ANNEXURE ‘A’ (FOR-2014-15)
Application form for
admission as member of
All India Central Excise Inspectors’
Association (AICEIA)
(To be obtained in
quadruplicate)
Applicant’s Name: _________________________________________________________________
(In Block Letters)
Designation in the
Office: INSPECTOR
Date of entry into
Service: ____________________________________
Office in which
employed: __________________________________________________
SURAT
Residential
address: ________________________________________________________________
________________________________________________________________
I declare that the
particulars furnished above are correct. I agree to abide by the Constitution,
discipline, and directive of the AICEIA. I may be enrolled as a member of the
AICEIA.
Station:
Date: Signature &
Initial:
(To be filled in by the
Office Bearer of Branch/Circle)
Name of the Branch
in which the applicant
is admitted as a primary member: SURAT
BRANCH
Name of the
Circle: GUJARAT CIRCLE
Receipt No. issued
to the Applicant for having received the admission fee:
_____________________________________
Signature of the
President/Secretary of Branch/Circle
(To be filled in by the Secretary
General)
It
is certified that Shri/Smt. ___________________________________________________________
is a member of the All India Central Excise Inspector’s Association (AICEIA).
Signature of the Secretary General,
AICEIA
--------------------------------------------------cut here & submit to DDO---------------------------------------
Letter of Authorisation
[Authority:
O.M. No. 2/10/80-JCA, dated 31-01-1994]
I,
___________________________________________________________________________________
(Name and Designation) being a member of the All India Central Excise
Inspector’s Association, hereby, authorize deduction of yearly subscription of Rs.720/- (Rupees Seven hundred twenty
only) from my salary and authorize its payment to AICEIA, Surat.
Signature
& Initial
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