Application Form for Admission as Member Of ALL INDIA CENTRAL EXICSE INSPECTORS’ ASSOCIATION (AICEIA)

ANNEXURE ‘A’

Application Form for Admission as Member Of

ALL INDIA CENTRAL EXICSE INSPECTORS’ ASSOCIATION (AICEIA)

(To be obtained in quadruplicate)

Applicant’s Name: ______________________________________________________________

(In Block letters)

Designation in the office: ________________________________________________________
Blood Group:____________________________________________________________ ______

Date of entry into Service:________________________________________________________

Office in which employed: ________________________________________________________

____________________________________________________________________________

Residential address (with phone number):____________________________________________            ______________________________________________________________________________

            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/Circle in which the                                                                            applicant is admitted as a primary member: __________________________________________

Name of the Branch/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 Inspectors’ 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 31-1-1994]

I,__________________________________________________(Name and Designation) being member of the All India Central Excise Inspectors’ Association, hereby authorize deduction of monthly subscription of Rs. 20(Rupees Twenty Only) from my salary and authorize its payment to (Name of the Branch/Circle) _________________________________________________

_________________________________________________________________________

Signature &Initial