Schedule I

(See section 13). Certificate of Appointment in the Police Force. 1[State of Karnataka] No . . . . . . . . . Certificate of appointment issued under Photograph to be affixed the 1[Karnataka] Police Act, 1963 . . . . . . in the case of Inspectors . . . . . . . . . . . . . . . . . . and Sub-Inspectors. Shri . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has been appointed as . . . . . . . . . . . . . . and is invested with the powers, functions and privileges of a Police Officer under the 1[Karnataka] Police Act, 1963 ( 1[Karnataka] Act 4 of 1964). On the . . . . . . . . . day of . . . . . . .19 . Seal Signature . . . . . . . . . . . Designation . . . . . . . . . Particulars— 1. Father’s Name . . . . . . . . . . . . . . . . . . Photograph to be affixed 2. Native place . . . . . . . . . . . . . . . . . . . . in the case of Inspector 3. Age . . . . . . . . . . . . . . . . . . . . . . . . . . and sub-Inspector. 4. Length of previous service, if any . . . . . 1. Adapted by the Karnataka Adaptations of Laws Order 1973 w.e.f. 1.11.1973 --------