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: _____________________