No Demand Certificate Form Page 2
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7.
Account of Shri/Smt./Ms.________________________________has been checked and no Government dues are to be recovered
from him/her.
OR
Amount of Rs.________________is due from Shri/Smt./Ms.______________________________________on account of advance/over
payment and this amount will be adjusted at the time of making final payment to him/her.
Signature_________________
Name & Designation______________________
(B&P Branch/PA(MG) Branch)
8.
Shri/Smt./Ms.____________________________________has not availed of any leave which is pending for inclusion in the Office
Order Part-Il/leave ccount.
Signature__________________
Name & Designation______________________
(AN-II Branch/PA(MG) Branch)
9.
Shri/Smt./Ms.____________________________________has surrendered his/her CGHS Token No. ____________issued to him/her.
Signature__________________
Name & Designation______________________
(AN-II Branch)
10.
Shri/Smt./Ms.__________________________________is not/is in possession of Government residential accommodation
No.___________His/Her accounts will be settled after he/she vacates the accommodation and the dues on account of license
_________________fee will be adjusted at the time of making final payment to him/her.
Signature_________________
Name & Designation_____________________
(AN-II Branch)
11.
Shri/Smt./Ms. _________________________________has not been/has been provided Telephone connection No. at his/her
residence. The Telephone connection has been disconnected/will be disconnected on _______________. Amount of Rs._______________is
due from him/her on account of Telephone rental/local call charges and it will be adjusted at the time of making final payment to him/her.
Signature_______________
Name & Designation___________________
(AN-II Branch)
12.
Shri/Smt./Ms. __________________________________is not/is a member of the L.S.S. Cooperative Thrift & Credit Society Ltd.
Amount of Rs_________is due from him/her on account of Ordinary/Emergent Loan.
Sri/Smt./Ms. _________________________________and Shri/Smt./Ms.______________________________have stood as surety. An
undertaking from them has been obtained to the effect that in case of default, they shall pay the dues to the Society.
Signature______________
Name & Designation__________________
(LSS Coop. T&C Society Ltd.)
13.
Shri/Smt./Ms. ______________________________has submitted/written all Probation Report(s)/Confidential Report(s) in the capacity
of officer reported upon/Reporting Officer/Reviewing Officer as forwarded to him/her(applicable for concerned supervisory officer(s)).
Signature_____________
Name & Designation_________________
(Confidential Cell)
14.
No disciplinary/judicial proceedings is pending or being contemplated against Shri/Smt./Ms._____________________________.
Signature____________
Name & Desigantion_________________
(DM&CC Unit)
15.
No inventory/physical report is pending or being contemplated against Shri/Smt./Ms./____________________________________.
Signature_____________
Name & Desigantion___________________
(O&M Section)
16.
Shri/Smt./Ms._______________________________is not/is a member of the Central Secretariat Library/Sahitya Academy Library etc.
and has produced the necessary 'No Demand Certificate' from the concerned.
Signature_____________
Name & Desigantion___________________
(AN-I Branch)
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