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    Application Form Draft Print For All

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    F F ID King
    Uttam Kumar has applied for the Constable (GD) in Central Armed Police Forces (CAPFs), SSF and Rifleman (GD) in Assam Rifles Examination 2024. His application is currently incomplete as he has not paid the application fee. The summary provides key details about Uttam Kumar including his name, father's name, date of birth, gender, category, nationality, education details, and contact information.

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    Application Form Draft Print For All

    Uploaded by

    F F ID King
    13 views3 pages
    Uttam Kumar has applied for the Constable (GD) in Central Armed Police Forces (CAPFs), SSF and Rifleman (GD) in Assam Rifles Examination 2024. His application is currently incomplete as he has not paid the application fee. The summary provides key details about Uttam Kumar including his name, father's name, date of birth, gender, category, nationality, education details, and contact information.

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    Uttam Kumar has applied for the Constable (GD) in Central Armed Police Forces (CAPFs), SSF and Rifleman (GD) in Assam Rifles Examination 2024. His application is currently incomplete as he has not paid the application fee. The summary provides key details about Uttam Kumar including his name, father's name, date of birth, gender, category, nationality, education details, and contact information.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    13 views3 pages

    Application Form Draft Print For All

    Uploaded by

    F F ID King
    Uttam Kumar has applied for the Constable (GD) in Central Armed Police Forces (CAPFs), SSF and Rifleman (GD) in Assam Rifles Examination 2024. His application is currently incomplete as he has not paid the application fee. The summary provides key details about Uttam Kumar including his name, father's name, date of birth, gender, category, nationality, education details, and contact information.

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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), SSF AND RIFLEMAN (GD) IN ASSAM RIFLES
    EXAMINATION 2024

    REGISTRATION NO: 30007147312

    APPLICATION IS INCOMPLETE

    1. NAME AS PER MATRICULATION 2. NEW/CHANGED


    3. FATHER'S NAME 4. MOTHER'S NAME
    CERTIFICATE NAME
    UTTAM KUMAR - RAGHUNATH SANGITA DEVI
    5. DATE OF BIRTH (DD/MM/YYYY) 6. AGE AS ON 01/01/2024 7. GENDER 8. CATEGORY
    08/09/2001 22.3 MALE OBC
    9. NATIONALITY 10. MARK OF VISIBLE IDENTIFICATION
    CITIZEN OF INDIA FACE TIL
    12. MATRICULATION (10th 13. MATRICULATION (10th
    11. MATRICULATION (10th CLASS) EXAMINATION BOARD
    CLASS) ROLL NO CLASS) YEAR OF PASSING
    UTTAR PRADESH BOARD OF SECONDARY SANSKRIT
    2143211 2018
    EDUCATION
    14.1. WHETHER YOU ARE AN EX-SERVICEMEN (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 THE ARMED FORCES
    (DD/MM/YYYY)
    - -
    14.5. HAVE YOU ALREADY JOINED A CIVIL POST BY
    AVAILING BENEFIT OF RESERVATION FOR EX-SERVICEMEN 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
    NO -
    16.1. ARE YOU A NATIONAL CADET CORPS (NCC)
    16.2. TYPE OF THE NCC CERTIFICATE
    CERTIFICATE HOLDER
    NO -
    17. PREFERENCE OF EXAMINATION CENTRES

    EXAMINATION CENTER EXAMINATION CENTER EXAMINATION CENTER


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

    LUCKNOW ( 3010 ) KANPUR ( 3009 ) PRAYAGRAJ ( 3003 )

    18. MEDIUM FOR COMPUTER BASED 19. STATE/ UT OF DOMICILE 20. DISTRICT OF DOMICILE
    EXAMINATION (CBE)
    HINDI UTTAR PRADESH BARABANKI
    21.1. HAVE YOU MIGRATED FROM THE STATE/ UT OF 21.2. WHETHER YOU WOULD LIKE TO AVAIL THE BENEFIT OF
    YOUR ORIGIN TO ANOTHER STATE/ UT RESERVATION FROM THE STATE/ UT OF YOUR ORIGIN
    NO -
    21.3. STATE/ UT OF ORIGIN 21.4. DISTRICT OF ORIGIN
    - -
    22. CANDIDATE BELONGS TO MILITANCY/ NAXAL
    23. CANDIDATE BELONGS TO BORDER DISTRICT
    AFFECTED DISTRICT
    NO NO
    24. PREFERENCE OF POST FOR CAPF(S)/ ORGANIZATION(S)
    A,B,C,D,E,F,H,
    25. HIGHEST EDUCATIONAL QUALIFICATION
    INTERMEDIATE/ HIGHER SECONDARY/ 10+2 (2)
    26. DETAILS OF QUALIFYING EDUCATION
    10TH STANDARD
    STATUS PASSING STATE/ UT OF BOARD/ NAME OF BOARD/ ROLL NO PERCENTAGE CGPA
    YEAR UNIVERSITY UNIVERSITY
    PASSED 2018 UTTAR PRADESH UTTAR PRADESH 2143211 59.33 -
    BOARD OF
    SECONDARY
    SANSKRIT
    EDUCATION
    27. 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
    28. CORRESPONDENCE ADDRESS 29. PERMANENT ADDRESS
    VILL MAIDASPUR MAJRE BRAHMANI TOLA POST VILL MAIDASPUR MAJRE BRAHMANI TOLA POST
    KANDAURALA TEH FATEHPUR BARABANKI225305 KANDAURALA TEH FATEHPUR BARABANKI225305
    DISTRICT: BARABANKI DISTRICT: BARABANKI
    STATE: UTTAR PRADESH STATE: UTTAR PRADESH
    PIN: 225305 PIN: 225305
    MOBILE NO. : 9555658279 EMAIL ID: [email protected]
    30. WHETHER PHOTOGRAPH HAS BEEN TAKEN ON OR AFTER 24-AUGUST-2023?
    YES
    FEE PAYMENT AMOUNT TRANSACTION NO TRANSACTION DATE

    NOT EXEMPTED 100 - -


    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.

    3. I DECLARE THAT THE PHOTOGRAPH UPLOADED IN THE APPLICATION FORM HAS BEEN TAKEN ON OR AFTER
    THE STIPULATED DATED.

    4. I AGREE TO AUTHORIZE SSC TO USE MY AADHAR DATA FOR VERIFICATION PURPOSE.


    PRINT TAKEN ON: 10/12/2023 8:25:28 PM IP ADDRESS: 106.221.50.35

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