iz:i&,d

¼fu;e 3 nsf[k,½
vuf/kd`r fodkl ds fu;fefrdj.k gsrq vkosnu
izfr]
lnL; lfpo]
ftyk fu;fefrdj.k izkf/kdkjh
eSa] esjs }kjk fd, x;s@esjs vf/kokl ds@esjs LokfeRo ds] vuf/kd`r fodkl ds fu;fefrdj.k gsrq
NRrhlx<+ vuf/kd`r fodkl ds fu;fefrdj.k vf/kfu;e] 2002 dh /kkjk 5 ds izko/kkuksa ds v/khu] ,rn~}kjk]
;g vkosnu izLrqr djrk gwa eS vuf/kd`r fodkl ds ekufp=] js[kkadu rFkk QksVks ds lkFk fuEukuqlkj
tkudkjh izLrqr djrk gw& wa
1- vkosnd dk uke ----------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------
2- Hkou dk fuekZ.k vf/klwfpr frfFk ds iwoZ gksus dk izek.k
;Fkk fctyh fcy@laifRr dj dh izfr----------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------ Affix recent
3- Hkwfe dk fooj.k] jktLo eksgYyk] uxj fuos'k ;kstuk] photograph of the
applicant with
losZ Øekad] IykV ua-@[kljk ua- ----------------------------------------------------------------
signature on the
-------------------------------------------------------------------------------------------------------------------------------- body of the
-------------------------------------------------------------------------------------------------------------------------------- photograph
--------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------
4- Hkw&LokfeRo nLrkost] v|ru ch&I] ih&II] [kljk ekufp= cVkadu lfgr %&
5- D;k vuf/kd`r fodkl] fodkl ;kstuk@Hkou foU;kl esa
lfEefyr gS rFkk l{ke vf/kdkjh }kjk Lohd`r gS ;fn gka] rc
¼1½ Lohd`r vkns'k Øekad ------------------------------------------------------------------------
¼2½ vkns'k fnukad dk mYys[k djsa -------------------------------------------------------
¼3½ Lohd`r fuekZ.k dk {ks=Qy ------------------------------------ oxZehVj
¼4½ vuf/kd`r fuekZ.k dk {ks=Qy -------------------------------- oxZehVj
6- D;k vuf/kd`r fodkl fcuk vuqeksnu ds fufeZr gS] ;k eatwjh ds fcuk eatwjh ds foijhr
vuqØekad&4 esa eatwjh ds foijhr gS %&
dqy {ks=] oxZehVj esa
¼,d½ ik'oZ [kqyk LFkku
¼nks½ ry{ks= vuqikr
¼rhu½ Hkw&mi;ksx esa ifjorZu %&
I. Hkwfe dk orZeku mi;ksx -------------------------------------
II. fodkl ;kstuk@vaxhd`r orZeku Hkwfe mi;ksx ekufp= vuqlkj mi;ksx ------------------------
¼pkj½ ikfdZax %&
ikfdZax dh deh ds {ks=Qy dh x.kuk %&
I. fnukad 01-01-2011 ds iwoZ vfLrRo esa vk;s vuf/kd`r fodkl@fuekZ.k %&
l--Ø- NRrhlx<+ Hkwfe fodkl ds fu;e 81 ifjlj esa miyC/k ikfdZax 'keu ;ksX; dkj
vuqlkj vko';d ikfdZax ¼bZ-lh-,l-½ dk {ks=Qy ikfdZax dk {ks=Qy
¼1½ ¼2½ ¼3½ ¼4½
1-
2-
1
K:\TCP dewangan\2022 All Data\2022 Niyamitikaran\Niyamitikaran Aavedan Shanshodhan.docx
 @@2@@
II. fnukad 01-01-2011 ds Ik'pkr~ vfLrRo esa vk;s vuf/kd`r fodkl@fuekZ.k %&
l--Ø- NRrhlx<+ Hkwfe fodkl ds ifjlj esa miyC/k ikfdZax dk 'keu ;ksX; dkj ikfdZax
fu;e 81 vuqlkj vko';d {ks=Qy dk {ks=Qy
ikfdZax ¼bZ-lh-,l-½
¼1½ ¼2½ ¼3½ ¼4½
1-
2-
III. 'keu ;ksX; ikfdZax dh x.kuk fuEukuqlkj gksxh %&
l--Ø- vf/kHkkx fufeZr {ks= ikfdZx gsrq miyC/k U;wure vkosnd }kjk dh xbZ
{ks=Qy ¼izfr dkj LFkku ¼bZ- O;oLFkk
lh-,l-½ ds vk/kkj ij ½
¼1½ ¼2½ ¼3½ ¼4½ ¼5½
1- vkoklh; 500 rd fujad
500 ls vf/kd 50 izfr'kr
2 xSj vkoklh; 500 rd fujad
500 ls vf/kd 50 izfr'kr

uksV %& mijksDr rkfydk ds dkWye Øekad ¼3½ esa ntZ fufeZr {ks= 500 oxZehVj ls
vf/kd gksus ij df.Mdk 5- ¼pkj½ ds fcanq Øekad I. ,oa II. vuqlkj x.kuk dh
tkosxhA
7- xSjykHk vtZu gsrq fufeZr laLFkku@fpfdRlky;@'kS{kf.kd laLFkku@/keZ'kkyk@vU;--------------------------------
8- igWaqp ekxZ dh pkSMkbZ --------------------- ehVj ¼orZeku½
9- NRrhlx<+ Hkwfe fodkl fu;e] 1984 ds vuqlkj jsu okVj gkosZfLVax dh O;oLFkk --------------------------------------
10- NRrhlx<+ Hkwfe fodkl fu;e] 1984 ds vuqlkj lkSj ÅtkZ dk izko/kku -----------------------------------------------------
11- ¼1½ 'kklu@LFkkuh; izkf/kdkjh ;k dkuwuh fudk; }kjk vkcafVr vFkok iV~Vk ij izi=kuqlkj Hkwfe
dk mi;ksx ------------------------------------------------------------------------------------------------------------------------------------------------------------
¼2½ orZeku mi;ksx --------------------------------------------------------------------------------------------------------------------------------------------------
12- Hkou ds pkjks vksj dk QksVksxzk¶l -----------------------------------------------------------------------------------------------------------------------------
13- cgqeaftyk Hkou gsrq e`nk ijh{k.k] LVªDpj fjiksVZ] vfXu 'keu dh O;oLFkk --------------------------------------------------
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

------------------------------------------------ --------------------------------------------------
vkfdZVsDV ds gLrk{kj@rduhdh O;fDr vkosnd ds gLrk{kj
uke : ----------------------------- uke : -------------------------------
iathdj.k Øekad : ------------------------- Qksu uEcj@eks-ua-: --------------------------
Qksu uEcj : ---------------------------- iksLVy ,Mªl
s : -------------------------------
iksLVy ,Mªl
s : -------------------------- bZ&esy % -----------------------------

2
K:\TCP dewangan\2022 All Data\2022 Niyamitikaran\Niyamitikaran Aavedan Shanshodhan.docx
 'kiFk&i=

eSa@ge ,rn~}kjk ;g ?kks"k.kk djrk gw@

a djrs gSa fd Åij fn;s x;s fooj.k lgh gSa vkSj eSa@ge
vkids }kjk visf{kr vU; fooj.k izLrqr djus ds fy, rS;kj gw@
a gSa-

------------------------------------------------ ------------------------------------------------
vkfdZVsDV ds gLrk{kj@rduhdh O;fDr vkosnd ds gLrk{kj
uke : ----------------------------- uke : -----------------------------
iathdj.k Øekad : ------------------------- Qksu uEcj : -----------------------------
Qksu uEcj : ---------------------------- Postal Address : ---------------------------
iksLVy ,Mªl
s : --------------------------

3
K:\TCP dewangan\2022 All Data\2022 Niyamitikaran\Niyamitikaran Aavedan Shanshodhan.docx
 'kiFk i=&v
¼vkosnd }kjk 'kiFk ds fy,½

eS@ge] Jh@Jherh ------------------------------------------ vk;q ---------------------- o"kZ] Jh@Jherh ---------------------------------------

------------------------------- ds iq=@iq=h@ifRu] tks fd xzke ------------------------------------------------------- iksLV vkWfQl -----------------------
---------------- rglhy --------------------------------------- ftyk -------------------------------------- ds fuoklh gS] ,rn~ }kjk 'kiFkiwoZ dFku
djrs gS fd %&
1- ;g fd] eSa@ge] us] Ø;@iV~Vk@migkj@ikfjokfjd cVokjk@dksVZ vkns'k ds ek/;e~ ls xzke ----------
-------------------- i-g-ua- ----------------- jk-fu-ea- ----------------------- rglhy ------------------------------- ftyk -------------------------------
------ fLFkr Hkwfe [kljk dzekad ------------------------ dqy jdck ------------------------- ij fLFkr Hkw[k.M+@Hkou
dzekad ------------------------- izkIr fd;k gS] ftl laifRr dk fooj.k uhps fn;k x;k gS %&
laifRr dh vuqlwph
ekStk@xzke dk uke % ------------------------------------------------------------------------------------
rglhy % ------------------------------------------------------------------------------------
lcd@gkWy IykWV uacj % ------------------------------------------------------------------------------------
[kljk uacj % ------------------------------------------------------------------------------------
jdck@{ks= % ------------------------------------------------------------------------------------
ys vkmV ¼vfHkU;kl½ dzekad % ------------------------------------------------------------------------------------
}kjk vuqeksfs nr --------------------------------------- i= dzekad ------------------------------------- fnukad -------------------------

prqZlhek dk fooj.k
¼d`Ik;k Hkw[k.M+ dzekad@ekxZ dk mYys[k djs½

iwohZ fn'kk % if'peh fn'kk %

mRRkjh fn'kk % nf{k.kh fn'kk %

2- ;g fd] Hkwfe ds vtZu izkfIr dh frfFk ls] eS@ge oS/kiwoZd ,oa 'kkafriwoZd rjhds ls Åij mYysf[kr
Hkw[k.M+@Hkou ij dkfct gS]
3- ;g fd] eSus viuh@gekjh dkuwuh LokfeRo dh Hkwfe ls ijs Hkou ;k mlds fdlh Hkkx dk fuekZ.k
ugh fd;k x;k gS]
4- ;g fd] esjs@gekjs }kjk Åij mYysf[kr Hkw[k.M+@Hkou ls lVs fdlh Hkh 'kkldh; Hkwfe vFkok vU;
dh Hkwfe vFkok feys gq, Hkwfe@Hkw[k.M+@Hkou ij vfrØe.k ugh fd;k x;k gS]
5- ;g fd] fu;ferhdj.k ds fy, izLrqr ;kstuk] LFky ij okLrfod fuekZ.k ds vuqlkj gh gS]
6- ;g fd] vkosnu i= esa nh xbZ tkudkjh ,oa vkosnu i= ds lkFk tek fd, x, nLrkost lgh gS]
7- ;g fd] eS@ge Hkou ds lajpukRed fMtkbu dh lajpukRed lqj{kk@iqujh{k.k dh ftEesnkjh ysrs
gS] vkSj izkf/kdkjh dks Hkou dh fdlh Hkh lajpukRed foQyrk ds fy, fdlh Hkh rjg ls ftEesnkj
ugh Bgjk;k tk;sxk]
8- ;g fd] vkosnu esa rF;ksa dks Nqikus vkSj@;k xyr rjhds ls izLrqr djus dh fLFkfr esa] izkf/kdjh
dks vuqefr dks vLohdkj djus@vuqefr dks j) djus vkSj esjs@gekjs }kjk tek fd, x, 'kkfLr
jkf'k dks tCr djus dk iwjk vf/kdkj gS vkSj eSa@ge vkijkf/kd eqdnek pyus ds fy, mRrjnk;h
jgsxa As

xokgksa ds uke ,oa gLrk{kj 'kiFkdrkZ dk iw.kZ uke ,oa gLrk{kj

4
K:\TCP dewangan\2022 All Data\2022 Niyamitikaran\Niyamitikaran Aavedan Shanshodhan.docx
 'kiFk i= & c
¼vkosnd }kjk 'kiFk ds fy,½

eSa@ge] Jh@Jherh ------------------------------------------------------------ vk;q ---------------------- o"kZ] Jh@Jherh ---------------------

---------------------------------------------------------------------------- ds iq=@iq=h@ifRu] tks fd xzke -------------------------------------------------- iksLV
vkWfQl --------------------------------------- rglhy ------------------------------------------ ftyk ------------------------------------------------ ds fuoklh gS]
,rn~ }kjk 'kiFkiwoZ dFku djrs gS] fd tks Hkh esjs fuekZ.k fd;k x;k gS] o iw.kZr% voS/k gS vkSj mlesa
fu;fefrdj.k gsrq tks Hkh 'kkfLr yxkbZ tk;sxh eSa tek djus gsrq ck/; gw¡A

xokgksa ds uke ,oa gLrk{kj 'kiFkdrkZ dk iw.kZ uke ,oa gLrk{kj

5
K:\TCP dewangan\2022 All Data\2022 Niyamitikaran\Niyamitikaran Aavedan Shanshodhan.docx
 iz:i&nks
¼fu;e 6 ¼1½ nsf[k,½
vuf/kd`r fodkl ds fu;fefrdj.k gsrq ekax uksfVl
izfr]
Jh@Jherh ----------------------------------------------------------------
---------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------

;r% eq>s] v/kksgLrk{kjdrkZ dk] izLrqr vkosnu fnukad ------------------------- ds vk/kkj ij] ;g er gS fd
Jh ---------------------------------------------------- }kjk ifjlj Øekad@¶ysV Ø-@mi Hkw&[kaM Øekad ----------------------------------
Hkw&[k.M Øekad -------------------------------- [kljk Øekad ---------------- eksgYyk ---------------------------------- ij Lokeh@vf/kHkksxh
ds :i esa vuf/kd`r fodkl fd;k x;k gS] ftldk fooj.k fuEukuqlkj gS]

lEifÙk dk fooj.k %&

----------------------------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------

vr,o] NRrhlx<+ vuf/kd`r fodkl dk fu;fefrdj.k vf/kfu;e] 2002 dh /kkjk 5 ds izko/kkuksa ds

vuqlkj] vki uhps fn, x;s fooj.k vuqlkj vuf/kd`r fodkl djus ds ckjs esa 'kkfLr jkf'k] " vk; ds eq[;
'kh"kZ 0217 mi'kh"kZ&06 vU; uxj fodkl ;kstuk,a y?kq'kh"kZ 800 vU; izkfIr;ka ;kstuk
Øekad&0190 " esa tek djus ds nk;h gS]
l-Ø- fooj.k izoxZ {ks=Qy nj :-@ dqy jkf'k :i, esa
oxZehVj esa oxZehVj
1 2 3 4 5 6
1- ik'oZ [kqyk LFkku
2- ry{ks= vuqikr
3- Hkw&mi;ksx esa ifjorZu
¼dysDVj xkbZMykbZu dk 5%½
4- ikfdZax

;fn vki lqus tkus dh okaNk j[krs gSa rks vki bl lwpuk ds izkIr gksus ls ,d ekl dh dkykof/k ds
Hkhrj lquokbZ djus ds fy, v/kksgLrk{kjh dks fy[k ldrs gS] vkSj ml rkjh[k dks] tks nh tk,] vius ekeys
ds laca/k esa lqlaxr vfHkys[k izLrqr dj ldrs gS]

rkjh[k % lnL; lfpo

LFkku % ftyk fu;fefrdj.k izkf/kdkjh
ftyk &

6
K:\TCP dewangan\2022 All Data\2022 Niyamitikaran\Niyamitikaran Aavedan Shanshodhan.docx
 iz:i&rhu
¼fu;e 6 ¼2½ nsf[k,½
vuf/kd`r fodkl ds fu;fefrdj.k gsrq vkns'k
izfr]
Jh@Jherh ----------------------------------------------------------------
---------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------

tSlk fd esjk v/kksgLrk{kjdrkZ] dk ;g er gS fd [kljk Øekad ---------------------- IykV Øekad ----------------

------------ {ks=@dkyksuh@ekgYys ------------------------------------------------------- esa fd;k x;k vuf/kd`r fodkl] NRrhlx<+
vuf/kd`r fodkl dk fu;fefrdj.k vf/kfu;e] 2002 dh /kkj 7 ds izko/kku vuqlkj fu;fefrdj.k gsrq
mi;qDr ik;k x;k gSA

vr,o izkIr vkifRr;ksa rFkk lq>koksa ij lE;d~ :i ls fopkj djus ds i'pkr~ NRrhlx<+ vuf/kd`r
fodkl dk fu;fefrdj.k vf/kfu;e] 2002 dh /kkjk 5 ds mica/kksa ds v/khu eSa bl lwpuk dh rkjh[k ls -------
--------------- fnu ds Hkhrj :i;s --------------------- ¼'kCnksa esa ------------------------------------------------------------------------- ½ 'kkldh;
[ktkus esa foizs"k.k ds v/;/khu jgrs gq,] vuf/kd`r fodkl dks fu;fer ?kksf"kr djrk gwa ,slk djus esa
vlQy gksus ij mDr vf/kfu;e dh /kkjk 8 ds v/khu dk;Zokgh dh tk,xh-
¼ftyk fu;fefrdj.k izkf/kdkjh }kjk vuqeksfnr½

rkjh[k % lnL; lfpo

LFkku % ftyk fu;fefrdj.k izkf/kdkjh

ftyk &

7
K:\TCP dewangan\2022 All Data\2022 Niyamitikaran\Niyamitikaran Aavedan Shanshodhan.docx
 iz:i&pkj
¼fu;e 6 ¼4½ nsf[k,½
vuf/kd`r fodkl ds fu;fefrdj.k gsrq izLrqr vkosnu dks fujLr djus laca/kh vkns'k

izfr]
Jh@Jherh ----------------------------------------------------------------
---------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------

;r% eq>s] v/kksgLrk{kjdrkZ dk] ;g er gS fd Hkw&[k.M Øekad -------------------- [kljk Øekad --------------------
dkWyksuh@xyh ij vkids }kjk fd, x, vuf/kd`r fodkl ds fu;fefrdj.k ds ckjs esa vkids vkosnu esa
vUrfoZ"V tkudkjh NRrhlx<+ vuf/kd`r fodkl dk fu;fefrdj.k vf/kfu;e] 2002 dh /kkjk 7 ds mica/kksa
ds v/khu fu;fefrdj.k dh 'krksZa ds vuqlkj ugha gS ;k fu;fefrdj.k yksd fgr esa ugha gksus ds fuEufyf[kr
dkj.k gS %&
1- -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
2- -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
3- -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
4- -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

vr,o /kkjk 6 ¼1½ ¼,d½ ds izko/kkuksa ds vuqlj.k esa vkids }kjk izLrqr vkosnu dks ,rn~}kjk ukeatwj
fd;k tkrk gSA

vkidks] ,rn~}kjk funsZ'k fn;k tkrk gS] fd vki Lo;a mDr vuf/kd`r fodkl dks vfoyac gVk ns]a
vlQy gksus ij mDr vf/kfu;e ds v/khu dk;Zokgh dh tk;sxh-
¼ftyk fu;fefrdj.k izkf/kdkjh }kjk vuqeksfnr½

rkjh[k % lnL; lfpo

LFkku % ftyk fu;fefrdj.k izkf/kdkjh

ftyk &

8
K:\TCP dewangan\2022 All Data\2022 Niyamitikaran\Niyamitikaran Aavedan Shanshodhan.docx
 iz:i&ikap
¼fu;e 7 nsf[k,½

fu;fefrdj.k izek.k&i=

;g izekf.kr fd;k tkrk gS] fd Jh@Jherh ------------------------------------------------------ vkRet@vkRetk Jh -----------

-------------------------------------------- }kjk fufeZr] ;k LokfeRo dh ;k vf/kHkksx esa fLFkr vuf/kd`r fodkl] tks fd l{ke
vf/kdkjh dh vuqefr ds fcuk ;k Lohd`r vuqKk dk mYya/ku dj ¼nsf[k, i= Øekad --------------------------- rkjh[k
-----------------------------------------½ jktLo [kljk Øekad -------------------------------------------- vfUre Hkw&[k.M Øekad --------------------------
xzke@uxj rFkk xzke fodkl ;kstuk Øekad --------------------------------------------- ij ifjlj Øekad@¶ySV Øekad ---------
----------------------------@edku Øekad ------------------------------------- esa] fodflr fd;k x;k gS] dks NRrhlx<+ vuf/kd`r
fodkl dk fu;fefrdj.k vf/kfu;e] 2002 ds v/khu] vis{kkvksa dks iwjh djus ds i'pkr~] fuEufyf[kr lkj.kh
esa mYysf[kr {ks= lfgr] ,rn~}kjk NRrhlx<+ vuf/kd`r fodkl dk fu;fefrdj.k vf/kfu;e] 2002 dh
/kkjk 6 ds v/khu fu;fefrdj.k fd;k tkrk gS %&

l-Ø- fu;fefrdj.k ds fo"k; {ks=Qy oxZehVj esa

1 2 3
1- ik'oZ [kqyk LFkku
2- ry{ks= vuqikr
3- Hkw&mi;ksx esa ifjorZu
4- ikfdZax

rkjh[k % lnL; lfpo

LFkku % ftyk fu;fefrdj.k izkf/kdkjh

ftyk &
¼ftyk fu;fefrdj.k izkf/kdkjh }kjk vuqeksfnr½

layXu %& ekufp= o js[kkadu

9
K:\TCP dewangan\2022 All Data\2022 Niyamitikaran\Niyamitikaran Aavedan Shanshodhan.docx
 psd fyLV

1- Hkwfe LokfeRo nLrkost v|ru ch&I] ih&II] [kljk cVkadu

2- Hkou dk fuekZ.k vf/klwfpr frfFk ds iwoZ gksus dk izek.k ;Fkk fctyh fcy@laifRr dj
dh izfr
3- Hkwfe dk fooj.k jktLo eksgYyk] uxj fuos'k ;kstuk] losZ Øekad IykV ua-@[kljk
ua@jdck %& ---------------------------------------------------------------------------------------------------------------------------------
4- Hkou vuqKk Lohd`fr dh izfr
5- Hkou dk orZeku mi;ksx % -------------------------------------------------------------------------------------------------------
6- fodkl ;kstuk@vaxhd`r orZeku Hkwfe mi;ksx ekufp= vuqlkj Hkw&mi;ksx izek.k i=
7- xSj ykHk vtZu fufeZr laLFkku@fpfdRlky;@'kS{kf.kd laLFkku@/keZ'kkyk@vU; dh
fLFkfr esa xSj ykHk vtZu lacaf/kr l{ke vf/kdkjh dk izek.k i=
8- ekxZ dh orZeku pkSMkbZ % ------------------------------------------------------------------------------------------------------------
9- ikfdZax dh x.kuk fjiksVZ % ----------------------------------------------------------------------------------------------------------
10- 'kklu@LFkkuh; izkf/kdkjh ;k dkuwuh fudk; }kjk vkcafVr vFkok iV~Vk dh Loizekf.kr
izfr
11- Hkou ds pkjks vksj dk QksVksxzke
12- cgqeaftyk Hkou gsrq e`nk ijh{k.k] LVªDpj fjiksVZ] vfXu'keu dh O;oLFkk
13- 'kiFk i= v ,oa c

xokgksa ds uke ,oa gLrk{kj 'kiFkdrkZ dk iw.kZ uke ,oa gLrk{kj

10
K:\TCP dewangan\2022 All Data\2022 Niyamitikaran\Niyamitikaran Aavedan Shanshodhan.docx