Form 'A' - Application For Certificate Of Competency As Boiler Attendant Class - Ii Page 2
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6PART-III
LIST OF TESTIMONIALS AND STATEMENTS OF SERVICE
(The testimonials to be numbered serially corresponding to the numbers given in column 1 below)
Serial
Date of
Name of
Address and
Number,
Capacity in
Service of Applicant
Period for which employed
Not to be filled in by
Number of
testimonials
person
designation
Type and
which
the applicant
testimonials
signing the
of factory or
heating
employed
testimonials
workshop
surface of
where
boilers
employed
worked
on
Date of
Date of
Years
Months
Days
Initial of
Remarks
Commencement
termination
Verifier
1
2
3
4
5
6
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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