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9/29/21, 9:43 PM :: ONLINE APPLICATION ::

ONLINE APPLICATION FORM


  Application No. : AR/2021-22/156715 Affix recent  
1. Name of the Trade Applied for : Rifleman (Cook) [TDN] passport size  
2. Applied Under Caste*: General colour  
Photo(Size -
3. Religion, Caste Belongs to* :         (if HINDU
 - 
MARATHA 4.5cm x  
belongs to SC/ST/OBC)
3.5cm)
4. Domicile State : MAHARASHTRA  
5. Gender, Marital Status  : MALE
 / 
Single
   
6. Name of the Candidate & Date of Birth (as MR.  
NIKHIL SAMBHAJI HADKE
 / 
in Matriculation Certificate) :  
01 Dec 2002
Father's Full Name  (as in Matriculation
7. Certificate) : SAMBHAJI BHAURAO HADKE
8. Correspondence Address: SANGVI BK PATHARDI, AHMEDNAGAR, PIN - 414102
(MAHARASHTRA)
9. Permanent Address: Same as above
10. Mobile No., Email & Aadhaar Card No. 7558534653
 
[email protected]
 
992136070530
11. Details of Educational Qualification* (Govt./Govt. Recognised Institute/Organization
only)
Compulsary
Qualification Univ/Board PassingYear MarkObtained TotalMarks Percentage
Subject/Trade
  Maharashtra State Board of
10th --NA-- Secondary and Higher Secondary 2018 310 600 51.67
Education
  Experience if any* (Govt./Govt. Recognised Institute/Organization only) :
 
13. Whether Ex-ServiceMan* : NO
 
14. Whether Sport Man* : NO
 
 
 
15. Recruitment Type : Advt Applied Candidate
 
STATE
Bank Challan 29
Bank Challan No/Online BANK
16. DUH6617500 Date/Online Payment Sep Amount: 100 Bank:
Payment Challan No: OF
Challan Date: 2021
INDIA
17. Community Certificate : --NA--
18. Criminal Proceedings details, if any : --NA--
19. Is EWS(Economically Weaker Sections) : --NA--
20. NCC Certification : NO
  Declaration :
I, hereby solemnly declare that, all the statement made in the above application are true and correct
to the best of my knowledge and belief. I fully understand that in the event of any
  information/document being found false/incorrect or ineligibility being
detected at any stage,
appropriate action can be taken against
me and my candidature be rejected/made null and void by the
Assam Rifles authorities.
  Note:- *Date, Time and location/site for PST/PET and Written Examination will be intimated through
Assam Rifles official website www.assamrifles.gov.in. You are instructed to check your status after two
weeks of last date and time for receipt of online applications. You are requested to bring this form with
www.assamrifles.gov.in/onlineapp/frmReport.aspx 1/2
9/29/21, 9:43 PM :: ONLINE APPLICATION ::

photocopies of all required certificates at the time of reporting to PST, PET and Written Examination
Board.
 
App Date :   
Place :  
SANGVI BK Signature :   
28/09/2021
Date :  
29/09/2021 Name of the Applicant :  
NIKHIL SAMBHAJI HADKE
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