APPENDIX SEVENTEEN FORM OF DISCHARGE CERTIFICATE [Vide Rule 79.1]- SS CODE
APPENDIX SEVENTEEN
FORM OF DISCHARGE CERTIFICATE
[Vide Rule 79.1]
1. Name and address of the school issuing the certificate ____________________________________
2. Full name of the teacher ___________________________________________________________
3. Qualifications ____________________________________________________________________
Degree/Diploma _______________________________________________________________
Class ______________________________________________________________________
Year ______________________________________________________________________
University ___________________________________________________________________
4. Whether temporary/permanent _______________________________________________________
5. Service rendered (inclusive) ________________________________________________________
6. Pay drawn : (a) __________________________________________________________________
Rs. ___________________ in the scale : ________________________________________
of _______________ (b) ____________________________________________________
Allowance, if any (c) ________________________________________________________
Date of next increment ________________________________________________________
7. Whether due notice by either party was given or not* ______________________________
8. (a) Whether subscribing to the government provident fund _______________________________
(b) Postal saving bank account No. ___________________________________________________
9. Whether he has returned all school money and books, etc. ___________________________
10. Remarks ________________________________________________________________
Place:
Date : Signature of the head of the school.
___________________________________________________________________________________
* In the case of removal or dismissal it should be stated whether a regular enquiry was held into the charges framed against him.
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