Gazette No. 2505 - PDF page 8

Extracted page text

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PART  I :  SEC.  (IIA) – GAZETTE OF THE DEMOCRATIC SOCIALIST REPUBLIC OF SRI LANKA –04.09.2026
3090
11.	
Passes in the G. C. E. Advance Level Examination :
Year : ........................ Index Number : ...........................................
Subject 
Pass
12.	
Other Educational Qualifications: ...........................................................................................................................
	
.................................................................................................................................................................................
13.	
Professional Qualifications:....................................................................................................................................
	
.................................................................................................................................................................................
14.	
Declaration /Certification of the candidate :
I do hereby certify that all the information mentioned by me in this application are true, and correct. I know that if 
any information mention here is found to be false before my selection to this post, I become disqualified, and if found 
after the selection I am subjected to be dismissed from the service without any compensation. 
	
...................................................
	
Signature of the Applicant
Date :   .................................
Should be completed by the Head of the Department :
01.	 Whether any disciplinary proceeding has been taken / intended to be taken in the future against this officer during the 
preceding 05 years ? Yes / No
02.	 If the answer is “Yes” what are the actions taken on that ? ...............................................................................................
............................................................................................................................................................................................
03.	 Has the officer taken no pay leave during his period of service? Yes / No
04.	 If the answer is “Yes” how many no pay leave has been taken?
Serial 
No.
The relevant condition for the approval 
Duration 
From 
To 
i.
< V:2:5:4 of the Establishment Code 
ii.
< XII:16 of the Establishment Code 
iii.
Management Services Circular No. 10
iv.
Management Services Circular No 33
v.
< XII:36 of the Establishment Code
vi.
Other no pay leave 
The application of Mr. ………………………………………………………………………. who is serving in the 
Post of ……………………………………………………………………….in this Department is recommended and 
forwarded. 
Date : .......................................	
..........................................................,	
	
	
Signature of Head of the Department 
	
	
	
	
	
	
	
	
	
     Official Seal
09-46