CABINET SECRETARIAT

Note: Please fill in the form in English capital letter Advt. No. 06/13 Post applied for (Tick Lower Division Desk Assistant 1) Name: against relevant post)

2) Address for correspondence:

3) Contacst No. : (Mobile) 4) Father Name:

5) Date & Place of Birth: Date Month Year 1 9 Place

6) Age as on closing date: (14/02/2014) Year

Months

Days

7) Code for Category:

8) If ex-serviceman, please indicate:-

i)

Length of Service:

Years

Months

Days

ii) Date of joining: iii) Date of discharge: 9) Sex: 10) Nationality: 11) Religion: ______________

12) Marital status:

__________________________

13) Educational Qualification: Exam/ Degree passed University/Board Year of Passing Duration of the Degree/Diploma Subjects Studied Aggregate marks with percentage

14) Whether employed or not: 15) Compute knowledge, if any: 16) Typewriting speed:

______________________________________ ______________________________________

17) Language known (English/Foreign): With proficiency to read, write & speak

Language

Read

Write

Speak

18) Examination Centre: (Tick against relevant column)

Delhi Mumbai Kolkata Chennai Lucknow Shillong Jammu

(Note: the department reserves the right of final allotment of examination centre)

DECLARATION
I hereby declare that a) I fulfil the eligibility for the post applied for; b) I have not submitted any other application in response to the same advertisement. In the event of information or part thereof being found incorrect at any stage, my candidature/appointment is liable to be cancelled/terminated without any notice to me and action can be taken against me.