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57 views

Print Application Form

Uploaded by

AVNEESH SINGH
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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 हद

उ र दे श अधीन सेवा चयन आयोग


Uttar Pradesh
Subordinate Services Selection
Commission
MENU

Home / Print Application Form

Print Application Form

Application  Photo & Signature  Other Details 


Fee Deposition & Final Submission  Print Application Form 

Uttar Pradesh Subordinate Services Selection Commission,Lucknow


उ र दे श अधीन सेवा चयन आयोग, लखनऊ
Detailed Application Form ( व तृत आवेदन प )
Under: PRELIMINARY ELIGIBILITY TEST (PET) - 2021

Notification Details :

Advt Number :
01-EXAM/2022

Applied For :
LEKHPAL,

Type of Recruitment :
General
Personal Details

Registration Number.

53905592787
Advertisement / Notification No

01-EXAM/2022
Candidate Name

AVNEESH SINGH

Father's / Husband's Name

RAMESH SINGH

Mother's Name

GEETA SINGH

Date Of Birth

17/07/1996

Domicile Of UP

Yes

Home State

UTTAR PRADESH

Home District

AMBEDKAR NAGAR

Gender

Male

Category

General

Economically Weaker Sections(EWS)

Yes

Are you Married ?

No

Mobile Number

74* * * *9751

Email ID

* * *[email protected]

Candidate's EWS Details

EWS Possess :
No
EWS Certificate Date :
Not Applicable
Not Applicable
EWS Certificate No. :
Not Applicable
EWS Issuing Authority :
Not Applicable

Other Details

Are You Dependent of UP Freedom Fighter?

No

Are You UP Ex. Army?

No

Are You ECO/SSCO/CO Of Army ?

No

Are You Handicap of UP?

No

Are You Skilled Player Of UP?

No

Level of Player

N/A

Are You Govt/Ex-Govt Employee of UP?

No

Service Duration(Day-Month-Year)

0-0-0

Are you Blind Or Have Vision problem?

No

Are you Deaf or Have hearing problem?

No

Have you any physical Problem?

No

Have you psychological/ neurological problem? :

No

Have you Multiple Disabilities? :

No

Academic Details

Examination Board Name Year of Roll Is Obtained Total Percentage


Passed Passing Number Grade Marks Marks
System
High School UTTAR PRADESH 2011 2273680 No 349 600 58.17
BOARD OF HIGH
SCHOOL AND
INTERMEDIATE
INTERMEDIATE
EDUCATION

Intermediate UTTAR PRADESH 2013 2070033 No 397 500 79.40


BOARD OF HIGH
SCHOOL AND
INTERMEDIATE
EDUCATION

Certificates/Documents Details

S.No. Document Name Issuing Issuing Certificate


Authority Date No

1 Age Proof (Certificate of UP BOARD 10/06/2011 64032533


Matriculation)

2 Residence Proof (Domicile SDM 30/11/2018 485182033248


Certificate)

Bank Transaction Details

Bank Name - Payment Mode :

State Bank Of India - INB

Fees, Transaction ID - Date:

Rs. 25.00 , CPABIDTVF4 -12/01/2022

Details of essential qualifications for the post (LEKHPAL, ) ↓

Sr Qualification Acquired Name of Board/ Year Of Certificate/Roll Marks


No. Institute/University Passing Number Detail
Issue Date

1 A Candidate Yes 2013 2070033 Is Grade:


must have BOARD OF HIGH No
passed SCHOOL AND 05/06/2013 Obt Marks:
Intermediate INTERMEDIATE 397.00
Examination EDUCATION UP Tot Marks:
from Board of 500.00
High School Per: 79.40
and
Intermediate
U.P. or any
Examination
recognized by
the
Government
as equivalent
there to.

Preferential Qualification Details

S No. Qualification Acquired

1 1-Served in the Territorial Army for a minimum period of two years or No


2 2- Has been obtained National Cadet Corps B certificate No

↓ Address Details ↓

Name , C/O:

House no./Village :

Street No./PO :

Locality/Kasba/City :

State / District Name :

Pin :

Permanent Address

RAMESH SINGH

SUTHARPARA

SUTHARPARA

ALAPUR

UTTAR PRADESH / AMBEDKAR NAGAR

224181

Correspondence/Mailing Address

RAMESH SINGH

SUTHARPARA

SUTHARPARA

ALAPUR

UTTAR PRADESH / AMBEDKAR NAGAR

224181

Declaration

✔ म एत वारा घोषणा करता/करती ं क मने व ापन भलीभां त पढ़ लया है और म इसके सभी


नयम और शत को वीकार करता/करती ं ।
I hereby declare that I have read the advertisement and I accept all the terms &
conditions of the same.
✔ म एत वारा घोषणा करता/करती ं क इस आवेदन म क गई सभी व यां/ ववरण मेरी
जानकारी और व ास के अनुसार स य, पूण और सही ह।
I hereby declare that all the entries/statements made in this application are true,
complete and correct to the best of my knowledge and belief.
✔ म एत वारा घोषणा करता/करती ं क आवेदन क अं तम त थ तक मु य परी ा के लए नधा रत
सभी शै णक/अ य पा ता मानदं ड को पूरा करता/करती ं । मै अवगत ं क मेरे ारा तुत क गई
कोई भी जानकारी गलत/अस य पाये जाने क दशा म मेरा अ यथन आयोग ारा नर त कर दया
जाएगा ।
I hereby declare that I fulfil all the educational/ other eligibility criteria prescribed for
I hereby declare that I fulfil all the educational/ other eligibility criteria prescribed for
the Main Examination in respect of the post being applied for, as on the last date of
application. I am aware that in case any of the information submitted by me is found
to be incorrect or false, then my candidature shall be liable to be cancelled by the
Commission.

Please login with your PET registration number to avail the Dashboard facility for all
activities of recruitment process.

Current status of application


Your application is under processing.
App. form submission date : DATE :12/01/2022 ,TIME :10:36:12
App. form printing Date & Time : [ 13/01/2022 ,12:02:34 PM ]

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