APPLICATION FOR NO OBJECTION CERTIFICATE FOR PERSONNEL

PROCEEDING ABROAD ON TRAVEL / POSTING AND FOR PASSPORT.
PART – 1
1.
2.
3.
4.

Name in block letters
Designation
a) Date of Joining in the Samiti
b) Present place of posting
c) Since
Address (Present)

:
:
:
:
:
:

______________________________
______________________________
______________________________
______________________________
______________________________
______________________________

5.

Address (Permanent)

:

______________________________
______________________________

6.

a)
b)
a)
b)
c)
d)

:
:
:
:
:
:

______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________

7.

8.
9.

10.

Father’s Name
Father’s Occupation & address
Countries proposed to be visited
Date of Departure
Purpose of visit
Probable period of stay in each
country with dates

e) Probable date of return
:
______________________________
Approximate amount expected to be spent for the trip including
Journey and stay abroad
:
______________________________
a) Is the trip abroad financed by self :
______________________________
b) If so, the source of amount being :
______________________________
spent
a) Is the trip being financed by other :
person
b) If so, the name of person :
indicating relation and address
(documentary evidence and an
undertaking from the concerned
person that he would bear the
expenditure are to be enclosed).

______________________________

______________________________

11.

Details of blood / close Relation :
working in Foreign Embassies/firms
in India/abroad

______________________________

12.

Details of applicant’s employment :
during last ten years.

______________________________
Signature of the candidate

Date : ____________

PART – II
1.

2.

3.

a) Are the entries given by the :
applicant in Part-I are correct

______________________________

b) If not, the reason/correct position :

______________________________

Is the applicant handling any :
classified work, Divulgence of
which may effect the security of
service and the country

______________________________

a) Was the individual even :
involved in any departmental
inquiry or any other case
pending against the applicant.

______________________________

the amount and mode of : recovery ? ______________________________ 7. 5. If yes. ______________________________ Is the applicant’s visit requested for. nature of inquiry and its result. ________________ Date : ______________ ----------------------------------------------------------------------------------------------------------NOTE :- Part II is to be filled by the Principal of the Vidyalaya concerned and permission is to be granted by the concerned Deputy Commissioner of the Region. : recommended? Are any financial dues outstanding : towards the application? ______________________________ 6.b) If so. : ______________________________ (Signature of the Principal) Name in ___________________ (BLOCK LETTERS) Office seal No. . Any compensation paid 9 of Part I ______________________________ 4.