शपथ पत्र

मैं श्री / श्रीमती / कु. ............................................ पुत्र / पत्नी / पुत्री स्व॰ श्री ............................................... यह सत्यापपत करता / करती ह ूं कक मेरे पपता / पतत स्व॰ श्री ........................................... जोकक भारतीय पशु-चिककत्सा अनुसूंधान सूंस्थान, इज्जतनगर बरेली में .................... के पद पर काययरत थे, का देहाूंत ददनाूंक ...................... को हो गया है । मेरे पररवार में मुझे ममलाकर कुल ........... पुत्र एवूं ............ पुत्रत्रयााँ हैं जोकक मेरे पतत / पपता पर आचश्रत थे । पररवार में जीपवकोपाजयक एवूं बेरोजगार सदस्यों का पववरण इस प्रकार है ।

सदस्य का नाम आयु /

जन्मततचथ मतृक से सूंबूंध

पववादहत / अपववादहत (यदद पववादहत हैं तो पतत /

पत्त्न का नाम तथा स्थायी पता भी मलखें)

नौकरी / व्यवसाय का पववरण

मामसक आय*

*मामसक आय के साक्ष्य के तौर पर सदस्य का पैन कार्य, इनकम टैक्स ररटनय पववरण एवूं बैंक खाते (सभी िल रहे खाते) का पपछले एक वर्य का स्टेटमैंट सूंलग्न है ।

यह भी घोपर्त ककया जाता है कक अनुकूं पा तनयुत्क्त हेतु मेरे द्वारा प्रस्तुत आवेदन पर पररवार के सभी सदस्यों की सहमतत है, त्जसकी पुत्टट के मलए सभी के हस्ताक्षर प्राप्त ककए गए हैं ।

आवेदक एवूं पररवार के सदस्यों के हस्ताक्षर (नाम एवूं ददनाूंक सदहत)

-2- मेरे पपता / पतत स्व॰ श्री ............................................... द्वारा अत्जयत तथा पैतकृ िल-अिल सूंपपि का पववरण इस प्रकार है – 1. िल सूंपपि (नगदी / जेवर / बैंक डर्पोमसट / वाहन इत्यादद) का पववरण -

पववरण वतयमान कीमत

2. अिल सूंपपि (जमीन जायदाद / मकान / दकुान / प्लॉट / कृपर् भ मम इत्यादद) का पववरण -

पववरण पता (खसरा सूंख्या / गली / मोहल्ला / कस्बा / तहसील / नगर / त्जले का प णय ब्यौरा सूंलग्न ककया जाये)

वतयमान कीमत (सूंबत्न्धत सरकारी पवभाग द्वारा तय ककए गए सककय ल रेट के अनुसार प्रमाणणत कॉपी

के साथ सूंलग्न की जाये)

यह सत्यापपत ककया जाता है कक ऊपर मलणखत ब्यौरे के माध्यम से दी गई समस्त जानकारी सत्य है । इनमें से कोई भी जानकारी गलत पाये जाने पर अथवा कोई जानकारी छुपाए जाने की त्स्थतत में मेरा आवेदन तनरस्त कर ददया जाये । आवेदक के हस्ताक्षर / अूंग ठा तनशानी ...................................................... (प रा नाम एवूं ददनाूंक सदहत) ...................................................... मोबाईल नूंबर / ई-मेल पता ......................................................

List of the Applicants

SI.NO. Name of the Applicant & Deceased Employee Date of Death

1. Sh. Manoj Singh Deolia S/o Late Sh. Late Sh. Mohan Singh

Deolia, SSS

11.07.2008

2. Sh. Prarabdh Johri S/o Late Sh. Arvind Kumar Johri, T-I-3 22.04.2009

3. Sh.Pratap Singh S/o Late Sh. Chunni Lal, SSS 18.05.2009

4. Ms. Neha Pant D/o Late Sh. D. C. Pant, T-5 03.07.2009

5. Sh.Jagdish Singh Rawat S/o Late Sh. Kharak Singh, SSS 15.07.2009

6. Sh. Robinson Mashee S/o Late Sh. Mashee Charan, SSS 13.09.2009

7. Sh. Kartik Kannojia S/o Late Sh. Kailash Chandra Kannojia,

Assistant

21.09.2009

8. Km. Kritika Pathak D/o Late Sh. K. C. Pathak, T-4 (Lab) 17.12.2009

9. Sh. Mohd. Aleem Salmani S/o Late Sh. Ali Hussain, SSS 11.01.2010

10. Sh. Chintan Prasad S/o Late Sh. Jagannath Prasad, Assistant 28.06.2010

11. Sh. Kultaj Singh S/o Late Sh. Deewan Singh, Assistant 29.07.2010

12. Sh. Manoj Kumar S/o Late Sh. Tika Ram, SSS 16.09.2010

13. Sh. Gaurav Kumar S/o Late Sh. Girendra Kumar, T-1 20.09.2010

14. Sh. Mirja Soharab Beg S/o Late Sh. Mirja Vikar Beg, SSS 03.01.2011

15. Sh. Rakesh Kumar S/o Late Sh. Dwarika Prasad, SSS 28.12.2010

16. Ms. Ruchi Saxena D/o Late Sh. Yatan Kumar, Assistant 13.08.2011

17. Sh. Ram Singh Adhikari S/o Late Sh. Sagat Singh Adhikari,

SSS 14.09.2009

18. Sh. Ram Autar S/o Late Sh. Tulsi Ram, SSS 06.11.2011

19. Sh. Touseem Khan S/o Late Sh. Rais Khan, SSS 26.11.2011

20. Sh. Mahesh Chandra S/o Late Sh. Mathura Dutt, SSS 03.01.2012

21. Sh. Harish Chandra Joshi S/o Late Sh. Chandra Ballabh

Joshi, SSS 20.03.2011

22. Sh. Brajmohan S/o Late Sh. Kishan Lal, Assistant 03.09.2000

23. Sh. Ram Singh S/o Late Sh. Lacham Singh, SSS 29.11.2011

24. Ms. Kalpana Saxena D/o Late Sh. Santosh Kumar, SSS 22.02.2012

25. Sh. Narendra Singh Mer S/o Late Sh. Ratan Singh Mer,

SSS

21.07.2012

26. Sh. Sanjay Singh Bisht S/o Late Sh. Narayan Singh Bisht,

AAO

20.09.2012

27. Sh. Shubhankar Sircar S/o Late Sh. Suprabhat Sircar, T-5 15.05.2012

28. Sh. Praveen Bisht S/o Late Sh. Khim Singh Bisht, SSS 04.07.2013

29. Ms. Bharti Thakur D/o Late Sh. Vir Bhan Singh, SSS 16.10.2012

30. Ms. Anupa Awadhiya D/o Late Sh. Gopal Awadhiya, T-6 30.06.2013

31. Sh. Shivaraju. V S/o Late Sh. Vijaya Kumar, SSS 26.11.2006

32. Sh. Chatrapal S/o Late Sh. Govind Ram, SSS 11.03.2008

33. Sh. Pankaj Kumar Kabdwal S/o Late Sh. Dayakrishna, SSS 25.03.2011

34. Sh. Tajendra Pratap Singh S/o Late Sh. Sunder Lal, UDC 04.02.2012

35. Sh. Akash Raj Mishra S/o Late Sh. Akhilesh Kumar Mishra,

SSS

28.06.2013

36. Ms. Madhu Bhatt D/o Late Sh. Harish Chandra Bhatt,

Assistant

20.08.2013

37. Km. Harshita Tripathi D/o Late Sh. Prakash Chandra

Tripathi, SSS

22.09.2013

38. Sh. Kumar Gaurav Saxena S/o Late Sh. Suresh Chandra

Saxena, T-1(Lab)

16.11.2013

39. Sh. Vikramaditya Sharma S/o Late Sh. Gopal Dutt Sharma,

Assistant

16.11.2013

40. Sh. Amit Kumar Singh S/o Late Sh. Tripal Singh, T-5 19.03.2014

41. Sh. Sunil Kumar S/o Late Sh. Pathanu Ram, SSS 23.10.2014

42. Sh. James Singh S/o Late Sh. Adwin, SSS 11.11.2014

43. Sh. Haseen Miyan S/o Late Sh. Dulha Miyan, SSS 01.12.2014

44. Sh. Ramachandra. U. Deshpande S/o Late Sh. Udaya R.

Deshpande, SSS 04.03.2015

45. Sh. Dharmdas S/o Late Sh. Chetram, SSS 14.05.2015

46. Sh. Gautam S/o Late Sh. Amba Prasad, SSS 06.08.2014

47. Sh. Israr Khan S/o Late Sh. Rehman Khan, SSS 19.01.2015

48. Ms. Bhawana Rani D/o Late Sh. Naresh Chandra, UDC 14.05.2008

49. Sh. Mohit Gautam S/o Late Sh. Om Prakash, SSS 06.09.2009

50. Smt. Leela Devi W/o Late Sh. Ram Chandra, SSS 16.02.2013

51. Sh. Sandeep Singh Khampa S/o Late Sh. B. S. Khampa, T-5 10.01.2007

52. Sh. Veer Singh Rana S/o Late Sh. Harsh Dev Singh Rana,

T-I-3

08.03.2015

53. Sh. Anuj Kumar S/o Late Sh. Anil Kumar, SSS 04.07.2016

54. Sh. Pratap Singh S/o Late Sh. Malkhan Singh, SSS 01.12.2010

55. Ms. Rubeena Sist/o Late Sh. Mohd. Naim, SSS 07.02.2011

56. Sh. Raj Kumar S/o Late Sh. Ram Avtar, SSS 18.08.2010

57. Sh. Mahendra alias Harish Kumar S/o Late Sh. P. R. Gupta,

SSS

31.12.2003

58. Sh. Arun Kumar S/o Late Sh. Roop Kishore, SSS 23.02.2015

59. Sh. Sharad Saxena S/o Late Sh. Kaushal Kishore, SSS 25.07.2014

60. Sh. Vinod Kumar S/o Late Smt. Prabha Devi, SSS 27.08.2010

61. Sh. Dalpat Ram S/o Late Sh. Shyam Lal, SSS 08.08.2013

62. Sh. Mahendra Pal S/o Late Sh. Nand Kishor, SSS 07.04.2013

63. Sh. Lalit Prasad S/o Late Sh. Bishan Dutt, SSS 21.05.2009

64. Sh. Mahipal S/o Late Sh. Bhajan Lal, SSS 10.12.2010

65. Sh. Sartaj Khan S/o Late Sh. Sharif Khan, SSS 22.07.2011

66. Sh. Hirdesh Kumar S/o Late Sh. Sundar Lal, UDC 26.06.2014

67. Sh. Sunil Kumar S/o Late Sh. Harish Ram, SSS 27.12.2012

68. Sh. Fahiyaz Khan S/o Late Sh. Mehtab Khan, SSS 17.02.2018

69. Sh. Yaseen Khan S/o Late Sh. Nathey Khan, T-I-3 09.03.2017

70. Sh. Puneet Sharma S/o Late Sh. Ganga Prasad, SSS 23.06.2016

71. Ms. Jyoti Kumari D/o Late Sh. Ram Kumar, SSS 12.06.2016

72. Sh. Virendra S/o Late Sh. Suraj Pal, SSS 02.12.2017

73. Sh. Harish Chandra Joshi S/o Late Sh. Naresh Chandra

Joshi, T-1

09.04.2017

74. Sh. Anil Kumar Kashyap S/o Late Sh. Shibbu Lal, SSS 08.10.2016

75. Sh. Ayush S/o Late Sh. Navneet Kumar, LDC 29.12.2016

76. Sh. Rohit Kumar S/o Late Sh. Naveen Chandra Arya, SSS 27.12.2016

77. Sh. Azhar Nisar S/o Late Sh. Sharif Ahmad Ansari, SSS 06.05.2018

78. Sh. Pooran Lal S/o Late Sh. Jagan Lal, SSS 07.09.2018

79. Sh. Pawan Kumar S/o Late Sh. Rakesh Kumar Maurya, SSS 17.04.2013

80. Sh. Vijay Kumar S/o Late Sh. Babu Lal, SSS 12.07.2018

81. Sh. Abhinash Kumar S/o Late Sh. Lal Singh, SSS 30.04.2003

82. Sh. Raj Kumar S/o Late Sh. Manmohan Lal, SSS 20.10.2018

83. Smt. Mukta Karmakar W/o Late Sh. Hari Dass Karmakar,

Sr. Scientist

06.03.2017

84. Ms.Rekha Devi D/o Late Sh. Om Prakash, SSS 28.01.2012

85. Sh. Rohit S/o Late Sh. Ved Prakash, SSS 24.03.2016

86. Smt. Natho Devi W/o Late Sh. Lala Ram, SSS 11.07.2018

87. Sh. Karan Kumar Tamta S/o Late Sh. Prem Shankar Tamta,

T-3

01.03.1998

88. Sh. Sandeep Talashi S/o Late Sh. M.L. Talashi, T- II (Lab.) 09.08.1996

89. Smt. Sadhna Saxena W/o Late Sh. Ashok Kumar, T-4 21.10.2002

90. Ms.Amita Agarwal D/o Late Sh. Ashok Kumar Agarwal,

Assistant 11.10.2002

91. Sh. Prem Singh S/o Late Sh. Kalu Singh, SSS 05.11.2002

92. Sh. Vijay Singh Rana S/o Late Sh. Nand Ram, SSS 10.11.2002

93. Sh. Radha Ballabh S/o Late Sh. Anand Ballabh Pandey, SSS 09.12.2002

94. Sh. Naveen Giri S/o Late Sh. Pooran Giri, T-4 21.12.2002

95. Sh. Manoj Kumar S/o Late Sh. Hoti Lal, T-3 17.11.2002

96. Smt. Ram Beti W/o Late Sh. Ram Das, SSS 19.11.2003

97. Smt. Poonam Devi W/o Late Sh. Sushil Kumar, SSS 22.01.2003

98. Sh. Sagar Kumar S/o Late Sh. Manphool, SSS 07.01.2003

99. Sh. Raju S/o Late Sh. Harksen, SSS 09.01.2003

100. Sh. Narashima Murthy S/o Late Sh. Gangappa, SSS 17.01.2003

101. Sh. Satish Babu S/o Late Sh. Radhey Shyam, SSS 23.01.2003

102. Sh. Vinay Prakash S/o Late Sh. Prem Prakash Charan, SSS 24.01.2003

103. Sh. Khook Karan S/o Late Sh. Lakhan, SSS 26.02.2003

104. Sh. Virendra Singh S/o Late Sh. Prem Prakash, SSS 03.03.2004

105. Sh. Biswajit Bera S/o Late Sh. Ashok Kumar Bera, SSS 18.03.2003

106. Sh. Vijay Kumar S/o Late Sh. Narayan Das, SSS 19.03.2003

107. Smt. Julee W/o Late Sh. Raj Kumar, SSS 21.10.2003

108. Sh. Hari Singh S/o Late Sh. Ram Prasad, SSS 04.06.2003

109. Sh. Sachin John S/o Late Sh. Rajendra John, SSS 04.09.2003

110. Sh. Omkar S/o Late Sh. Shyam Lal, SSS 19.11.2003

111. Sh. Sunil Kumar S/o Late Sh. Bachi Ram, SSS 05.12.2003

112. Sh. Gautam Kumar S/o Late Sh. Kishan Lal, SSS 21.12.2003

113. Smt. Diksha Pandey W/o Late Sh. D. C. Pandey, Assistant 25.01.2004

114. Sh. Rinku Kumar Singh S/o Late Sh. Raj Bahadur Singh,

SSS

21.04.2004

115. Sh. Pankaj Malik S/o Late Sh. Zafar Ali, SSS 29.04.2004

116. Ms. Joile Christina C. Sis/o Late Sh. C. Xavier, SS Gr. II,

Bangalore 26.06.2004

117. Sh. Vikas Chitranshi S/o Late Sh. Manoj Kumar, SSS 27.06.2004

118. Sh. Mohit Kr. Saxena S/o Late Sh. S.C. Saxena, AAO 18.07.2004

119. Sh. Pradeep Kumar S/o Late Sh. Ravi Datt, T-4 23.07.2004

120. Sh. Naveen Chandra Arya S/o Late Sh. Dhani Lal, SSS 31.07.2004

121. Sh. Sunil Prakash S/o Late Sh. Roop Kishore Sharma,

Assistant

16.08.2004

122. Sh. Lokendra Madhukar S/o Late Sh. Shyam Babu, T-2 16.08.2004

123. Ms. Deep Shikha Lawal D/o Late Sh. Nathoo Singh Lawal,

SSS 19.08.2004

124. Smt. Laksmi Shukla W/o Late Sh. Gulshan Shukla, SSS 06.09.2004

125. Sh. Naveen Chandra S/o Late Sh. Harish Chandra, SSS 09.09.2004

126. Sh. Bhuwan Chandra Tamta S/o Late Sh. Ganesh Lal, SSS 06.10.2004

127. Ms. Indra Nagarkoti D/o Late Smt. Kala Devi, SSS 10.10.2004

128. Smt. Satyawati W/o Late Sh. Arjun, SSS 10.11.2004

129. Sh. Manoj Kumar S/o Late Sh. Munshi Lal, SSS 17.12.2004

130. Sh. Naveen Prakash S/o Late Sh. Ved Prakash, SSS 31.12.2004

131. Sh. Prem Chandra S/o Late Sh. Nanhey Ram, SSS 21.01.2005

132. Sh. Devendra Singh S/o Late Sh. Jeet Singh, SSS 01.02.2005

133. Sh. Chandan Singh S/o Late Sh. Lachham Singh, SSS 13.03.2005

134. Sh. Tara Datt Joshi S/o Late Sh. Ram Datt Joshi, SSS 21.04.2005

135. Sh. Sompal Singh S/o Late Sh. Surendra Pal Singh, SSS 05.05.2005

136. Sh. Shabab Ahmad S/o Late Sh. Imtiyaz Ahmad, T-4

(Driver) 30.05.2005

137. Smt.Ramkali/ Rajbala W/o Late Sh. Ramesh Prasad, SSS 02.10.2005

138. Sh. Rahul Kumar S/o Late Sh. Nandan Ram, Assistant 12.11.2005

139. Smt. Renuka Devi W/o Late Sh. Ramesh Chandra, SSS 05.12.2005

140. Sh. Pankaj Singh Raikwal S/o Late Sh. Laxman Singh

Raikwal, SSS 09.12.2005

141. Sh. Vineet Kumar Balmiki S/o Late Sh. Kailash Chandra

Balmiki, SSS

26.10.2005

142. Smt. Surja Devi/ Surjawati W/o Late Sh. Chhotey Lal, SSS 14.12.2005

143. Sh. Rakesh Babu Kannojia S/o Late Sh. Pyare Lal,

Assistant 14.12.2005

144. Smt. Neetu Sharma W/o Late Sh. Dharmendra Sharma, T-2 15.12.2005

145. Sh. Ugra Sen S/o Late Sh. Tara Chandra, SSS 30.12.2005

146. Smt. Balpa Devi W/o Late Sh. Joga Singh, SSS 14.01.2006

147. Sh. Rahmat Khan S/o Late Sh. Rais Khan, SSS 13.02.2006

148. Sh. Puran Chandra Upreti S/o Late Sh. Girish Chandra

Upreti, UDC

21.01.2017

149. Sh. Deepak Bisht S/o Late Sh. Mohan Singh Bisht, SSS 31.10.2018

150. Sh. Digvijay Singh S/o Late Sh. Lallu Singh, SSS 29.01.2019

151. Smt. Rashmi W/o Late Sh. Manoj Kumar Vyas, T-5 16.02.2019

152. Sh. Jitendra Pathak S/o Late Sh. Hoshila Prasad Pathak,

SSS 23.02.2019

153. Sh. Mahendra Pal Singh S/o Late Sh. Siya Ram, SSS 29.05.2019

154. Ms.Prerna Rai D/o Late Sh. Pankaj Roy, Assistant 29.10.2019

155. Sh. Suraj Singh Jeena S/o Late Sh. Deewan Singh Jeena,

SSS

06.09.2014

156. Sh. Kapil Sharma S/o Late Sh. Brahma Shankar, SSS 18.12.2019

157. Sh. Raja S/o Late Sh. Anand Kumar, SSS 26.03.2020

158. Sh. Bobby Singh S/o Late Sh. Vijay Kumar, SSS 26.03.2020

159. Sh. Neeraj Singh Mer S/o Late Sh. Harendra Singh Mer,

SSS 06.11.2016

160. Sh. Chaman Prakash S/o Late Sh. Asarfi Lal, SSS 19.12.2001

161. Smt. Babli W/o Late Sh. Babu Lal, SSS 11.12.1998

162. Sh. Nitul Sarkar S/o Late Sh. N. Sarkar, T-4 05.02.2005

163. Sh. Sanjay Mer S/o Late Sh. D.S. Mer, T-4 02.05.2006

164. Sh. Mansij Tripathi S/o Late Dr. H.C. Tripathi, Pri. Sci. 08.05.2006

165. Sh. H. S. Harish S/o Late Sh. D. Shisha Giri, SSS 12.04.2006

166. Sh. Mohd. Mobeen Khan S/o Late Sh. Rafiq Ahmad, T-5

(Driver)

11.06.2006

167. Sh. Thakur Das S/o Late Sh. Ram Das, SSS 15.06.2006

168. Sh. Noorain Ansari S/o Late Sh. A.A. Bharti, SSS 27.07.2006

169. Sh. Devendra Kumar S/o Late Sh. Nathoo Lal, SSS 06.10.2006

170. Sh. K.B. Gutholia S/o Late Sh. A.D. Gutholia, SSS 04.12.2006

171. Sh. Omkar S/o Late Sh. Shyam Lal, SSS 20.02.2007

172. Sh. Rakesh S/o Late Sh. Dhani Ram, SSS 18.08.2007

173. Sh. Sachin S/o Late Sh. Chandra Pal, SSS 19.08.2007

174. Sh. Yogesh Pandey S/o Late Sh. P.K. Pandey, Assistant 05.10.2007

175. Sh. Karbir S/o Late Sh. Tika Ram, SSS 28.01.2008

176. Sh. Rajesh Kumar S/o Late Sh. Mahi Pal, SSS 20.03.2008

177. Sh. Manesh Bhakuni S/o Late Sh. C.S. Bhakuni, T-5

(Driver)

10.04.2008