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    20 Jun 2023

    Uploaded by

    ashishsahoo1433

    Copyright:

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

    20 Jun 2023

    Uploaded by

    ashishsahoo1433
    2 views4 pages

    Original Title

    2609908004145_20-Jun-2023

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    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    2 views4 pages

    20 Jun 2023

    Uploaded by

    ashishsahoo1433

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 4

    Post Applied Details

    Candidate Photo
    Application Status Application Number Candidate's Name
    PaymentSuccess CRPFT230514637 ASHISH SAHOO
    Date of Birth Age as on 31.01.2023 Gender
    28/Mar/2005 18 Years 4 Months 5 D Male
    ays
    Father's Name
    PRASANTA SAHOO
    Mother's Name Email ID Mobile Number
    SUMITRA SAHOO ashishsahoo1433@gm 8658757415
    ail.com

    Post Details

    Post Name Post Code


    Constable-Tailor 05

    Test City Preferences

    Preferred Test State Preferred Test City 1 Preferred Test State


    1 Bhubaneswar 2
    Odisha Odisha
    Preferred Test City 2 Preferred Test State Preferred Test City 3
    Cuttack 3 Balasore
    Odisha

    Candidate Domicile and Category Details

    Nationality Reservation Category


    A citizen of India UR

    Ex Servicemen Details

    Are you an Ex Service


    men (ESM) or child of
    ESM?
    No

    Departmental Employee Details

    Are you an in-service


    Government Employ
    ee
    No
    Are you a Children an
    d dependent of victi
    ms killed in the 1984
    riots or communal ri
    ots of 2002 in Gujara
    t?
    No

    Correspondence Address

    Address Line 1 Address Line 2 Country


    PALLI BALIPUT India
    State City/District Pincode/Postal Code
    Odisha Puri 752045
    Is Permanent Addres
    s Same as Correspon
    dence address?
    Yes

    Permanent Address

    Address Line 1 Address Line 2 Country


    PALLI BALIPUT India
    State City/District Pincode/Postal Code
    Odisha Puri 752045

    Matriculation (10th) Details

    Name of the Board/C Institute Name Subject Combination


    ouncil Panchayat high school Odia
    Hse baliput Please select any of t
    he following
    Percentage
    Marks Obtained Maximum Marks Percentage of Marks
    260 600 (%)
    43.33
    Year of Completion
    2020

    lntermediate (12th) Details

    Name of the Board/C Institute Name Please select any of t


    ouncil Shastri smruti higher s he following
    Chse econdary school Percentage
    Marks Obtained Maximum Marks Percentage of Marks
    416 600 69.33
    Year of Passing
    2022

    Payment Details

    Amount Payment Mode Payment Status


    100 online Payment Success
    Payment Transaction
    No.
    CPACRYAVM1

    Documents Upload
    Signature
    View / Downloa
    Document
    d

    To view your copy of scanned 10th class certificate/Marksh


    Click here.
    eet:

    To view your copy of scanned 12th class certificate: Click here.

    Declaration

    I hereby certify that the information given by me in this Application Form is tru
    e to the best my knowledge. I certify that I fulfill the Govt Form eligibility criteria
    and undertake to produce original documents whenever necessary and I will n
    ot demand any reschedule of exam. I agree to abide by the declaration of the a
    uthorities regarding the eligibility of my application and understand that any m
    isrepresentation or omission of facts in my application may justify cancellation
    of my Govt Form application & scores. I understand that all disputes will be sub
    ject to the territorial jurisdiction of city of Indore only.

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