(Refer to Para 29(c) of

Prospectus)
CERTIFICATE NO – 3

CHILDREN OF ARMY MEDICAL CORPS /AD CORPS OFFICERS SERVING

IN AIR FORCE /NAVY MEDICAL ESTABLISHMENT/MNS/APS AND TA PERSONNEL
(By Parent, Countersignature by OC Unit)

1. I, No ______________Rank __________Name___________________________
Father/Mother of _________________________________ certify that:-

(a) I am/was commissioned in Army Medical/Army Dental Corps and have/had not been
seconded to Navy or Air Force and have 10 years of service in the Army.

(b) I am/was commissioned in Army Medical /Army Dental Corps and have been transferred
to Navy or Air Force but I have served in the Army for minimum ten years.

(c) I am an APS personnel on deputation who has put in more than 10 years of service
in the Army from ____________________to __________________.
OR
(d) I am an APS personnel directly recruited into APS and who is still serving in Army wef
_____________

(e) I am a TA personnel who is in receipt of pension/who has put in more than 10 years
of embodied service in TA from _________to______________.

(f) I am MNS personnel who is in receipt of pension/who has put in more than 10 years
of service as member of MNS.

Place : Signature

Date : Name, Designation and Unit

CERTIFICATE
(BY OC UNIT)

The facts in the above mentioned undertaking have been verified from official records and
found correct.
OC Unit (for serving personnel)
DSS & A Bd(for retired personnel)
Date : Name, Designation and Unit
Office Seal
COUNTERSIGNED

Concerned Staff Officer of Fmn HQs

(for serving personnel)
Date : DSS&A Board(for retired personnel)
Office Seal Name and Designation

Name and Signature of the Candidate …………………………………………………………

Note:
1. Strike out the portion /Para not applicable.
2. Relevant documents of service records.