To prepare autofilled file of ACP case. एसीपी केस की ऑटोफिल्ड फाइल तैयार करने के लिए।

Application Form for ACP Case

Through Proper Channel (Cover Letter)

ACP Case (1st, 2nd, or 3rd)

Applicant Name

Applicant ID No.

Designation

Name of School

Date of Appointment

Mobile No.

Due From Date

Memo to DEO

Recipient

Memo No.

Memo Dated

ACP Rules details (Para & Rule)

SERVICE VERIFICATION CHART

Name of Govt. Employee

Designation

Date of appointment on regular basis

Present Place of Posting

Sr. No.	Detail of Qualifying Service Period (From)	To	Part & Page No. of Service Book	Details of Non-Qualifying Service Period (From)	To	Reason	Actions
1

RESULT SHEET (Previous Years)

Sr. No.	Name of the Examination	Subjects	Number of Students	Number Passed	Pass %	Pass % (Board/Dept.)	Difference	Actions
1

UNDERTAKING

I hereby undertake that any excess payment that may be found to have been made as a result of incorrect fixation of pay or any excess payment detected in the light of discrepancies noticed subsequently will be refunded by me to the Government either by adjustment against future payments due to me or otherwise.

UNDERTAKING

I hereby undertake that as a result of any rectification or adjustment in the pay matrix granted to me on the strength of any interim order by any Court of Law or on the basis of any interim order by any Court of Law, any excess amount which may be found to have been made as a result of relevant appropriate decision taken by the Government on the final decision of the Court of law, will be refunded by me to the Government either by adjustment against future payments due to me or otherwise. I further undertake to abide by such relevant appropriate decision of the Government taken on the final decision of such Court of law as the case may be.

Certificates (Auto-filled)

No Complaint / Enquiry Certificate

Certified that there is no complaint/enquiry under rule is pending against [Name] (ID: [ID]) Designation [Designation] at [School].

Integrity Certificate

Certified that the Integrity of [Name] (ID: [ID]) is not doubtful.

No Judicial / Department Proceeding Certificate

Certified that no Judicial/Department Proceeding have been instituted/pending against [Name] (ID: [ID]).

Hint: All table cells are editable. Use the "+ Add" / "- Remove" buttons to manage rows. The Date fields will automatically format as dd/mm/yyyy.

Application Form for ACP Case

---

SERVICE VERIFICATION CHART

Name:   Designation:

Appointment on regular basis:   Posting:

RESULT SHEET

UNDERTAKING

Date:

Station:

Countersigned

Signature of the employee

Name:

Designation:

Office:

UNDERTAKING

Date:

Station:

Countersigned

Signature of the employee

Name:

Designation:

Office:

Certificates

No Complaint / Enquiry Certificate

Counter Signed by

Signature (Name & Seal)

Integrity Certificate

Counter Signed by

Signature (Name & Seal)

No Judicial / Department Proceeding Certificate

Counter Signed by

Signature (Name & Seal)