110003 CONSTABLE (GD) IN CAPFS, NIA, SSF AND RIFLEMAN (GD) IN ASSAM RIFLES EXAMINATION 2018 REGISTRATION NO :72000193248
APPLICATION IS PROVISIONALLY SUBMITTED
1. CANDIDATE'S NAME 2. FATHER'S NAME 3. MOTHER'S NAME SONU PAHADIYA MANDAN LAL PAHADIYA GEETA DEVI 4. DATE OF BIRTH (DD/MM/YYYY) 5. AGE AS ON DATE (01/08/2018) 6. GENDER 12/03/1998 20.4 FEMALE 9. MARK OF VISIBLE 7. CATEGORY 8. NATIONALITY IDENTIFICATION SC CITIZEN OF INDIA CUT MARK ON RIGHT LEG 10. MATRICULATION (10th CLASS) 12. MATRICULATION (10th 11. MATRICULATION (10th CLASS) ROLL NO EXAMINATION BOARD CLASS) YEAR OF PASSING BOARD OF SECONDARY EDUCATION, 1703395 2016 RAJASTHAN 13. PREFERENCE OF EXAMINATION CENTER PREFERENCE OF EXAMINATION CENTER CODE PREFERENCE OF EXAMINATION CENTER 2405 JAIPUR 2401 AJMER 2402 ALWAR 14.WHETHER EX- 14.1. IF EXS, WHETHER 14.2. LENGTH OF SERVICE ( 14.3. DATE OF DISCHARGE SERVICEMAN (ExS)? ELIGIBLE FOR IN YEARS ) RESERVATION? NO - - - 15. WHETHER SEEKING AGE 15.1. IF YES,INDICATE CODE 16. STATE / UT OF DOMICILE 17. DISTRICT OF RELAXATION? DOMICILE NO RAJASTHAN JAIPUR 18. HAVE YOU MIGRATED FROM THE 18.1 IF YES,WHETEHR YOU WOULD 18.2 IF NO,WHETHER YOU WANT TO STATE/ UT OF YOUR ORIGIN TO THE LIKE TO AVAIL RESERVATION FROM BE CONSIDERED AS A UR STATE/ UT WHERE YOUR CASTE IS THE STATE/ UT OF ORIGIN CANDIDATE FROM THE STATE/ UT NOT RECOGNISED AS SC/ ST/ OBC? OF DOMICILE NO - - 18.3. STATE OF ORIGIN 18.4. DISTRICT OF ORIGIN 19. CANDIDATE BELONGS 20. CANDIDATE BELONGS TO MILITANCY/ NAXAL TO BORDER DISTRICT AFFECTED DISTRICT - - NO NO
21. PREFERENCE OF POSTS FOR CAPF'S & ORGANISATIONS
BCADEFGH 22. DO YOU WANT TO MAKE AVAILABLE YOUR PERSONAL INFORMATION FOR ACCESSING JOB OPPORTUNITY IN TERMS OF DoP&T'S O.M NO.39020/1/2016-ESTT.(B) DATED 21.06.2016 ? NO 23. EDUCATIONAL QUALIFICATION BA
STATE: RAJASTHAN STATE: RAJASTHAN PINCODE: 302029 PINCODE: 302029 MOBILE NO: 9782642564 EMAIL: 2019sonu19982019@gmail.com SIGNATURE THUMB IMPRESSION
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EXEMPTED - - - DECLARATION I HEREBY DECLARE THAT ALL STATEMENTS MADE IN THIS APPLICATION ARE TRUE, COMPLETE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THAT IN THE EVENT OF ANY INFORMATION BEING FOUND SUPPRESSED/FALSE OR INCORRECT OR INELIGIBILITY BEING DETECTED BEFORE OR AFTER THE EXAMINATION, MY CANDIDATURE/ APPOINTMENT IS LIABLE TO BE CANCELLED.I AM WILLING TO SERVE ANYWHERE IN INDIA. PRINT TAKEN ON: 21/08/2018 6:36:46 PM