Annexure-C
Prescribed Form for Inivitng applications for Khadim-ul-Hujjaj for Haj-2016
Attention of applicatnts is invited towards Rule 20 of CCS (Conduct Rules),
1964 which says “No Government servant shall bring or attempt to bring any
political or other outside influence to bear upon any superior authority to further
his interests in respect of matters pertaining to his service under Government.” Haj
Committee may recommend disciplinary action against such applicants who violate
the above-mentioned clause.
Nominations filled up incompletely and received without supporting documents will be
summarily rejected.
Sl.
No.
1.
Particulars
2.
Father’s Name
3 (a)
Date of Birth (attach duly
attested copy of proof of
date of birth)
(b)
Age as on 01-07-2016
4.
Whether Government
Servant/Employee of
PSU/ Statutory body of
Government, etc. or not.
5 (a)
Name
(b)
Name &
Address of the Office
(Present working on duty)
Designation
6.
Educational Qualification
7.
State of Health
(attach a certificate issued
by Certificate issuing
authority of Government
Hospital)
Languages Known (other
than Arabic READ (R)
WRITE (W) SPEAK (S)
(please tick in the relevant
box)
8.
Details
Affix
Your
Latest
Attested
Photograph
YES
If yes, (Please attach a copy of the Identity
Card issued by the parent office)
(1)
R
(2)
W
S
R
(3)
W
S
R
(4)
W
S
R
W
S
√
9.
Knowledge of Arabic
SPEAK
YES
(Please tick)
READ
YES √
(Please tick)
WRITE
YES √
(Please tick)
Contd…2.
::2::
10.
Have you already
performed Haj ?
( Plase tick )
11.
Experience in organizing
public congregations and
in social work
( please give details )
12.
Previous experience as a
Khadim-ul-Hujjaj/
AHO/HA
(please tick)
13.
Yes. ( Performed )
( If yes, attach copy of documentary proof )
1.
2.
3.
4.
Any other information of
interest
Place: Hyderabad.
Date: – 02 – 2016.
Signature of Applicant
Seal and signature of EO/Secretary/
Chairman of forwarding State Haj Committee
Date:
- 02 - 2016.
Important Note:(i)
(ii)
(iii)
Incomplete application form/application form not signed and forwarded by
the State Haj Committee will not be entertained.
Application received without supporint documents will not be entertained .
An individual who has not attended the Training Camp will not be eligible
as Khadim-ul-Hujjaj.
Cont..3.
:: 3::
Other Details:
Sl. No Particulars
Details
1.
Profession / Occupation / Designation
with Official Address, District
presently working.
(Attach Proof)
2.
Year of 1st Haj performed (Not as
Khadimul Hujjaj)
(Attach Proof and mention cover
number and details)
3.
Previous Experience as Khadim-ulHujjaj
(Please mention the year and number
of times Haj Performed as Khadimul-Hujjaj with Cover Numbers)
4.
Head of the Departmnet for Relieving
5.
Native Place as per service Record
6.
International Passport No. &
Date of Expiry
7.
Residential Address:
8.
Mobile No:
9.
Email Id:
DECLARATION
I solemnly declare that the information furnished above is correct and true
to the best of my knowledge and belief.
I also understand that in case, if any material information is suppressed or
found false at a later date, the Haj Committee shall have a right to take legal action
against me at any state besides cancelling the canditature.
Place: Hyderabad.
Date: 05 – 02 – 2016.
Signature of the Applicant
CERTIFICATE
This is to certify that the particulars furnished by the above applicant are
correct as per offical recordsand he is a Government Servant/Employee of PSU/ Statutory
body of Government,
Signature of Head of the Office
With Designation and Seal.
Contd..4.
:: 4 ::
Terms and Conditions:
1. The individual (male) must be between the age limit of 25 to 50 years as on 01-07-2016.
2.
3.
4.
5.
No family member should accompany to perform Haj-2016.
The individual should not have any connection with any of the Saudi Moallims.
The individual must have performed Haj earlier (attach proof of Haj).
He should be sound health and medically fit to travel.
6. The applicant should enclose certificate/documents, duly attested by any gazetted officer.
7. Only Government Servant/Employee of PSU/ Statutory body of Government, are
eligible subject to approval of Haj Committee of India, Mumbai.
8. The period of deputation/absence for Central Government employees shall be
treated as on leave.
9. The individual should submit NOC from the respective department, if selected.
Selection is at the discretion of the Telangana State Haj Committee.
10. The Telangana State Haj Committee is empowered to accpet or cancel any
application without specifying any reason thereof.
11. No TA and DA will be paid for attending selection process.
12. No TA and DA will be paid for attending the Orientation/Training camp of
Haj committ of India.
13. If any false information is furnished, the same shall be rejected without assigning
any reason thereof.
14. The selection of your candidature is subject to the final approval of
Haj Committee of india, Mumbai.
15. The selected Khadim-ul-Hujjaj should not leave the place of his duty during his
stay in Makkah Mukarramah and Madina Munawwara.
16. He should have valid international Passport with validity upto 10th March-2017.
with Machine Readable Passport.
17.The application must be submitted through respective department through
proper channel.
18. The individual who did not attend the Haj Orientation/Training Camp are not
eligible for selection as Khadim-ul-Hujjaj for Haj-2016.
19. He should be well acquainted with the Religious knowledge including Haj rituals
and should have experience handling functions and public congregations.
20. He should ready to travel on any moment as per the direction of the Telangana
State Haj Committee.
21. All correspondences will be communication through Official address of the
eligible candidates for selection as Khadim-ul-Hujjaj.
*NOTE: The selection of Khadim-ul-ujjaj for Haj-2015 will be based on the individual
working in the office situated in concerned District.
I shall abide by all the above terms and conditions as laid by the Telangana
State Haj Committee.
Signature of the Applicant
-
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