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924 · (22)

1 · . Short titie, extent and commencement ~ (1) These rules may be called the Chhattisgarh Private Placement Agencies (Regulation) Rules, 2014 . (2) These rules shall be applicable in the whole State of Chhattisgarh. (3) These rules shall come into force from the date of its publication in the Official Gazette. 2 Definitions:- (1) In these rules, unless the context otherwise requires," (a) "Act" means the Chhattisgarh Private Placement Agencies (Regulation) Act, 2013 (No. 23 of 2013); (b) Agency' means a Private Placement Agency as defined under clause (h) of Section 2 of the Act; (c) Appellate Authority" means the Principal Secretary, Department of Home, Government of Chhattisgarh;

924 · (23)

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924 · (23)

924 · (26)

924 · (27)

924 · (28)

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924 · (JI)

10 · Suspension Or cancellation of licenses - (1) No license granted under this Act shall be cancelled or suspended until the licensee has been given a reasonable opportunity of being heard after giving due service of show cause as to why his license should not be cancelled or suspended, as the case may be;

11 · Appeals and Procedure.- (1) Any person aggrieved by any order passed by the Controlling Authority refusing to grant a license, varying the conditions of a license, suspending or revoking a license may prefer an appeal against the said order to Appellate Authority:

924 · (32)

914 · (JJ)

924 · (34)

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924 · (35)`

6 · 3. Please read the instructions carefully before filling the form. Please fill in BLOCK LETTERS: (Note: Please fumisi correct information. Furnishing of incorrect information or suppression of &i; material information in the form wil render the candidate unsuitable for grant 0f iicense) 1. Name of applicant (Initials not allowed) First Name Middle Name Last Name 2 . If you have ever changed your name, please indicate the previous nane in full

3 · Sex (male / female) 4 . Date ol Birth 5. Place of Birth: Village / Town District_ State &' Country 6, Father' & full name / Legal Guardian's Full Name (including surname, if any):(Initials not allowed) 7 Mother's full name (including surname, if any): (Initials not allowed)_ 8 If Married: Full name of spouse (including surname, if any): (Initials not allowed)_

924 · (36)

9 · Present Residential Address including Street No. / Police Station, Vlage and District (with PIN code) Telephone No._ Mobile No. Off. Res. Fax Email ID 10. Please give the date from which applicant residing at the above - mentioned address: DD/ MM/YY 11. Permanent Address including Street No./ Police Station, Village and District (with PIN code) 12. If you have not resided at the address given at column (9) continuously for the last five years, please furnish the other address (addresses) with duration (s) resided_ You should furnish edditional photocopies of this form for each additional place o stay during the last five years. Forms may be photocopied; but photograph and signature in; original are required on each Iorm, Address From Ta

13 · In Cabe of stay abroad, particulars of all places where you have resided for 'more than one year after attaining the age of twenty-one years

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15 ·

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20 ·

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8 · . If marricd Full name of spouse (including surname if any) (Initials not allowed)_ 9 . Present Residential Address including Street No: / Police Station, Village and District (with PIN code)

924 · (40}

12 · If you have not resided at the address given at column (9) continuously for the last five year, please fumish the other address with duration (s) resided. You should fumnish additional photocopies of this form for each additional place of stay during the last five years. Forms may be photocopied, but photograph and signature in original are required 0n each Irom. Address From To

13 · In case of abroad stay, particulars of all places where you have resided for more than one year after attaining the age of twenty-one years

14 · Othcr Dctailo: (a) Educational Qualifications: (b) Previous posts held along with name and address of employer (s) (c) Reason (s) for leaving last employment: _ (d) Have you ever been dismissed /removed from Government service on account of misconduct Or moral turpitude? (Yes/ No) (e) Visible Distinguishing Mark (f} Height (cms) 15. Are you working in Central Government/ State Government/ Public Sector Undertakings/ Statutory Bodies (Yes/ No)

924 · (41)

16 · Are you citizen of India by: (Birth/ Descent/ Registration/ Naturalisation) If you have ever possessed any other citizenship: Please indicate previous citizenship? 17. (a} Have you, at any time, been convicted by a court in India for any offence & sentenced to imprisonment? [f s0, give name of the court, case number and offence. (Attach copy of judgment)

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5 · No:

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