ANDHRA PRADESH VAIDYA VIDHANA PARISHAD, HYDERABAD. OPTION FORM (To be filled by the Employee) Note: Please submit this form, duly filled, signed and obtain acknowledgement in proof of submission SERVICE PARTICULARS 1 Name of the employee 2 Designation & Place of work 3 Father /Husbands name 4 Date of Birth 5 Social Status 6 Qualification Design: D.O.A: D.O.R: A.A: P.D: 7 Initial post 8 1st promotional post 9 2nd promotional post 10 3rd promotional post (Expansion: Design=Designation, D.O.A=Date of Appointment, D.O.R=Date of Regularisation, AA=Appointing Authority, P.D=Parent Department) DECLARATION I Sri/Smt/Ms._______________ S/o, D/o, W/o. _______________R/o ____________do hereby declare that on my own free will, I am exercising my option for absorption into A.P. Vaidya Vidhana Parishad services and abide by the APVVP Special Service Regulations 2000, i.e., G.O.Ms. No. 48, HM & FW (C1) Dept, dt: 29.01.2000 and subsequent G.Os and rules issued by Govt./Commissioner, APVVP from time to time. I am fully aware and understood that the Option once exercised is final and cannot be reversed in future. I certify that all the information given above is correct and I accept full responsibility for any wrong information or misinformation, if found at a later date. DATED: SIGNATURE OF THE EMPLOYEE SIGNATURE OF THE CONTROLLING OFFICER WITH STAMP ---------------------------------------------------------------------------------------------------------------- ACKNOWLEDGEMENT (To be issued to the Employee) Received the Option Exercised Form from Sri/Smt.Ms ________________________________ S/o, D/o, W/o.____________________________________working as _________________________ in this Office / Hospital / Dispensary. Dated: SIGNATURE OF THE CONTROLLING OFFICER WITH STAMP
