( In organization Letter Head)
	
Annexure I	

             Service cum Experience Certificate

It is hereby certified that Dr./Mr./Mrs./Ms.
has worked/is working in this organization, viz. _________________________________
____________________________________________________ and the details of his/her employment is furnished below 

Designation	Group A/B/C	Pay Scale	Grade pay	Period	Nature of employment Permanent/ Temporary/ Contract	
				From	To		

							

			 
Further certified that, Dr./Mr./Mrs./Ms.------------------------------------- has not suffered any punishment and no disciplinary or criminal case is pending/ contemplated against him/her at this organization.

    (Signature of the officer with name & Seal)

Place: _____________________

Date: __________