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CET-2015 Rural Service affidavit

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Execution of bond by Candidates who select MBBS seats in Government Medical Colleges OR Government seats in Private Medical Colleges

(On Rs.100/- e- Stamp Paper)




I, Mr. / Kum ………………………………………………………………………………………………… S/o. / D/o………………….…………………………………………… a candidate with ‘CET–2015’ Admission Ticket No…………………… residing at ……….…………………………………………………………………………….
…………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………..

have    on  my  own  volition   allotted  a   MBBS  seat  on  …………..………………….   In

…………………………………………   vide  admission  order  number  …………………………..  dated

………………… and do hereby undertake as follows:

In accordance with the Amendment to Rule 11 of the Karnataka Selection of Candidates for Admission to Government seats in Professional Educational Institutions Rules, 2006, vide Government Notification – 1. No.HFW 79 RGU 2011 dated 17-07-2012, I am prepared on completion of the course to serve in any Primary Health Center or Primary Health Unit situated in Rural Areas in the State of Karnataka for a minimum period of ONE year, failing which I render myself liable to pay a penalty of Rupees Ten Lakhs to Government of Karnataka.

What is stated above is true and correct and I and my parent hereby undertake to act accordingly.



Signature of the candidate
Signature of the Parent
Date:……………………..
(Father / Mother)
Place :……………………..

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