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STATE BOARD OF TECHNICAL EDUCATION : HARYANA

FORM FOR REPORTING CASES OF UNFAIRMEANS FOR ACTS OF INTERFERENCE

WITH THE PROPER CONDUCT OF STATE BOARD EXAMINATIONS.

General Particulars

1. Name of the examination2.

Centre of Examination

3. Subject4. Paper5. Date exact time of the detection of the case under report 6. Date of dispatching the case to the Directorate

I am sending herewith a case of the use of unfairmeans by an examinee whose particulars are given below:-

1. Name of the candidate2. Name of the candidates father3. Name of the Examination4. Roll No.5. Institution6. District7. Permanent address of the candidate

I am also enclosing the following evidence in support of the allegation of the use of unfairmeans by this examinee in

the State Board Examination

(i) The incriminating material recovered from the candidate.( In case of loose papers , please indicate the exactnumber of pages recovered from the candidate.)

(ii) The scripts ( Answer-books) of the candidate(iii) The statements of the Supervissor-in-charge & the Dupty Superintendent.(iv) The statement of the Candidate.(v) The statement of the Superintendent.(vi) A copy of the seating plan.(vii) A copy of the Question Paper.

I, ____________________ Superintendent of the __________________Examination __________ Centre

Do hereby certify that the said incriminating/objectionable material was recovered from the candidate during the course of the

State Board Examination.

1. The material was found from the candidate under reference as indicated below:

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(i) In candidates hand;(ii) In candidates pockets;(iii) In candidates shoes or shocks;(iv) Under the clothes worn by the candidate;(v) Under candidates question paper;(vi) Under candidates answer book;(vii) Under his feet;(viii) Near his seat;(ix) Any other place

Note:- Please strike out the columns which are not applicable

2. When some incriminating material is recovered from near the seat of a candidate as far as possible, a rough sketchindicating the place of the recovery of the material should be prepared and sent alongwith the seating plan.

II The candidate Roll No. __________________________ was found giving /receiving help to /from candidate

Roll No. ___________________who was siting just in front /behind/left or right of the candidate Roll No.__________

III This case was detected by ______________________ as detailed below:-

________________________________________________________________________________________________

________________________________________________________________________________________________

I further certify that

(1) Instructions were read to all the candidates just before the commencement of the examination on ______________To dispossess paper, notebook, book etc. or any other helpful material relating to the subject of the examination of

the day.

(2) The examination Hall/Rooms and their surroundings were searched by the members of the supervisory staff beforethe commencement of the examination on ____________________and that no papers, books, copies etc. relating

to the subject of the examination of the day were fourd lying anywhere in or near the examination hall, the rooms

and the desks of the examinees.

SuperintendentExamination Centre

Permanent Address

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Statement of the Deputy Superintendent:-

( Note:-Please give in your statement clearly the nature of offence(s) committed by the candidate. Also please state specifically in

the space provided below the EXACT PLACE of the recovery of the incriminating material found from the candidate , whose

case is being reported i.e. whether the incriminating material was recovered from his/her hand or pocket or answer-book or

question paper or table or desk or chair etc. In case the incriminating material is found near the seat of the candidate, its exact

distance and direction from his/her seat should be mentioned specifically.)

Signature

Name___________________

Dated Permanent address:

Statement of the Centre Superintendent:-

( Note:-Please give in your statement clearly the nature of offence(s) committed by the candidate. Also please state specifically in

the space provided below the EXACT PLACE of the recovery of the incriminating material found from the candidate , whose

case is being reported i.e. whether the incriminating material was recovered from his/her hand or pocket or answer-book or

question paper or table or desk or chair etc. In case the incriminating material is found near the seat of the candidate, its exact

distance and direction from his/her seat should be mentioned specifically.)

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Statement of the candidate of the exam. Centre

Dated: Signature

Roll No.

Name & Permanent Address

Any other remarks by the Superintendent/ Deputy Superintendent