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DECLARATIONFORM

CPMT2015

CANDIDATE'S NAME :

PASTEYOUR
PHOTOGRAPH

FATHER'S NAME:

MOTHER'S NAME:

Give fingerprint impression of your right index finger in the given boxes without re-inking your
finger. Ink your finger on the stamp pad once then apply it on the first box without smudging the
impression, then apply the same finger on the second box without taking the ink again, repeat the same
on the third box without re-inking your finger, as given in the example below.
lHkh vH;FkhZ dks vius nk;sa gkFk dh rtZuh 1

FirstImpression

(Index Finger) ds fu'kku dks fukkZfjr

LFkku ij vfuok;Z :Ik ls yxkuk gksxkA


SecondImpression

dsoy ,d ckj LVSaEi bad maxyh ij yxk;sa 2


vkSj igys [kkus ij fu'kku yxk;sa] nqckjk
LVSEi L;kgh maxyh ij yxk;s fcuk mlh
rjg nwljs ,oa rhljs [kkus esa Hkh fu'kku
nsaA
3

nqckjk LVSEi L;kgh maxyh ij yxk;s


fcuk
ThirdImpression
nqckjk LVSEi L;kgh maxyh ij yxk;s
fcuk

Forsamplehandwriting.Writethefollowingsentenceinyourusualhandwriting.

Thequickbrownfoxjumpedoverthelazydog.

candidate'ssignature
(inEnglish,withinboxonly)

Father's/Guardian'ssignature
(inEnglish,withinboxonly)

Attested by principal/gazetted officer with seal

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