Official :: Vidyut Suraksha Nideshalay

Form-W-B

(See condition no.4 and 6)

Application for grant of wireman permit

1. Name of applicant: .......................................................................................................................................................... (in clear words)

2. Father's Name: ...............................................................................................................................................................

3. Caste: .............................................................................................................................................................................

4. Full address of the post: .................................................................................................................................................

5. Date of Birth: ..................................................................................................................................................................

6. Certificate permit:

(1) ........................................

(2) ........................................

7. (A) Number of invoices ...........................date .........................................

(B) Name of Treasury Treasury: .........................................................................................................................................

I hereby declare that the details given above are correct, two certified photographs (one on one front and one on the other side) are attached with the Treasury invoice and the original certificate of service provided by my service provider.

8. Details of service or experience from the last date of renewal of issuance .........................

In the presence of the following persons:

(1) ........................................

(2) ........................................

Signature of Applicant

........................................

Note -:

1- Renew the renewal fee of 180 rupees for the certificate fee by depositing it under the following account head in a treasury of Uttar Pradesh with the acknowledgment copy of the challan with the application form: - Accounting Title - '' 0043- Taxes and fees on electricity, 102- Fees under Indian Wage Rules "

2- If the certificate / permit is submitted for renewal within one year of such date but after the expiry of its period, the delay charge will also be payable at the lower rate, but any proof after one year of the expiry date The letter or permit will not be renewed.

Certificate - 45.00 Rupees

Permit - 30.00 rupees

3- Restriction for renewal of certificate / permit is that the director of electrical security should get the solution that the purchaser has actually executed at least two years during the period of the certificate or due to the permit, In relation to the licensed contractor of power, electricity supply, licensee or approved registered factory or an institution which is government Be done by working in places where the Indian Electricity Rules, 1956, the rules have been freed from -45 or worked with any government department, therefore, certificate / permit validity period to attach his certificate.

4- Apply two latest passport size photographs with the application form, by which one has been certified with a gazetted official or your service sponsor by typing his name in front of one and the other.

5- Authenticate the two signatures of the sample on a plain paper.

6- If the applicant has completed 58 years of age, then submit a certificate from the Registered Doctor to the effect that you are capable of doing physical work.