Family declaration on TA.doc

1.

Name of Govt.servant:

2.

Designation:   

3.

Date of Birth:

4.

Date of appointment:

5.

Details of the member of family as on:

Sl.No.

Name of the member of family

Date of Birth

Relationship with the official

Initial of Head of Office

Remarks

1.

2.

3.

            I hereby undertake to keep the above particulars update of notifying to the Audit Officer/head of Office any addition or alteration          

Dated Aizawl,the 24^th February, 2012

Signature of Govt.Servant

Family for this purpose means:           

(a)

Wife/Husband of Govt.servant as the case may be residing with the Govt.servant 

(b)

Legitimate children and step-children residing with and wholly dependent upon the Govt.servant

(c)

Except in Rule 116, C-155A and 163, it includes, in addition, parents, sisters and minor brothers,

if residing with and wholly dependent upon the Govt.servant       

COUNTERSIGNED:

           I   Lalrindika    solemnly affirm that the above declarations are true to the best of my knowledge and behalf and that in the event of the declaration being found to be incorrect after my appointment, I shall be liable to termination/dismissal from service.

Dated Aizawl, the 24^th February, 2012

Signature of Govt.servant.