G.A.R. 21

(See rule 68)


1. Certified that the Government servants named on the reverse have earned the prescribed periodical increments from the date cited in column 6, having been the incumbents of the posts specified for not less than ................................... year (s) from the date shown in column 5, after deducting periods of absence from duty not counting for increment, absence on leave without pay, etc. Further certified that during the period or periods of leave taken from............to............and from.............. to.............. which have been counted for increment in the case of officiating Government servant/servants named on the reverse, he/they would have officiated in the post/posts but for his/their proceeding on leave.

2. Certified that the Government servant/servants named on the reverse has/have earned/will earn periodical increments from the date cited for reason stated in the explanatory memo, attached hereto.

Name of incumbent Whether substantive or officiating Scale of pay of


Present pay Date from which present pay is drawn Date of present increment Future pay Absence from duty not counting for increment Leave without pay and in the case of those holding the post in officiating capacity, all other kinds of leave during which he/they would not have continued to officiate in the post
From To From To
1 2 3 4 5 6 7 8 9 10 ' 11






1. When the increment claimed is the first to carry a Government servant over an efficiency bar columns 5, 6 and 7 should be filled up in red ink.

2. The figure (1) or (2) should be placed against each name according as the certificate (1) or (2) applies. The explanatory memorandum should be submitted in any case in which certificate (2) applies.

Signature and Designation Drawing of Officer