I................................., hereby declare that the information furnished above is true. I undertake:(a)that in the event of any change in the facilities at my disposal (either addition or deletion) or my leaving the aforesaid organization, I will promptly inform the Chief Inspector;(b)to maintain the facilities in good working order. calibrated periodically as per manufactures instructions or as per National Standards; and(c)to fulfil and abide by all the conditions stipulated in the certificate of competency and instructions issued by the Chief Inspector from time to time.PlaceDateSignature of the applicant.Declaration By The Institution (if employed)I......................certify that Shri..........................whose details are furnished above, is in our employment and nominate him on behalf of the organisation for the purposes of being declared as a competent person under the Act. I also undertake that I will(a)notify the Chief Inspector in case the competent person leaves our employment;(b)provide and maintain in good order all facilities at his disposal as mentioned above;(c)notify the Chief Inspector any change in the facilities (either addition or deletion).Dated:Signature.......................Designation..................................Telephone No.................................Official SealForm of Application for grant of Certificate of Competency to an Institution under Sub-Rule (2) of Rule 2A.
