PUNJAB PUBLIC SERVICE COMMISSION

S. No.
For Commission's use only Application No.___________

PPSC 2

APPLICATION FORM
Photocopy of Application Form is not acceptable.
Downloaded Application Form will also acceptable.
Paste one latest passport size attested photograph here and sign across the photograph. ( Compulsory for both male & female. )

This form is for all posts advertised by the Commission.

Roll No.________________ Candidates must read detailed "Instructions to the Candidates" and relevant advertisement of the Commission before filling the Application Form. Write "N/A", if any information/column, is not relevant to you.
In case of change/deletion/addition in any column of the prescribed

Note:

Application Form, the candidate would be liable to rejection of his/her candidature.

Assistant BS(14) POST APPLIED FOR: _______________________________________

SUBJECT (If applicable) : ____________________

Police Department DEPARTMENT/ORGANISATION _______________________________________________________________

1. Advertisement No.

2. Case No. Receipt Date

/ /

3. Bank Receipt No. _____________________

(paste original receipt at the space provided at page 5)

4. Receipt Amount ______________________ 5.

Candidate's Name

Bank of Issue ___________________________

J |A |H |A |N | Z | A |I |B | | |Q |B | A |L | I

| | | | | | | | | | | | | | | | |

(in Capital Letters - Box in between First, Middle and Last part of the name to be left blank)
PERVAIZ IQBAL Accountant 6. Father's Name ________________________________________Occupation_____________________________

7. Postal Address

27-B,1/2 Ghazi Colony, Faisal Street, Near Firdous Cinema, Main Sanda Road, Lahore

Phone 0334-4184287

E-Mail jaz4pak@yahoo

8. Permanent Address 27-B,1/2 Ghazi Colony, Faisal Street, Near Firdous Cinema, Main Sanda Road, Lahore Phone 9. District of Domicile Lahore 11. National Identity Card No. (New) 3 5 National Identity Card No. (Old) 10. Marital Status
(tick the relevant)

0334-4184287

S ingle

M arried

D ivorced - 9

W idow

2 0
-

- 5 4 -

Yasmeen Pervaiz House Wife 12. Mother's Name ______________________________________ Occupation_____________________________

13. Name of Spouse _______________________ Domicile _________________Occupation_________________ 14. Religion (tick the relevant) 16. Date of Birth M uslim / 0 N
on-Muslim

15. Sex (tick the relevant) 17. Age on Closing Date

(including the day of birth)

M ale

F emale

1 0

/ 8

(as recorded in the Matriculation Certificate)

4 years

0 1 months

2 days

18. Are you in Govt. Service? (tick the relevant)

P unjab

F ederal

S emi Govt. /

O ther Provincial Govt. /

Yes Yes Yes

and quote commencement date of current continuous service

19. Are you an Armed Forces Released/Retired Commissioned Officer/Personnel? (tick the relevant) 20. Has your last service been terminated by Govt. for want of vacancy? (tick the relevant) 21. Do you claim to be a Disabled Person? (tick the relevant)

No No No

22. APPLICABLE TO COMBINED COMPETITIVE / PROVINCIAL MANAGEMENT SERVICE EXAM. ONLY. Please mention optional subject group, serial no. and subject name, carrying a total of 600 marks but not more than 200 marks from each group as provided in the syllabus:
i) Group________________ ii) Group________________ iii) Group________________ Sr. No._________ Sr. No._________ Sr. No._________ Subject Name__________________________________ Subject Name__________________________________ Subject Name__________________________________

Note: Subsequent change in the selection of optional subjects shall not be allowed.

-223. ACADEMIC QUALIFICATIONS: Certificate/Degree Institution Matric/S.S.C.

Intermediate/H.S.S.C
Naveed Publiic High School

Indicate details of your entire academic record including additional / higher qualification & training courses if any Subjects Board/University Result Examination System Marks Total Percentage * Division/ Position in Registration No. Declared on (Annual/Semester) Obtained Marks % Grade Board/Univ.
Science
2001

Annual

713

850

84

A+

Forman Charistian College, Lahore Pre-Engineering

Govt. Islamia College Civil Lines, Lhr Phy, Che, Math University of the Punjab, Lahore Chemistry

2003
2006 2008/

Annual
Annual Semester

753
451 2011

1100
800 2600

69
56 77

A
B B+

Graduation Masters
Other Qualifications

Additional/Higher Qualifications/Training Courses

* Percentage will be calculated as IMPORTANT:

(Marks Obtained)

100

Percentage

Total Marks
Attach attested copies of certificates/degrees/detailed marks sheets in respect of all above examinations showing qualification/detail of marks obtained and total marks. Also attach equivalance certificate of competent authority if your qualifications are different but equivalent to prescribed qualifications. 24. SERVICE RECORD : Indicate details of your entire service record upto your present post. Attach a separate page if this space is not sufficient.

Post Held

Department/Office

Government/ Semi Government/ Private

DURATION From To
Day Month Year Day Month Year

Scale/ Salary

SPECIALITY

( if any )

-325. you claim additional marks as an unemployed child of a Punjab Govt. Servant who was incapacitated or died while in service? If so, attach the certificate as mentioned in the instructions. (tick the relevant)
Do

Yes

No

26. Detail of Post Graduate Research Work if any. (Attach a separate page if this space is insufficient) ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ 27. Your Registration Number with PMDC/PEC/PCATP/PBC ______________ (for Doctors/Engineers/Architects & Town Planners/lawyers only) Valid upto: / /

28. If you have ever been disqualified/debarred, as a punishment, from appearing in any Examination, Test or Interview by the Federal /Punjab Public Service Commission, please mention detail of the Post/ Exam./Test/Interview ______________ ___________________________________________ Years for which disqualified: __________________ Date of Disqualification Order / /

29. If you have ever been dismissed/terminated/removed from service in any Provincial/Federal Govt/Autonomous/Semi-autonomous agency for reasons other than want of vacancy, retrenchment of post? Mention Post ___________________________________ Department ______________ Year ________ and tick the appropriate One; D ismissed T erminated R emoved 30. Please indicate all three centres Lahore, Rawalpindi and Multan, in the order of your priority, for appearing in the Written Lahore Rawalpindi Multan Test/Examination/Interview :- 1._________________ 2._________________ 3._________________. The Commission however reserves the right to call you for Written Test/Examination or Interview at any place. 31. Number of chances already availed for the post applied for: ____________ 32. If you had applied previously to the Punjab Public Service Commission for any post irrespective of the fact whether you appeared in the examination/test/interview or not, please give below particulars of all of them. S.No. Year Name of Post Test APPEARED IN Examination Interview Remarks

33. Please mention detail of your visits abroad: Country Visited From Duration of Visit To Purpose of Visit

34. Applicable to Combined Competitive / Provincial Management Service Exam. only. Please mention your preference to the posts advertised in the relevant column by writing post code and post name in order of your preference. Order of Preference 1 2 3 4 5 Post Code Post Name Order of Preference 6 7 8 9 10 Post Code Post Name

Note: The option once exercised will be considered final as far as the candidate is concerned.

-4APPLICABLE TO "CIVIL JUDGES CUM JUDICIAL MAGISTRATES" EXAM. ONLY 35. Please mention exact period of practice as Barrister/Advocate of High Court or Subordinate Courts. From: / / To: / /

APPLICABLE TO THE POSTS OF ASI & INSPECTOR LEGAL OR PRISONS DEPTT.

(and any other post where indicated) Attacth Original Medical Certificate. b. Chest c. 36. a. Height (exemption for female candidate) ______________ i. Normal __________ ii. Expanded __________

Vision i. Left _____________ ii. Right ______________

37. If you are overage/underage and relaxation of age limit where permissible (for the post applied for) has been obtained from the concerned Competent Authority, please quote relaxation order No.& date. / / Period of Relaxation Years Months Days (Attach age relaxation order)

CHECK LIST
38. Please ( ) Tick application:Yes National Identity Card Matriculation Intermediate Graduation B.Ed.

'Yes' or 'No' against the certificates and other documents which you have attached with this
No LL.B/LL.M M.A./M.Sc./M.Ed. M. Phil./Ph.D/Equivalent F.C.P.S/Equivalent Research Paper(s) Yes No Yes No One attested Photograph Domicile Certificate Experience/Service Certificate(s) Yes No

In case of Govt Service, Departmental Permission Certificate In case of Disabled Person, Registration and Medical Certificates If applying on the basis of equivalent qualification, Certificate of equivalence In case of Overage/Underage, Age Relaxation Order (in original) If last service was terminated for want of vacancy, Certificate of such service In case of Ex-Serviceman, Discharge Certificate Certificate of Registration with PMDC/PEC/PCATP/PBC Medical Certificate of Physical Standard, if prescribed Certificate of Practice as Lawyer, if prescribed Certificate of service as Barrister/Advocate/Member of Establishment of Courts Affidavit declaring actively participating in the Profession of Law (if prescribed)
39. I DO HEREBY SOLEMNLY DECLARE THAT THE REPLIES GIVEN BY ME IN THIS APPLICATION FORM ARE CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I FULLY UNDERSTAND THAT THE FACTS GIVEN ABOVE WILL SERVE AS THE BASIS FOR DETERMINATION OF MY ELIGIBILITY BY THE COMMISSION AND MY CANDIDATURE SO DETERMINED BY THE COMMISSION WILL STAND PROVISIONAL UNTIL IT IS VERIFIED WITH THE ORIGINAL CERTIFICATES AT THE TIME OF INTERVIEW. I WILL NOT CLAIM BENEFIT OF ANY INFORMATION WHICH IS NOT MENTIONED IN THE APPLICATION FORM AND IS PRODUCED AFTER THE CLOSING DATE FOR SUBMISSION OF APPLICATIONS. I ALSO UNDERSTAND THAT IF AFTER THE CLOSING DATE FOR SUBMISSION OF APPLICATIONS MY APPLICATION IS FOUND INCOMPLETE , WRONGLY FILLED IN, UNSIGNED OR NOT ACCOMPANIED BY TREASURY RECEIPT/BANK CHALLAN IN ORIGINAL AND ATTESTED COPIES OF OTHER REQUISITE DOCUMENTS, IT WILL BE LIABLE TO REJECTION, AND THAT IF ANY FACT IS CONCEALED OR MIS-STATED IN THE ABOVE REPLIES, DISCIPLINARY ACTION SHALL BE TAKEN UNDER THE RULES. I ALSO UNDERSTAND THAT MY RECOMMENDATION FOR SELECTION COULD BE WITHDRAWN BY THE COMMISSION AT ANY STAGE IN MY SERVICE IF I AM FOUND INELIGIBLE FOR THIS POST.

40.

41.

Date:________________ ADDRESS

CANDIDATE'S SIGNATURE: _______________________

Complete Application Form should be sent to the Secretary Punjab Public Service Commission, 2-Agha Khan (Davis) Road, Lahore or PPSC Regional Office Rawalpindi or Multan. Applications are received by the Commission through postal mail/courier service and by hand on or before the closing date advertised.

R&CA/PPSC-2

-5-

Receipted Challan Form of Application/Exam Fee to be firmly pasted here.

____________________________________________________________________________________ POSTAL ADDRESS Please fill in the following Postal Address slips in capital letters. All communications from the Commission shall be sent to the candidate on this address. To ensure prompt delivery, address should be complete and legible. Any change of address should be communicated to the Commission immediately.

Name ___________________________________ Address___________________________________ _________________________________________ _________________________________________ ...................................................................................

JAHANZAIB IQBAL

JAHANZAIB IQBAL
Name____________________________________ Address___________________________________ _________________________________________

27-B, 1/2, GHAZI COLONY,

27-B, 1/2, GHAZI COLONY,

FAISAL STREET, NEAR FIRDOUS

FAISAL STREET, NEAR FIRDOUS

CINEMA, MAIN SANDA ROAD, LAHORE

CINEMA, MAIN SANDA ROAD, LAHORE _________________________________________ .................................................................................

Name____________________________________ Address___________________________________ _________________________________________

JAHANZAIB IQBAL
Name ___________________________________

JAHANZAIB IQBAL

27-B, 1/2, GHAZI COLONY,

Address___________________________________ _________________________________________ _________________________________________ .................................................................................... Name ___________________________________ Address___________________________________ _________________________________________ _________________________________________

27-B, 1/2, GHAZI COLONY,

FAISAL STREET, NEAR FIRDOUS

FAISAL STREET, NEAR FIRDOUS

CINEMA, MAIN SANDA ROAD, LAHORE

JAHANZAIB IQBAL

CINEMA, MAIN SANDA ROAD, LAHORE

_________________________________________ ................................................................................. Name ___________________________________ Address___________________________________ _________________________________________

JAHANZAIB IQBAL

27-B, 1/2, GHAZI COLONY,

27-B, 1/2, GHAZI COLONY,

FAISAL STREET, NEAR FIRDOUS

FAISAL STREET, NEAR FIRDOUS

CINEMA, MAIN SANDA ROAD, LAHORE

CINEMA, MAIN SANDA ROAD, LAHORE _________________________________________

PPSC 3 -6-

PUNJAB PUBLIC SERVICE COMMISSION

CERTIFICATE OF DEPARTMENTAL PERMISSION
TO BE SUBMITTED BY THE CANDIDATES WHO ARE IN GOVT./SEMI GOVT. SERVICE WITH THE APPLICATION FORM DULY COMPLETED FAILING WHICH THE APPLICATION SHALL BE LIABLE TO REJECTION

1.

The following particulars should be filled in by the candidate:a) b) c) d) e) f) g) Name Father's Name Substantive post Post held presently Office/Department Post applied for ________________________________________________ ________________________________________________ _______________________________________________ ________________________________________________ ________________________________________________ ________________________________________________

Commission's Advertisement No.__________________ Case No. ___________________

Dated ____________________ Signature of the Candidate ____________________________________________________________________________________ 2. (This portion should be filled in completely by the Department/Office.) Certified that the above candidate has been permitted to apply for the said post and that:a) He/She has been employed in this Department/Office as________________________ ________________________________________ Since _____________________________ . b) He/She holds this post in permanent / temporary, adhoc capacity or contract basis. ________ c) The candidate's domicile as accepted by this Department/Office and recorded in official record is _________________________ District. There is nothing on record of this Department which may render him ineligible for the post and that his/her record of service is satisfactory and no departmental proceedings are pending against the candidate.

d)

(Signature) Appointing Authority

Dated ________________ Note :

Stamp of the Appointing Authority or authorised Officer on his behalf.

The signing authority of the above permission should please ensure that all the blank spaces meant to be filled in by the Department are accurately filled in. If a departmental candidate/employee is selected/nominated by the Commission, the parent Department of that candidate shall be bound to relieve him/her to enable him/her to join the post for which he/she has been recommended by the Commission.

R&CA/PPSC-3/

-7EXPERIENCE CERTIFICATE

PPSC 4

JAHANZAIB IQBAL Certified that Mr./Miss/Mrs. _____________________________________________________ has

been/is employed in this Department/Organization as ___________________________________________ from _____________ to _____________ (dates) regular whole time/part time/ad hoc/current charge/acting charge/contract basis. The work of Mr./Miss/Mrs. ________________________________ while employed in this Department/Organization was/is satisfactory. The detail of his/her experience is as under: Designation Field of Specialisation *Nature of Experience From Duration To

*Please specify very clearly the nature of experience such as (a) Regular whole time (b) Part time (c) Ad hoc Current charge (e) Acting charge (f) Contract; etc.

(d)

Note: The experience gained as trainee, part time, honorary, apprentice and internee will not be considered/counted as experience. The duties/job specifications are/were as follows: (Give complete description including research if involved. May attach an additional sheet if required.)

________________________________________________________________
______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ File No: ______________________ Date: ______________________ Name & Designation of Issuing Authority ________

____________________________________________ Telephone No. ________________________________ Address ________________________________

Office Stamp/Seal

____________________________________________
_____________________________________________________________________________________________________________________________________________________________________________________________________________

Note-1

Benefit for experience will only be granted for the period which has been officially approved and recorded by the competent authority. For example, appointments on Ad hoc/Current charge/ Acting charge/Contract basis can only be made by the appointing authority and that too for specific period, specific purpose and under specific circumstances. PPSC will not accept any violation of these conditionalities. Experience certificate of regular appointment must be issued by the head of Institution/ Organisation/Department where the candidate is/has been employed on regular basis. Experience certificate on Ad hoc/Current charge/Acting charge and Contract basis must be issued by the Appointing Authority for the period a candidate has been employed as such. The certificates issued by the Principal or Medical Superintendent or Head of Department/Organization will not be accepted. In case of a candidate who has served or is serving in a private Firm/Organization, Experience Certificate must be issued under the signature of chief executive/head of private Firm/Organization. In case applicant is submitting an additional or separate Experience Certificate, then it should give complete information and nature of experience and must be issued by competent authority on the official letter pad with reference, file number and date of issue and duly stamped with full address, designation and telephone number. Vague, incomplete and inaccurate Experience Certificate will be rejected. In the case of Barrister or an Advocate of High Court and the Courts subordinate thereto, or a pleader, the exact period during which he/she practiced at the Bar should be mentioned. This Certificate should be signed by the President District Bar Association and duly counter-signed by the District and Sessions Judge concerned (rubber stamps of the both must also be affixed).

Note-2 Note-3

Note-4

Note-5

Note-6