Gazette No. 2505 - PDF page 27

Extracted page text

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PART  I :  SEC.  (IIA) – GAZETTE OF THE DEMOCRATIC SOCIALIST REPUBLIC OF SRI LANKA –04.06.2026
3109
09.	
Details regarding the receipt for payment of the Examination Fee
	
I.	 Bank where the Examination Fee was Paid - ................................. Branch - .................
	
II.	 Date of payment - ............. ../............../.........    Amount paid - .....................................
10.	
Declaration of the Applicant
	
(i)	 I hereby certify that all information provided by me in this application is true and correct to the best of my 
knowledge. I agree to accept any loss that can happen for not completing any or few of the information or for 
incorrectly completing. Further, I hereby declare that all the parts have been correctly perfected. I agree to abide 
by all the conditions of the examination. Further, I agree to the rules and regulations imposed by the Head of 
the Institution conducting this examination regarding the conduct of the examination or to the decisions taken 
regarding the issue of results. 
	
(ii)	 I am aware that I am subjected being disqualified before appointment to this post or dismissal after appointment 
if it is proved out that the declaration I have made found to be untrue. 
Date  .............................	
	
	
	
        ............................................................,  
                                                                 	
	
 	
	
   Signature of the Applicant.    
11.	
Attestation of Applicant’s Signature 
I hereby certify that Mr./Mrs./Miss ………………………………………………… submitting this application is 
personally known to me and that he/she placed his/her signature in my presence on ………………………….....…………. 
	
……………………………………………, 
	
Signature of the Attesting Officer. 
Name of the Attesting Officer: ………………………………………… 
Designation: ……………………………........................………………. 
Address: …………………………………………………………………
(To be certified with the Official Seal)
12.	
Certification of the Head of Institution 
Mr./Mrs./Miss …………………………………………………………. submitting this application is serving in the 
……………………………………………office/institution and that his/her service has been satisfactory and that 
the Examination Fee has been paid and the receipt is affixed and if he/she is selected based on the results of this 
examination he/she can be/cannot be released from service and that the information given above is true. 
Date: ……………………. 	
	
…………………………………., 
	
Signature of Head of Institution. 
Name of the Head of the Institution: ……………………
Designation: ………………………………………………
Address: …………………………………………………
(To be certified with the Official Seal)
09-11	
Affix the Bank Payment Receipt Here Securely.