Appendix 'G'
(Refer to Para 19 (b ) of SOP)

 

CERTIFICATE

 

This is to certify that the details of Shri/Smt. ………..............................…… son/daughter of  Shri …………………….................resident of (R/O)................................... .........................….............…  ……………………………………………. who has been nominated as proxy in respect of P No .....…..……… Rank………..……………has been published vide DO Part-1 order No. ……...........………..dated………….

 

  Place: ………….. Signature/Sea1of Unit
  Date: