GOVERNMENT OF INDIA

MINISTRY OF COMMUNICATIONS

DEPARTMENT OF TELECOMMUNICATIONS

01. Name :

02. Designation with present address :

03. Father’s Name :

04. Staff No. :

05. Date of Birth :

06. Date of Superannuation :

07. Circle / Unit / SSA where :

transfer is sought

08. Month in which academic :

session of wards ends

09. Educational Qualification & :

Branch of Specialisation

10. Details of previous postings :

SL No.

Name of the Post

From

To

Unit/SSA/Circle

11. Ground on which transfer is sought :

12. Date of joining in tenure Circle :

13. Date on which completing tenure :

14. Any other details which the :

individual may like to state

Date: Signature of the Officer

( )

For Office Use : -

¨ Certified that the facts given by the officer has been verified from records and the same have been found to be correct

¨ Certified that no vigilance or disciplinary case is either pending or contemplated against the officer

¨ The request of the officer for transfer is recommended /not recommended. The officer can be relieved with/without substitute.

Chief General Manager