DGMS Mines Experience Certificate

C.I.M.502

GOVERNMENT OF INDIA MINISTRY OF LABOUR AND REHABILITA REHABIL ITATION TION DIRECTORATE GENERAL OF MINES SAFETY

Certif Certifica icate te of pract practica icall exper experiec iecee !rate !rate" " #$ t%e Maa!e Maa!err to a ca"i"a ca"i"ate te for a Maa!e Maa!er&' r&' ( S)r S)r*e$ *e$or& or&'' ( O*er+a&' ( Sir"ar&' ( Mate&' ( S%otfirer&' ( Bla'ter&' Certificate of Co+petec$ Exa+iatio )"er t%e ,Coal Mie' re!)latio-./01 Metallifero)' Mie' Re!)latio-./2.,3

I Shri

being the Manager of  4

' I ' 54

 belonging to  4 Shri

46 Mine

do hereby certify that Son of Shri

 44  (Whose  (Whose

signature is appended) !or"ed in the abo#e $ine fro$ 4

444  to  to  4

444  and   and is still

!or"ing. %uring his ter$ of !or" aforesaid he has obtained practical e&perience as detailed o#erleaf. he duties connected !ith his !or" ha#e in#ol#ed his continuous attendance at the Mine and ha#e  been efficiently perfor$ed by hi$.

I belie#e hi$ to be of good character and a fit and proper person to be e&a$ined for certificate of co$petency.

........................................................... (Signature !ith date and official seal)

......................................... (Signature of Candidate)

 +ote , %elete if not applicable. ' I ' (State +a$e of Mineral)-

Manager



Mine



.*.



%istrict



State



S3N

7artic)lar' of practical experiece 5a6

7lace of  Experiece 5#6

7erio" of practical experiece 5 c6 Fro+

Total experiece

To

Year' Mot%' Da$'

Gra" Total

AVERAGE MONTHLY OUT7UT 5"6 AVERAGE DAILY EM7LOYMENT 5e6 DURING THE ABOVE 7ERIODS GIVEN BELO89

I #elo:;!ro)" :or
I ope;ca't :or
I all

........................................

........................................................................

(Signature of the Candidate)

(Signature of Manager !ith date and official seal)

 +a$e of Mines ;

Instruction(a) State clearly the nature of duties. (b) State whether on-surface, in opencast working or belowground. (c) State Specially the period spent by the applicant in different mining operation, or surveying  operation as the case may be, if the employment has not been such as to involve continuous attendance of the applicant at the mine, whether underground or aboveground and in what  capacity. (d) Delete if the mine is a Metalliferous Mine. (e) Delete if the mine is a oal Mine.  !ote"  #ny certificate of e$perience of training, which is not issued under the official seal of the concerned Mine manager, would be re%ected.