Appendix X

CERTIFICATE OF LAND

File No. Date:

Certified that the land measuring (Area of land in Square meters)

is owned by the (Name of the owner)
by way of (Sale Deed/Conveyance Deed/Gift
Deed/Allotment Letter etc. (In case of allotment of land, if it is
not perpetual, periodicity of allotment to be mentioned from to ).

It is further certified that owner of the land has leased the said land to (In case of
lease /sub- lease only) (Name of the School/Society/Trust/Company
under
Section 8 of companies Act, 2013) fully described in the schedule mentioned
hereinafter with the following details for a period of years from
to
.

SL Particula Detail
rs s
1. Plot No. (s)/ Survey No. (s)/Khasra No.
(s)/Khata
No.(s)/Khatauni No.(s)
2. Name of street/village, Sub Division,
District and
State

It is certified that the said entire land comprise of a single contiguous plot of
land. It is further certified that....................(Name of the School with name of street,
village,
sub-division and district) run by name of……………………………………………………
(Society / Trust / Company under Section 8 of companies Act, 2013) is located on
 the said plot of land.

THE SCHEDULED OF LAND ABOVE

REFERRED TO

All that piece and parcel of land measuring............(area of land in square meters)
situated in ....................[Plot No. (s)/Survey No.(s)/ Khasra No. (s)] at........................(name
of street/village, sub division, district and state) and bounded as follows:

North :

East :

West :

South :

DM/ ADM/ SDM/ TEHSILDAR/ NAIB TEHSILDAR/ REGISTRAR/ SUB-

REGISTRAR/EQUIVALENT LAND AUTHORITY

(Stamp and Signature of the land authority)

(Name of
Officer) (Name
of District)

* The filled up certificate should be either in Hindi or English. If it is issued

in vernacular language, translated notarized version in English be
uploaded along with the original vernacular certificate as a single pdf.
 APPNENDIX - XI

BUILDING SAFETY CERTIFICATE

No. Dated:

Certified that the existing building ……………………………………................. (name of the

building or premises) at ………………………………………………………………………………..
………………............ (address) comprised of …………………………….….. basement(s) and

………………………………………………………………… (upper floors) owned/occupied by

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

…………………………………………....... (name of the Institution) have complied with

the Building safety requirements in accordance with National Building code Rules,
and verified by the officers concerned of ……………………………… (Name of
Department/ Govt.) on………………………(date of inspection)
in the presence of
………………………………….…………………….………………… (name and addresses of the
Manager/Secretary or his representative) and that the building/premises is fit
for occupancy upto classes ………………………(X/ XII) with effect
from………………… for a period of
…………………… years in accordance with rule and subject to compliance of the
specific conditions as appended.
1.

2.

3.

4.

Issued on ………………………… at..........................................by

* Strike out whichever is not applicable.

Signature with Seal :

Name :

Designation :

Name & Address of Department/ Office:

(Assistant Engineer & above officer of concerned Govt. Department only)

Note: This certificate should be signed / issued by Assistant Engineer & above
officer of concerned Govt. Department only
* The filled up certificate should be either in Hindi or English. If it is issued
in vernacular language, translated notarized version in English be uploaded
along with the original vernacular certificate as a single pdf.
 APPENDIX - XII
FIRE SAFETY CERTIFICATE

No. Dated:

Certified that the ……………………………………………………………… (name of the

building or premises) at ………
……………………………………………………………………………………. (address) comprised
of ………………………………… basement(s) and ………………………………………………
(upper floors) owned/ occupied by …………………………. ……………………………………
(name of the institution) have complied with the fire prevention and fire safety
requirements in accordance with rule of State/ UT Fire Service Rules, and verified
by the officers concerned of Fire Service on …………………… (date of
inspection) in the presence of
……………………………. (name and addresses of the Manager/ Secretary or his
representative) and that the building/ premises is fit for occupancy
upto classes
…………………………… ( X/ XII) With effect from ……………………… for a period of
………………………… year in accordance with rule and subject to compliance of
specific conditions as appended:-

1.
2.
3.
4.

Issued on ……………………… (date of issue) at.........................................(place) by

*Strike out whichever is not applicable.

 APPENDIX - XII
Signature with Seal: …………………………………
To

Name : …………………………………
…………………………………………

Designation : …………………………………
(Name & Address of the
Institution) Name & Address of Department/ Office: ……………

ENDORSEMENT

The No Objection Certificate issued by Fire Service stand cancelled an annulled due to
……………………………………………………………………………………………………………… (reasons
to be recorded).
(Name and designation of the authorized signatory)

* The filled up certificate should be either in Hindi or English. If it is issued

in vernacular language, translated notarized version in English be uploaded
along with the original vernacular certificate as a single pdf.
 APPENDIX - XIII

PROFORMA FOR SAFE DRINKING WATER AND SANITARY CONDITION CERTIFICATE

No. Dated:

It is certified that an inspection team headed by …………………………………………………….

(Name of Officers with designation) from ……………………………………………………………

(Name of Department/ Office) inspected the ………………………………………………………..

(Name & Address of the school) on …………………….(date of inspection) and found that the

……………………………………………………….( Name of school) has safe drinking water

facilities for the students and members of staff of the institution and is
maintaining the hygienic sanitation condition in the school building & the campus
as per norms prescribed by the Central/ State/ U.T. Govt.

The above is valid for a period of ………………………

To

…………………………………………

…………………………………………

(Name & Address of the Institution)

 APPENDIX - XIII
Signature with Seal:
………………………………… Designation : …………………………………

Name : Name & Address of the Office / Department : ……..

…………………………………

* The filled up certificate should be either in Hindi or English. If it is issued

in vernacular language, translated notarized version in English be uploaded
along with the original vernacular certificate as a single pdf.
 APPENDIX - XIV

Office Memorandum No. Date:

……………………………………………………… (Name &

Address of State Education Department)
To

From
:
………………………………………... ……………………………………………
………………………………………… (Name …………………………………………… (Name&
and Address of issuing department) Address of school)

Sir/Madam,

Sub: Issue of No Objection Certificate to ……………………………………………………

(Name & Address of school) for affiliation to the Central Board of Secondary
Education—Regarding.

Ref:

In the reference ……. cited, ………………………………………………………… (Name &

Address of school) Run by …………………………………………………… (Name &
Address of Trust/ Society / Company) (Registered in Sub Registrar
Office,
………………………….) is accorded “Certificate of Recognition” from the
academic year …………… to.............for Classes I to VIII Standard under section 18 of
Right
 APPENDIX - XIV
of Children to Free and Compulsory Education Act- 2009 and Rule....of

…………………………………………………….. (State Act/ Rules).

Details of School

1. Name :
2. Survey No :
3. Revenue Village / City:
4. Taluk :
5. Total area of land:

6. Recognition Code :

The Department ………………………………………. (Name & Address of State Education

Department) has No Objection for the Correspondent of
the

Page 1 of 2
 APPENDIX - XIV

………………………………………………………………………. (Name & Address of school) for

applying for affiliation to Central Board of Secondary Education, subject to the
conditions laid down in the Certificate of Recognition.

The School Management Shall be having full responsibility if any court case arise
in this regard. The details furnished if any by the management is found to be
false or incorrect at any stage, this No Objection Certificate is liable to be
cancelled

Signature with Seal: ………………………..

Name of issuing authority: ………………..

Designation: ………………………………..

Copy To:

1. The Correspondent..........................................................(Name & Address of school).

2. The Secretary, Central Board of Secondary Education, 2 Community

Centre, Preet Vihar, Delhi 110092

* The filled up certificate should be either in Hindi or English. If it is issued
in vernacular language, translated notarized version in English be uploaded
along with the original vernacular certificate as a single pdf.
APPENDIX - XIV

Page 2 of 2
 APPENDIX - XV

CERTIFICATE OF RECOGNITION

…………………………………………….. (Name
& Address of the issuing authority)
No. Date:

To

……………………………….

……………………………….
(Name & Address of the
school)

Sir/ Madam,

Sub: Recognition Certificate for the school under …………………………………………………

(Rule/ sub- rule of the State Act/ Rules).

Ref:

With reference to your application dated.........and subsequent school inspection in this

regard, I hereby convey the grant of Recognition to ……………………………………………….
(Name & Address of school) for class I to VIII standard for the period (no. of years)
from the academic year ……………. to …………….. in compliance to section 18 of
Right of Children to Free and Compulsory Education, Act, 2009 & rule..........of
………………….. (State Act/ Rule).

The above recognition is subject to the following conditions:-

 APPENDIX - XV

1. The temporary recognition accorded to the school is valid from the academic year
………………. to ………………. and is to be renewed at an interval of every ………….
years.
2. The grant of recognition is available initially for classes I to VIII standard
and to be extended for Secondary /Senior Secondary classes subsequently
in due course of time.
3. The school shall abide by the provisions of the Right of Children to Free
and Compulsory Education Act, 2009 and the.......................(State Education
Act/
Rules).
4. The school shall admit in pre-school / class I to the extent of …… (%age) of
the strength in each class, children belonging to Weaker Section and
Disadvantaged Group in the neighborhood and provide free and
compulsory elementary education till its completion.
5. The school shall maintain a separate bank account for the purpose of reimbursement.
 APPENDIX - XV

6. The school shall not collect any capitation fee and subject the child or his
or her parent or guardian to any screening procedure.
7. The school shall not deny admission to any child, -
a. For lack of age proof if such admission is sought subsequent to the
extended period prescribed for admission.
b. On the ground of religion, caste or race, place of birth or any of them.
8. The school shall ensure that,-
a. No child admitted shall be held back in any class or expelled from
school till the completion of elementary education in a school.
b. No child shall be subjected to physical punishment or mental harassment.
c. No child is required to pass any board examination till the
completion of elementary education.
d. Inclusion of students with disabilities/ special need as per provision of the
…………… (rule/ clause of State Act).
e. The teachers are recruited with minimum qualifications as laid under ……………
(rule/ clause of the state Act).
f. The teachers perform his duties specified under ………….. (rule/
clause of the state Act).
9. The school shall follow the syllabus on the basis of curriculum laid down by
appropriate authority.
10. The school shall maintain the standards and norms as specified in. (rule/
clause of the state Act).
11. No unrecognized classes shall run within the premises of the school or
outside in the name of school.
12. The school building plan must have been approved by the current rules or
G. Os. The school building or other structures and the grounds are used only
for the purposes of education and skill development. Construction work
within the compound should not be carried out in school working hours
and safety measures in all respect are under whole responsibility of the
 APPENDIX - XV
managements.
13. The school is run by a society registered under the …………………… (Act
under with Society is registered), or a public trust constituted under any
law for the time being in force.
14. The school is not run for profit to any individual, group or association of
individuals or any other persons.
15. The accounts should be audited and certified by a Chartered Accountant
and proper accounts statements should be prepared.
16. The school shall furnish such reports and information as may be required
by the competent authority from time to time and shall comply with such
instructions of the State Government or the competent authority as may
be issued to secure the continued fulfillment of the condition of recognition
or the removal of deficiencies in working of the school.
17......................(language subject) shall be taught as a subject from in standards I to X in all
schools notified under …………………(concerned Act/ rule) from academic
session recognition is granted.
 APPENDIX - XV

18. The school shall abided by the provisions of the...............(State Act/ Rules).
19. The certificates of recognition issued by the department shall be subject to
the fulfillment of deficiencies if any pointed out by the department at any
stage/ time.
20. The management shall rectify the deficiencies pointed out in infrastructure
or administration by the authorities.
21. The management shall apply for renewal of recognition three months
before the expiry of this order to this ……………………….. (Name & Address of
the certificate issuing authority).
22. The management shall follow the directions issued by the Government/
Department form time to time keeping in view of the safety and security of
the children and the overall administration of the school.
23. The recognition shall be withdrawn if any contravention of the provisions
of the Act, Rule or the conditions of recognition are found and proved.
24. The school management shall have to full responsibility if any court cases
arises this regard. The management is not entitled to seek affiliation to
other Board without obtaining NOC from the (Concerned State
Authority).

Seal & Signature of issuing authority ……………………

Name & Address of issuing authority ……………..

* The filled up certificate should be either in Hindi or English. If it is issued

in vernacular language, translated notarized version in English be uploaded
along with the original vernacular certificate as a single pdf.
 APPENDIX - XVI

CERTIFICATE OF REGISTRATION OF
SOCIETIES

I hereby certify that (society name with address) has this

day been registered under the Societies Registration Act __XXI of 1860 .

Given under my hand at (place) this (date

of registration) day of (month) Two thousand
(year).

Seal & Signature of Registrar of Societies

Place :

Date :

* The filled up certificate should be either in Hindi or English. If it is issued

in vernacular language, translated notarized version in English be uploaded
along with the original vernacular certificate as a single pdf.