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Membership Form
ALL INDIA ANTI CORRUPTION COMMISSION
(An ISO9001:2008 Certified Organization)
(Registered Under Indian Trust Act “Government of India”)
(Registration No-DEL/4131/29-DEC/2013)
To,
The Chairman/Secretary
All India Anti Corruption Commission
Regd. Off:#88,Old Courts Compound,Kashmere Gate, Delhi -110006
Corp.Off: 4th Floor, Rectangle No.1, Behind Saket Sheraton Hotel,
Commercial Complex D4, Saket,New Delhi – 110017, India
Website: www.allindiaanticorruption.org Email:[email protected]
below: USE CAPITAL LETTERS
Name:………………………………………………………………………………
Father’s Name:…………………………………………………………………….
Profession:…………………………………………………………………………
Date of Birth:……………………………………………………………………….
Education:…………………………………………………………………………..
Blood Group:……………………………………………………………………….
Identification Marks:………………………………………………………………..
Mailing Address:……………………………………………………………………
……………………………………………………………………………………….
P.O:………………………………..Dist:……………………………………………
State:……………………………...Pin Code:……………………………………….
Nearest Police Station:………………………………………………………………
Mobile:.........................................Email Id:…………………………………………
Details Of Bank Draft No / Cheque No:…………………………………………….
Date:…………………………………
Place:………………………………… Signature ______________________
Declaration: I hereby solemnly affirm and declare that. 1. the Particulars mentioned by me here in above are true & Correct to the best of my
knowledge and belief .Nothing has been concealed or suppressed thereof. If anything found incorrect at any stage, my membership can be
terminated. 2. I honestly declare that I will not involve myself directly or indirectly in any act which will be against the prestige of nation, society
,journalism and AIACC as well. 3. Abide by the rules and regulations and bye-laws of the AIACC in force from time to time.
Date:……………….
Place:………………..
Signature_______________________________
Information: All documents should be attested by any one authorized officials with seal
1. Magistrate 2.Gazetted Officers 3.MP/MLA 4. Police Station House Officers. Membership Fee: All payments should be made by cheque / draft
in favour of ALL INDIA ANTI CORRUPTION COMMISSION * payable at Delhi Please don’t give any cash to any members
TERMS AND CONDITIONS
1. The Member and officers of AIACC are working on voluntary basis and no payment will be given to them. Membership fee of Rs.5000/- is not
transferable and once the payment is made it is not refundable.
2. Any Kind of misbehaviour or misconduct may result in cancellation of membership of AIACC .All disputes are subject to jurisdiction of Delhi.
3. AIACC will not be responsible for any misuse of identity card issued to the member during the course of the membership with AIACC.
4. Application duly filled along with the Membership Fee and Citation/Bio-Data should be submitted.
5. Approval of Membership is at the Sole Discretion of the AIACC.
6. On expiry of Membership the identity card must be surrendered to the national office. The Membership is valid for 3 years from the date of issue.
7. Further Membership can be renewed as per terms and conditions based on the active participation of the member.
8. Member will get Unique Identity Card along with Accidental Insurance Coverage of Up to Rs.1, 00,000/- Valid till the expiry of the Membership.
9. In case of change of address/mobile no member should inform the concerned office.
10. In case of loss of identity card that should be informed to the national office in writing along with FIR from concerned police station immediately.
11. All AIACC members should be in contact with their respective Area Office /State Office National Office every month and Acitve Participation in the
Volunteer Programs organized by AIACC is must.
12. Strict action will be taken against the Member, if found guilty violating the rules and regulation of AIACC.
13. Any of the above Terms and Conditions may be altered or any new conditions can be added without Prior Notice.
14. Regarding any doubt, question or problem, please contact AIACC admin. office. All rights reserved to AIACC.
Affidavit Format
Affidavit on stamp paper of Rs. 100/- Notary
To,
The Chairman/Secretary
All India Anti Corruption Commission
Regd. Off:#88, Old Courts Compound, Kashmere Gate, Delhi -110006
Corp.Off:4th Floor, Recangle No.1, Behind Saket Sheraton Hotel,
Commercial Complex D4, Saket, New Delhi – 110017, India
Website: www.allindiaanticorruption.org Email:[email protected]
Dear Sir,
I…………………………………………………………S/O, D/O, W/O…………………………………………………………….
R/O……………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………..
Applying for the membership of ALL INDIA ANTI CORRUPTION COMMISSION do hereby solemnly firm /declare/certify as under:
1.
I will follow all the rules & regulations AIACC as per the membership form.
2.
I do not have any criminal background & do not have any criminal FIR/case lodged / pending against me.
3.
AIACC will not be responsible any/such illegal/wrong/immoral act done by me
4.
Whenever required I will present Identity Card / Certificate
5.
I will never misuse my membership/Identity Card.
6.
I have read & understood the Terms & Conditions and undertake to comply with them.
7.
In case above submitted information is found incorrect / false, I will be subject to the law of the land and the chairman reserves the rights to
cancel the membership without assigning any reason.
8.
The Chairman ALL INDIA ANTI CORRUPTION RESERVES the rights to reject my membership forms without assigning any reason
9.
The Chairman of AIACC may terminate/cancel/suspend the membership without any prior intimation / information /reason.
Deponent
Signature
Verification: Verified that the above statement is true and correct to the best of my knowledge and belief & nothing has been concealed
therein.
Date:…………………………………..
Place:………………………………..
Deponent
Signature
ALL INDIA ANTI CORRUPTION COMMISSION
(An ISO9001:2008 Certified Organization)
(Registered Under Indian Trust Act “Government of India”)
(Registration No-DEL/4131/29-DEC/2013)
Police Clearance Certificate
I Certify that Mr./Mrs./Ms……………………………………………………………………………………………..
S/O,D/O,W/O………………………………………………………………………………………………………….
Resident of…………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
Police Station……………………………………………Dist………………………………………………………..
State……………………………………………………..Pin Code…………………………………………………..
Contact No…………………………………………………………………………………………………………….
1.
2.
3.
4.
5.
His/her Character is good in all Manners.
She/he does not have any Criminal Background.
He/She has no relation with any type of Anti Social Activity.
I am fully satisfied with his/her character.
He/She does not have any criminal FIR/Case Lodged.
Date:………………………………..
Place:……………………………….
Applicant Signature
Verification by Local Police Authority
Date:………………………………..
Police Station:……………………………….
SHO/Officer/Station In charge
Signature with stamp