TAURUS BUS CELL
C/O 972 TPT COY ASC TYPE ‘ B’
S/No …………..
(SCHOOL BUS FACILITY IS NOT ENTITLED FOR WARDS OF EX-SERVICEMEN)
Photo to be attested by head of the organization
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(Auth: AI 15/87)
To,
The President of India,
In consideration of ………………………………..of whom I am the legal /natural guardian being carried at my request as a passenger in hired Transport by The Indian Army Indian / Army Mechanical Transport in charge of any Officer or other rank of the Army or any other person in the employee of the Indian Army or person in service of Government I undertake and agree that neither I nor my executors or administrators or other legal representatives will make any claim against the government or against any officer or other rank or any employee of the Indian Army or against any person in the service of Government in respect of any loss or injury to property or person including injury resulting in death which the said minor …………………………………..may suffer while the said person is or in consequence or the said being carried or whilst he /she is boarding or alighting from the said transport and I understand and agree that no compensation will be paid by the Government or any officer or other rank or employees of the further agree so as to bind myself, my heirs my executors and administrators to indemnity you and or any officer or other rank or employee of the Indian Army person in the service of them arising out or default on the part of the said person during or in connection with such journey in the hired Transport by The Indian Army/Indian Army Mechanical Transport.
It is further declared that stamp duty payable on this undertaking shall be borne by me
Dated ………………day of ………………..
Sig of Witness………………. Sig of Guardian………………………………..….
No…………………………… Son of /Daughter of No………………………..…
Rank ………………………… Rank ………………………………….…………
Name………………………… Name……………………………………………
Designation …………………. Designation ……………………………………
Address……………………… Address…………………………………………
………………………………… …………………………………………………
………………………………… ………………………………………………….
(TO BE FILLED BY OFFICE ONLY)
ROUTE NO ………………………. OLD PASS NO………………. Dated…………………..
PICK UP POINT ………………….. Date: (Form submitted to School Bus Cell): …………………….
PASS ISSUED ON ………………….. STATUS …………………………………Amount……..………
COUNTERSLIP
Name …………… S/D of No ……………… Rank…………Name…………………….. Mob No……………...
School …………………………………… Date: (Form duly filled recd) ……………..
Route No …………………………………
Status ……………………………………. S/No ……………..
NOTE: - (1) Please see reverse of page for instructions on filling up of application and documents to be attached for bus pass.
(2) Parent are requested to please ensure Pre class to class III children are collect &drop to their pick up point.
Contd . . . . . Page-2/-
-2-
Please furnish the following details (IN CAPITAL LETTERS)
OLD PASS NO ______________Dated________________ Admission No (School) ……………………
Route No _________________ Pick up point ______________________________ Class _____________
School __________________ Name & age of child _________________________ Age ______________
D/O S/O NO: _________________ Rank _____________ Name ___________________________________
Unit of parent/guardian ____________________________ Date of retirement: ____________ (in present rank)
Identity Card No _____________________ Date of issue ________________ Issued by ___________________
Residential Address _______________________________________________Mobile No _________________
I undertake full responsibility for my child’s behavior while in bus. I or my dependent will not get into any kind of argument/altercation with co-dvr or staff of bus. In case of any damage to bus / SBC property any ward, I undertake the responsibility to pay compensation for the same. I will address all my grievances to bus cell. I agree that pass of my ward whose particulars are given above can be cancelled by OC, 972 Tpt Coy ASC in case of any lapse. I am entitled to services of school bus as per AI 15/87.
…………………………………
Dated: (Signature of parent/guardian)
Son of /Daughter of No ___________________
Rank __________Name ___________________
Unit ______________________________________
COUNTERSIGNED/ATTESTED
1. It is certified that Master/Miss _______________________________________, whose date of birth is ____________, Son/Daughter of No _________________ Rank _____________ Name ________________ as per IAFF 958/Record of service. (Auth: (Unit) _______________DO Part-II No_____________ dt_____). The indl is not retiring before 31 Mar 2013 (Pl specify date if retiring before that ____).
2. The indl is presently posted in ____________________________________ which is in Peace/field location ______________ His family is staying at the following address:-
______________________________________
______________________________________
3. I have read AI 15/87 and aware of entitlement of this facility of this facility and undertake responsibility for the correctness of above furnished info.
Round stamp (Signature of CO/OC/Registrar/Director/
OC Tps of parent unit only)
No _____________ Rank_________
Date : Name _________________________
Appt ____________________________
Instructions for filling up the form
1. Two stamp size photographs. (One pasted on front page right top corner, duly attested).
2. All columns to be filled and countersigned by the competent auth mentioned above.
3. Indl posted in fd (Forms to be countersigned by unit auth only).
4. For Widows, photocopy of pension documents (PPO) & Battle casualty certificate are required.
5. For Defence civilians, photocopy of identity card, serving certificate and date of birth certificate of child (duly mentioned that wards Salary certificate and indl paid out from Ministry of Defence) are required.
6. Please attach Old Pass along with forms at the time of renewal of bus pass Otherwise your forms will be treated as fresh one and security fees will be charged.
7. Please bring your Identity card and valid dependent card (issued within one year) and produce at the counter, while depositing/collection of your bus pass form and bus pass.
8. Please mention mobile number for availing SMS service facilities.
9. Children Birth DO Part II Number, date and unit must be fill up duly attested by competent authority.
10. CTC of Latest Quarterly/Monthly statement of accounts must be attached with the form OFFRs/
PBORs.
11. School Admission/fee slip.
12. Incomplete forms will be placed in waiting list/observation list.
