Application for Empanelment of Mediator or Conciliator on the Panel

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..... lip;…. resident of ............................ (address) am hereby pleased to offer my services as Mediator or Conciliator so as to take up any assignment or matters referred by the Central Government at the places furnished hereunder: 1.________ 2._________ 3.___________ 4._______________ I possess requisite qualifications and experience in the following fields for the past _____years. .....

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