Form 'A' - Application For Certificate Of Competency As Boiler Attendant Page 2
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1
2
3PART III: LIST OF TESTIMONIALS AND STATEMANTS OF SERVICE
(The testimonials to be numbered serially corresponding to the numbers given in column below)
Serial
Date of
Name of
Address and
Number, type and
Capacity in which
number of
testimonials
person
designation of
heating surface of
employed
testimonials
signing
factory or
boilers worked on
testimonials
workshop where
employed
1
2
3
4
5
6
Service of applicant
Period for which employed
Not to be filled by the applicant
Date of
Date of
Years
Months
Days
Initials of
Remarks
commencement
termination
verifier
7
8
9
10
11
12
13
Total Service
Time served for which certificates are produced
Time served for which no certificates are produced
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