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    Staff Selection Commission: Combined Graduate Level Examination, 2019

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    Pranjal Sharma
    1. This document is an application for the Combined Graduate Level Examination, 2019 that was provisionally accepted. 2. It provides personal details of the applicant such as name, father's name, date of birth, gender, category, address, education qualifications. 3. The applicant has declared that all statements made in the application are true and correct, and is willing to serve anywhere in India if selected.

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    © All Rights Reserved
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    Staff Selection Commission: Combined Graduate Level Examination, 2019

    Uploaded by

    Pranjal Sharma
    11 views2 pages
    1. This document is an application for the Combined Graduate Level Examination, 2019 that was provisionally accepted. 2. It provides personal details of the applicant such as name, father's name, date of birth, gender, category, address, education qualifications. 3. The applicant has declared that all statements made in the application are true and correct, and is willing to serve anywhere in India if selected.

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    1. This document is an application for the Combined Graduate Level Examination, 2019 that was provisionally accepted. 2. It provides personal details of the applicant such as name, father's name, date of birth, gender, category, address, education qualifications. 3. The applicant has declared that all statements made in the application are true and correct, and is willing to serve anywhere in India if selected.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    11 views2 pages

    Staff Selection Commission: Combined Graduate Level Examination, 2019

    Uploaded by

    Pranjal Sharma
    1. This document is an application for the Combined Graduate Level Examination, 2019 that was provisionally accepted. 2. It provides personal details of the applicant such as name, father's name, date of birth, gender, category, address, education qualifications. 3. The applicant has declared that all statements made in the application are true and correct, and is willing to serve anywhere in India if selected.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    STAFF SELECTION COMMISSION

    BLOCK NO. 12, CGO-COMPLEX, LODHI ROAD, NEW DELHI


    110003

    COMBINED GRADUATE LEVEL EXAMINATION, 2019

    REGISTRATION NO: 92000497095

    APPLICATION IS PROVISIONALLY ACCEPTED


    1. NAME AS PER 2. NEW/ CHANGED 3. FATHER'S NAME 4. MOTHER'S NAME
    MATRICULATION CERTIFICATE NAME
    VISHNU KUMAR SHARMA - HANUMAN PRASAD SHARMA KAMLESH DEVI
    6. AGE AS ON
    5. DATE OF BIRTH (DD/MM/YYYY) 7. GENDER 8. CATEGORY
    01/01/2020
    10/07/1992 27.5 MALE OBC
    9. WHETHER PERSON WITH DISABILITY (PWD) ? 9.1 IF YES, TYPE OF DISABILITY (OH, HH,VH, OTHERS)

    NO -

    10. NATIONALITY 11. MARK OF VISIBLE IDENTIFICATION


    CITIZEN OF INDIA CUT AT STOMACH
    12. MATRICULATION (10th CLASS) EXAMINATION 13. MATRICULATION (10th 14. MATRICULATION (10th
    BOARD CLASS) ROLL NO CLASS) YEAR OF PASSING
    BOARD OF SECONDARY EDUCATION, RAJASTHAN 0068804 2008
    15. DO YOU BELONG TO ECONOMICALLY WEAKER SECTION (EWS) ?
    -
    16. PREFERENCE OF EXAMINATION CENTERS
    EXAMINATION CENTER EXAMINATION CENTER EXAMINATION CENTER
    (FIRST PRFERENCE ) (SECOND PREFERENCE ) (THIRD PREFERENCE )
    JAIPUR ( 2405 ) ALWAR ( 2402 ) AJMER ( 2401 )
    17.1. HAVE YOU ALREADY
    JOINED A CIVIL POST BY 17.3. DATE OF DISCHARGE
    17.WHETHER EX- 17.2. LENGTH OF SERVICE IN
    AVAILING BENEFIT OF FROM ARMED FORCES
    SERVICEMAN (ESM) ? ARMED FORCES ( IN YEARS )
    RESERVATION FOR EX- (DD/MM/YYYY)
    SERVICEMAN (ESM) ?
    NO - - -
    18. WHETHER SUFFERING FROM CEREBRAL-PALSY ?
    -
    18.1. DO YOU HAVE A PHYSICAL LIMITATION TO WRITE AND SCRIBE IS REQUIRED TO WRITE ON YOUR BEHALF
    (CERTIFICATE TO THIS EFFECT FROM THE CHIEF MEDICAL OFFICER/ CIVIL SURGEON & MEDICAL
    SUPERINTENDENT OF A GOVERNMENT HEALTH CARE INSTITUTION AS PER NOTICE OF THE EXAMINATION
    WOULD BE REQUIRED AT THE TIME OF EXAMINATION) ?
    -
    18.2. WHETHER SCRIBE IS REQUIRED ? 18.3. WILL YOU MAKE YOUR OWN 18.4. IF SCRIBE IS TO BE ARRANGED
    ARRANGEMENT OF SCRIBE ? BY SSC, INDICATE MEDIUM
    - - -
    19. ARE YOU ALSO APPLYING FOR THE POST OF JUNIOR 20. DO YOU POSSESS EQ FOR THE POST OF JUNIOR
    STATISTICAL OFFICER (MoSPI)? STATISTICAL OFFICER (MoSPI)?
    NO -
    21. ARE YOU ALSO APPLYING FOR THE POST OF 22. DO YOU POSSESS EQ FOR THE POST OF STATISTICAL
    STATISTICAL INVESTIGATOR GRADE II (RGI) ? INVESTIGATOR GRADE II (RGI) ?
    NO -
    23. WHETHER SEEKING AGE RELAXATION ? 23.1 IF YES, AGE RELAXATION CODE
    YES 02-OBC
    25. DO YOU WANT TO MAKE AVAILABLE YOUR
    PERSONAL INFORMATION FOR ACCESSING JOB
    24. QUALIFICATION DETAILS OPPORTUNITY IN TERMS OF DoP&T'S O.M
    NO.39020/1/2016-ESTT.(B) DATED 21.06.2016 ?

    BA (5) YES

    ADDRESS DETAIL
    26. CORRESPONDENCE ADDRESS 27. PERMANENT ADDRESS
    VPO-BARKHERA TEH-MALAKHERA ALWAR RAJASTHAN VPO-BARKHERA TEH-MALAKHERA ALWAR RAJASTHAN

    DISTRICT: ALWAR DISTRICT:ALWAR


    STATE: RAJASTHAN STATE: RAJASTHAN
    PIN : 301406 PIN : 301406
    MOBILE NO: 8441993180 EMAIL: [email protected]
    FEE PAYMENT AMOUNT TRANSACTION NO TRANSACTION DATE
    NOT EXEMPTED 100 CPV9087410 03/11/2019
    DECLARATION
    1. I HAVE READ THE NOTICE OF EXAMINATION AND ACCEPT ALL THE TERMS & CONDITIONS
    MENTIONED THEREIN.

    2. 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: 06/11/2019 8:28:00 PM

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