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PUNJAB POLICE RECRUITMENT 2016

APPLICATION FORM FOR THE POST OF SUB INSPECTOR (OPERATOR) IN INFORMATION TECHNOLOGY
& TELECOMMUNICATION WING OF TECHNICAL AND SUPPORT SERVICES CADRE OF PUNJAB POLICE.

APPLICATION STATUS: SUBMITTED

Name: VIPAN KUMAR Registration
40018360
Father's Name: CHAMAN LAL ID:
Mother's Name: KANTA DEVI Gender: Male
DoB: 1989-03-26 Mobile No: 9915155389
Category: SC-OTHERS Marital
Unmarried
Aadhaar Card No: 289317866722 Status:
Qualification: Post-Graduation
Punjab Domicile: YES
Address: C/O INSP. CHAMAN
LAL,GURU AMARDASS
COLONY,H.NO 2 GALI NO 2,
OPPOSITE BRIGHTWAY SCHOOL,
NEAR PETROL PUMP,
NARIANGARH. AMRITSAR.
State: Punjab
District: Amritsar Commissionerate
Pincode: 143105
Police
PSSK Chheharta Amritsar
Station:
OTHER DETAILS
Have you passed matriculation examination with Punjabi as one of the
compulsary or elective subjects or any other equivalent examination in Yes
Punjabi language
Whether any FIR or Criminal case(S) has ever been registered againt you? No
Have you ever been arrested/detained in any criminal case(s) No
Have you ever been tried & convicted or acquitted by a Court of law in any
No
criminal case(s)?
Have you ever had to execute any bond for keeping peace/good behavior
No
under security proceeding of CrPC?
Have you ever been proceeded against by any
School/College/University/Board in case of Unfair Means (UMC) or any No
charges
Are you facing any Criminal Proceedings in any Court of Law in India?: No
Is there any departmental enquiry / court enquiry pending against you?: No

DECLARATIONS
1.) I hereby declare and confirm that all the entries made by me in this Common Application
Form are correct. I undertake that in case any information furnished by me is found to be false or
incomplete or any material information is found to be concealed by me, my candidature may be
cancelled and I understand that no claim, whatsoever, shall be entertained in this regard
afterwards.

2.) I certify that the documents uploaded by me alongwith this Application Form are genuine and
in case any of the documents are found to be fake/forged, appropriate Departmental (including
Dischare/Dismissal from service) and/or Criminal proceedings may be initiated against me. I

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undertake to abide by the general Rules and Regulations governing the recruitment process and I
will also abide by the instructions/commands given by the staff conducting the recruitment
process.

3.) I undertake that I shall not cause any disruption in the Recruitment Process and shall refrain
from indulging in any anti-social, unlawful activities during the entire recruitment process. If I
am found indulging in any such activities at any time during the Recruitment Process, my
Candidature may be cancelled and I shall be liable for any Departmental and/or Criminal
Proceedings consequent upon such act/activity.

4.) I undertake that I shall not canvass for my Candidature/Selection in any form.

5.) If after the submission of this Application Form, any Criminal case(s) is/are registered against
you or you are arrested/detained by Police in any Criminal Case, the complete details relevant to
the same should be communicated by you immediately, in writing, either personally or by
registered post/email, to the Chairman, Central Recruitment Board, Punjab Police failing which it
shall be deemed to be the willful concealment of factual information on your part.

6.) I hereby giving my willingness to undergo substance abuse test for drug addiction at the
District/ onal Recruitment Center before the Physical Measurement Test and Physical Screening
Test.

7.) I undertake that i will produce the original certificates whenever required by Recruitment
Board or Punjab Police.
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