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.

______________________________

Any compensation paid 9 of Part I ______________________________ 4. ________________ 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. nature of inquiry and its result. : recommended? Are any financial dues outstanding : towards the application? ______________________________ 6.b) If so. 5. . If yes. ______________________________ Is the applicant’s visit requested for. the amount and mode of : recovery ? ______________________________ 7. : ______________________________ (Signature of the Principal) Name in ___________________ (BLOCK LETTERS) Office seal No.

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