Tick ( ) which ever is relavent Moderation Paper Setting Evaluation Examination held in ____________________ 1

Tick ( ) which ever is relavent Moderation Paper Setting Evaluation Examination held in ____________________ 1.Name2. Designation 3.Address on which the payment to be sent (one self addressed envelope to be attached) 4.Institution / Department / Retiree 5.Particulars of work done : From _______________ To _______________ No of days __________. Identity No.Subject Rate per Unit Unit(s) Rs. 6.Bus f (Extractive summary — verify with official source.)