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    Staff Selection Commission

    Uploaded by

    Awinash Chowdary
    This document is a registration application that has been provisionally accepted for Raja Nalluri to take the Constables (GD) in Central Armed Police Forces (CAPFs), NIA, SSF and Rifleman (GD) in Assam Rifles Examination, 2021. The application provides Raja Nalluri's personal details like name, father's name, date of birth, gender, category, address and contact information. It also includes details of his educational qualifications and preferences for examination centers. Raja Nalluri has declared that all information provided in the application is true and he is willing to serve anywhere in India if selected.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Staff Selection Commission

    Uploaded by

    Awinash Chowdary
    43 views3 pages
    This document is a registration application that has been provisionally accepted for Raja Nalluri to take the Constables (GD) in Central Armed Police Forces (CAPFs), NIA, SSF and Rifleman (GD) in Assam Rifles Examination, 2021. The application provides Raja Nalluri's personal details like name, father's name, date of birth, gender, category, address and contact information. It also includes details of his educational qualifications and preferences for examination centers. Raja Nalluri has declared that all information provided in the application is true and he is willing to serve anywhere in India if selected.

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    Original Title

    GDForm2021

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    This document is a registration application that has been provisionally accepted for Raja Nalluri to take the Constables (GD) in Central Armed Police Forces (CAPFs), NIA, SSF and Rifleman (GD) in Assam Rifles Examination, 2021. The application provides Raja Nalluri's personal details like name, father's name, date of birth, gender, category, address and contact information. It also includes details of his educational qualifications and preferences for examination centers. Raja Nalluri has declared that all information provided in the application is true and he 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
    43 views3 pages

    Staff Selection Commission

    Uploaded by

    Awinash Chowdary
    This document is a registration application that has been provisionally accepted for Raja Nalluri to take the Constables (GD) in Central Armed Police Forces (CAPFs), NIA, SSF and Rifleman (GD) in Assam Rifles Examination, 2021. The application provides Raja Nalluri's personal details like name, father's name, date of birth, gender, category, address and contact information. It also includes details of his educational qualifications and preferences for examination centers. Raja Nalluri has declared that all information provided in the application is true and he is willing to serve anywhere in India if selected.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 3

    STAFF SELECTION COMMISSION

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


    110003

    CONSTABLES (GD) IN CENTRAL ARMED POLICE FORCES


    (CAPFs), NIA, SSF AND RIFLEMAN (GD) IN ASSAM
    RIFLES EXAMINATION, 2021

    REGISTRATION NO: 71000919883

    APPLICATION IS PROVISIONALLY ACCEPTED

    1. NAME AS PER MATRICULATION 2. NEW/CHANGED


    3. FATHER'S NAME 4. MOTHER'S NAME
    CERTIFICATE NAME
    RAJA NALLURI - N SEKHAR BABU N KUSUMA KUMARI
    6. AGE AS ON
    5. DATE OF BIRTH (DD/MM/YYYY) 7. GENDER 8. CATEGORY
    01/08/2021
    25/12/1996 24.7 MALE SC
    9. NATIONALITY 10. MARK OF VISIBLE IDENTIFICATION
    CITIZEN OF INDIA A MOLE I AWAY THE LEFT WRIST
    12. MATRICULATION (10th 13. MATRICULATION (10th
    11. MATRICULATION (10th CLASS) EXAMINATION BOARD
    CLASS) ROLL NO CLASS) YEAR OF PASSING
    BOARD OF SECONDARY EDUCATION ANDHRA PRADESH 1312117059 2013
    14.1. WHETHER YOU ARE AN EX-SERVICEMAN (ESM) OR
    14.2. DATE OF JOINING THE ARMED FORCES (DD/MM/YYYY)
    SERVING IN THE ARMED FORCES?
    NO -
    14.3. DATE OF DISCHARGE FROM ARMED FORCES
    14.4. LENGTH OF SERVICE IN ARMED FORCES
    (DD/MM/YYYY)
    - -
    14.5. HAVE YOU ALREADY JOINED A CIVIL POST BY
    AVAILING BENEFIT OF RESERVATION FOR EX-SERVICEMAN 14.6. DATE OF JOINING TO CIVIL POST (DD/MM/YYYY)
    (ESM) ?
    - -
    15.1. WHETHER SEEKING AGE RELAXATION? 15.2 IF YES, AGE RELAXATION CODE
    YES 01-SC/ST
    16.1. ARE YOU A NATIONAL CADET CORPS (NCC)
    16.2. TYPE OF THE NCC CERTIFICATE
    CERTIFICATE HOLDER
    YES NCC "B" CERTIFICATE
    17. PREFERENCE OF EXAMINATION CENTERS

    EXAMINATION CENTER EXAMINATION CENTER EXAMINATION CENTER


    ( FIRST PREFERENCE ) ( SECOND PREFERENCE) ( THIRD PREFERENCE)

    VIJAYWADA ( 8008 ) GUNTUR ( 8001 ) VISHAKHAPATNAM ( 8007 )

    18. STATE/ UT OF DOMICILE 19. DISTRICT OF DOMICILE

    ANDHRA PRADESH KRISHNA


    20.1. HAVE YOU MIGRATED FROM THE STATE/ UT OF 20.2. WHETHER YOU WOULD LIKE TO AVAIL THE BENEFIT OF
    YOUR ORIGIN TO ANOTHER STATE/ UT RESERVATION FROM THE STATE/ UT OF YOUR ORIGIN
    NO -
    20.3. STATE/ UT OF ORIGIN 20.4. DISTRICT OF ORIGIN
    - -
    21. CANDIDATE BELONGS TO MILITANCY/ NAXAL
    22. CANDIDATE BELONGS TO BORDER DISTRICT
    AFFECTED DISTRICT
    NO NO
    23. PREFERENCE OF POST FOR CAPF(S)/ ORGANIZATION(S)
    B,A,H,D,E,F
    24. HIGHEST EDUCATIONAL QUALIFICATION
    INTERMEDIATE/ HIGHER SECONDARY/ 10+2 (2)
    25. DETAILS OF QUALIFYING EDUCATION
    10TH STANDARD
    STATUS PASSING STATE/ UT OF BOARD/ NAME OF BOARD/ ROLL NO PERCENTAGE CGPA
    YEAR UNIVERSITY UNIVERSITY
    PASSED 2013 ANDHRA PRADESH BOARD OF 1312117059 - 5.2
    SECONDARY
    EDUCATION ANDHRA
    PRADESH
    26. 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 ?
    YES
    ADDRESS DETAIL
    27. CORRESPONDENCE ADDRESS 28. PERMANENT ADDRESS
    D NO 4-4 D NO 4-4
    DHARMAGAHNI STREET KANURU POST AND VILLAGE DHARMAGAHNI STREET KANURU POST AND VILLAGE
    PENAMALURU MANDAL PENAMALURU MANDAL
    DISTRICT: KRISHNA DISTRICT: KRISHNA
    STATE: ANDHRA PRADESH STATE: ANDHRA PRADESH
    PIN: 520007 PIN: 520007
    MOBILE NO. : 8019392456 EMAIL ID: [email protected]
    29. DATE ON WHICH PHOTOGRAPH HAS BEEN TAKEN 30. WHETHER THE DATE OF PHOTOGRAPH IS CLEARLY
    (DD/MM/YYYY): PRINTED ON THE PHOTOGRAPH

    10/06/2021 YES

    FEE PAYMENT AMOUNT TRANSACTION NO TRANSACTION DATE

    EXEMPTED - - -

    DECLARATION
    1. I HAVE READ THE NOTICE OF THE EXAMINATION AND ACCEPT ALL THE TERMS & CONDITIONS OF THE
    NOTICE OF THE EXAMINATION.

    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: 26/07/2021 1:32:53 PM IP ADDRESS: 49.37.154.169

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