rights of the Authority to proceed against the original surety
or his estate.

16. That in case the trainee-employee does not comply with the terms and conditions contained
in the offer of appointment the Rules and Regulations of the authority and the covenants contained
in this Bond, the Trainee-employee and his surety undertake that they shall jointly and severally pay
to the authority on demand without any demur the amount demanded by the Authority towards the
expenses incurred by it on account of and in connection with the training of the trainee-employee
including salary, TA/DA passage fare, cost of supervision, overhead charges, direct and indirect
expenses incurred by the Authority, provided that the total amount recoverable on account of and in
connection with the training shall not exceed Rs. 3,00,000/-(Rupees three lacs only) plus an
amount equivalent to one months salary in lieu of notice period, if any, as per offer of appointment
applicable and any other amount that may be due to the Authority on account of other payments or
on other accounts, if any.

AND upon making such payment and satisfaction of this clause the above written obligation of the
bond shall be void otherwise it shall remain in full force and virtue.

PROVIDED FURTHER that the liability of the said

_____________________________________(Trainee-employee and ________________
_____________________(Surety) hereunder shall not be impaired or discharged by reasons of time
being granted to the Trainee-employee and/or the surety for fulfilling their obligations under this
bond or by any forbearance, act of omission or commission on the part of the Authority or any
person(s) authorized by it (whether with or without the consent or knowledge of the said surety),
nor shall it be necessary for the Authority to sue the Trainee-employee before suing the Surety for
recovery of amount due hereunder.

17. All suits in respects of any dispute arising out of this service agreement bond shall be
instituted in the courts at Delhi only.

18. That the Trainee-employee and surety agree that the decision of the Chairman or an officer
nominated by the Chairman of the Authority as to the correct interpretation of the Bond, rules and
regulations of the authority and as to whether the trainee-employee has or has not observed and
complied with the obligations herein recited, shall be final and binding.

(Signature of Trainee)

Signature of Surety:
Name: __________________
Address: __________________
__________________
IN WITNESS WHEREOF the parties here to have signed these presents on this
________(day) of _________(month)____________(year) at _________________(Station) in
the presence of the following witness:

1. Witness: _____________________________
Signature__________________ (Signature of the trainee employee)

Name__________________________ Name_________________________
(IN BLOCK LETTERS) (IN BLOCK LETTERS)
Occupation_____________________ Occupation____________________
Address________________________ Address______________________
_________________________ ______________________
_________________________ ______________________

2. Witness: _____________________________
Signature__________________ (Signature of Surety)

Name_____________________ Name of the Surety____________________

(IN BLOCK LETTERS) (IN BLOCK LETTERS)
Occupation_____________________ Occupation____________________
Address________________________ Address______________________
________________________ ______________________

Income Tax A/C No. of Surety: ___________

Attested Attested
Signature & seal of Gazetted Officer / Signature & seal of Gazetted

Notary Public Notary Public

ACCEPTED FOR AND ON BEHALF OF AIRPORTS AUTHORITY OF INDIA

____________________________
(Signature of the authorized Officer)

Name:_______________________

Address: ____________________________
____________________________
_______________________________
 F
RECENT
PHOTO

ATTESTATION FORM
(To be submitted in triplicate)

POST : _________________________________

“WARNING”
The furnishing of false information or suppression of any factual information in the
Attestation form would be a disqualification and is likely to render the candidate unfit for
employment under the Government.

II. If detained, arrested, prosecuted, bound down, fined, convicted, debarred, acquitted etc.,
subsequent to this form, the details should be communicated immediately to the authorities to
whom the attestation form has been sent early, failing which it will be deemed to be suppression of
factual information.

III. If the fact that false information has been furnished or that there has been suppression of any
factual information in the attestation form comes to notice at any time during the services of a
person, his service would be liable to be terminated.
________________________________________________________________________

1. Name in full (in block capitals) SURNAME NAME

with aliases if any (please indicate
if you have added of dropped in
any stage any part of your name
or surname)
______________________________________________________________________________

2. Present address in full i.e. village

Thana and district or House
Number Lane/street /Road and
Town.
-----------------------------------------------------------------------------------------------------------------------------------
3. (a) Home address in full i.e. village
Thana and District or
House number, Lane/Street
Road and Town and Name of
District Headquarters

(b) If originally a resident of Pakistan /

Bangladesh (erstwhile East Pakistan)
the address in that country and the
date of migration to Indian Union.

--------------------------------------------------------------------------------------------------------------------------------
 4. Particulars of places (with periods, or residence) where you have resided for more than a year at a
time during the previous five years, in case of stay abroad (including Pakistan) particulars of all places
where you have resided for more than one year after attaining the age of 21 years, should be given.

From To Residential address in full (i.e. Village, Name of the District

Thana and District or House Hqrs, of the place
No./Lane/Street/Road and Town) mentioned in the
preceding column

5.
Name Nationality Place Occupation (if Present Permanent home
(by birth of birth employed give postal address
and/ or by designation and address (if
domicile official address) dead give last
address)

i) Father’s name
in full with aliases
if any
______________________________________________________________________________
ii) Mother
______________________________________________________________________________
iii) Wife/husband
______________________________________________________________________________
iv) Brother(s)
______________________________________________________________________________
v) Sister(s)

______________________________________________________________________________

6. (a) Information to be furnished with regard to son(s) and/or daughter(s) in case they are studying/ living
in a foreign country :-

Name Nationality (by Place of Country in which Date from which studying/living
birth and/ or by birth studying/living with in the country mentioned in the
domicile previous column
full details

(b) Nationality ____________________________________

7. (a) Date of Birth (a)

(b) Present Age (b)

(c) Age at Matriculation (c)

________________________________________________________________________

8. (a) Place of birth, District

and State in which situated (a)

(b) District and State to which

you belong (b)

(c) District and state to which your

Father originally belongs (c)
________________________________________________________________________

9. (a) Your Religion

(b) Are you a member of SC/ST/OBC/

Physically Handicapped/ Ex-Serviceman Yes or No

(c) If yes, mention caste/category/Details

10. Educational qualification showing place of education with years in schools and colleges
since 15th year of age :

Name of School/College with full Date of Date of Examination passed

address entering leaving

11.(a) Are you holding or have any time held an appointment under the Central or
State Government or a Semi Government or a Quasi Government Body or an
Autonomous Body or a Public Undertaking or a Private Firm or in any Institution.
If so, give full particulars with dates of employment, up-to-date.

Period Designation, emoluments Full name and Reason for leaving

and nature of address of employer previous service
employment
11.(b) If the previous employment was under the Government of India/ State Government/ an
Undertaking owned or controlled by the Government of India or a State
Government/ an Autonomous Body/ University/ Local body.

If you had left service on giving a month’s notice under rules 5 of the Central Civil
Services (Temporary Service) Rules, 1965 or any similar corresponding rules were
any disciplinary proceedings framed against you, or had you been called upon to
explain your conduct in any matter at the time you gave notice on termination of
service or at a subsequent date before your services actually terminated?
Yes/No

12. (I) a) Have you ever been arrested ? Yes/No

b) Have you ever been prosecuted ? Yes/No

c) Have you ever been kept under detention? Yes/No

d) Have you ever been bound down? Yes/No

e) Have you ever been fined by a Court of Law? Yes/No

f) Have you ever been convicted by a Court of Yes/No

Law for any offence?

g) Have you ever been debarred from any examination

or rusticated by any university or any other
Educational Authority/Institution ? Yes/No

h) Have you ever been debarred/disqualified by any

Public Service Commission /Staff Selection
Commission for any of its Examination/ Selection Yes/No

i) Is any case pending against you in any Court of

Law at the time of filling up this Attestation Form ? Yes/No

j) Is any case pending against you in any University

or any other Educational Authority/ Institution at
the time of filling up this Attestation Form? Yes/No

k) Whether discharged/expelled/withdrawn from any

Training Institution under the Government or Yes/No
otherwise ?

(II) If the answer to any of the above mentioned question is ‘YES’ give full particular of the
case/arrest/detention/nature of the case pending in the Court/University/Educational
Authority etc. at the time of filling up this form.

NOTE : (I) Please also see the ‘warning’ at the top of this Attestation Form.

(II) Specific answers to each of the questions should be given by striking out ‘Yes’ or
‘No’ as the case may be.
13. Name of the two responsible 1.
persons of your locality or
two references to whom you
are known
(with Tel./Mobile No.)

2.

I certify that the foregoing information are correct and complete to the best of my
knowledge and belief. I am not aware of any circumstances which might impair my fitness
for employment under Government.

_____________________

Signature of candidate
Date :

Place :
 IDENTITY CERTIFICATE

Certificate to be signed by any one of the following:

1. Gazetted Officer of the Central or State Government;

2. Member of Parliament or State Legislature belonging to the constituency where the

candidate or his Parents/Guardian is ordinarily resident;

3. Sub-Divisional Magistrates/Officers;

4. Tehsildars or Naib/Deputy Tehsildars authorized to exercise magisterial powers;

5. Principal/Head Master of the recognized School/College/Institution where the candidate

studied last;

6. Block Development Officer;

7. Post Master;

8. Panchayat Inspectors.

Certified that I have known Shri/Smt/Kum _______________________________

son/daughter of Shri ______________________________ for the last _________ years
_______ months and that to the best of my knowledge particulars furnished by him/her are
correct.

Signature____________________

Designation or Status_____________________

Address :______________________

Date : __________

Place :__________

TO BE FILLED BY OFFICE

1. Name, Designation and address of the appointing authority

2. Post for which the candidate is being considered.

 G

CHARACTER CERTIFICATE

Certified that I have known Mr./Mrs./Miss ______________________________

son/wife/daughter of Shri ________________________________ for the last _________ years
_________ months and that to the best of my knowledge and belief, he/she bears a good moral
character and has no antecedents which should render him/her unsuitable for Government
employment.

Mr./Mrs./Miss _______________________ is not related to me.

Signature___________________

Date: Name in Block letters ___________________

Place: Designation and Seal

Office Telephone/Mob. No.___________________

INSTRUCTIONS

1. To be signed or counter-signed by a Gazetted Officer of the Government of India or a State

Government or Magistrate 1st Class or a Member of the Parliament or State Legislature.

2. Signatory’s designation may also be given in type block letters.

3. Period, for which the vouching officer should have known the candidate should be at least
one year.

4. The certificate should be of recent date.

 H

DECLARATION

( To be obtained from new entrants to AIRPORTS AUTHORITY OF INDIA)

I Mr./Mrs./Miss _______________________________________________

* (i) that I am unmarried/widower / a widow

* (ii) that I am married and have only one spouse living

* (iii) that I have entered into and contracted a marriage with another person during the
life time of my spouse. Application for grant of exemption is enclosed.

* (iv) that I have entered into and contracted a marriage with another person during the life
time of my spouse. Application for grant of exemption is enclosed.

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

Signature _____________________

Designation ___________________

Station _______________________

Date ________________

Note : Please strike out clause/clauses not applicable.

 I

OATH OF ALLEGIANCE TO THE CONSTITUTION

I _________________________________ do swear solemnly affirm 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 uphold the sovereignty and integrity of India and that I will
carry out the duties of my office loyally, honestly and with impartiality.

(SO HELP ME GOD)

Signature ____________________

Designation __________________
 J
AIRPORTS AUTHORITY OF INDIA

Declaration regarding “Home Town” vide sub-para (4) of paragraph 1 of the Ministry of
Home Affairs O.M. No.43/1/55-Ests. (a) part II dated the 11th October, 1956, as amended from time
to time.

I, _______________________ son/daughter of ____________________________ Employed as

_____________________ in the office of Airports Authority of India, here declare that my
permanent “Home is (Town/village) ______________ Distt _____________ in the state of
______________________ being

* (i) the place, which requires my physical presence of the intervals discharging various domes
and social obligations and I had been visiting that place frequently after my entry into service.

*(ii) the place, where I own residential property or I am a member of a joint family having
residential property there.

*(iii) the place is the permanent residence of my parents, brothers etc., where I would normally
reside but for my absence from that place for service in Government.

*(iv) the place, where I had been living there for some years prior to my entry into Govt service.

*(v) the place of my permanent home town or village as entered in the service book or other
appropriate official record.

*(vi) the place of my domicile in India after migration from ___________________.

Signature ___________________

Designation __________________
Dated :

* Strike out whichever is not applicable.

* Any additional reason/reasons, if necessary, may be given for declaring “Home” in space
provided above.

N.B. A declaration of “Home” once made shall ordinarily be treated as final.