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    Public Service Commission U.P., Allahabad लोक से वा आयोग उ0 0, इलाहाबाद

    Uploaded by

    Joshua Walsh
    This document is an application form submitted by Rupak Kumar for the position of RAJASVA NIRIKSHAK EXAMINATION -2014 under the Public Service Commission U.P., Allahabad. The form provides details of the applicant such as application ID, name, date of birth, contact information, educational qualifications, and address. It also includes bank transaction details for the application fee and declarations signed by the applicant accepting the terms and conditions of the advertisement and confirming the truthfulness of the information provided in the application.

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

    Public Service Commission U.P., Allahabad लोक से वा आयोग उ0 0, इलाहाबाद

    Uploaded by

    Joshua Walsh
    23 views2 pages
    This document is an application form submitted by Rupak Kumar for the position of RAJASVA NIRIKSHAK EXAMINATION -2014 under the Public Service Commission U.P., Allahabad. The form provides details of the applicant such as application ID, name, date of birth, contact information, educational qualifications, and address. It also includes bank transaction details for the application fee and declarations signed by the applicant accepting the terms and conditions of the advertisement and confirming the truthfulness of the information provided in the application.

    Original Title

    RUPAK

    Copyright

    © © All Rights Reserved

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    This document is an application form submitted by Rupak Kumar for the position of RAJASVA NIRIKSHAK EXAMINATION -2014 under the Public Service Commission U.P., Allahabad. The form provides details of the applicant such as application ID, name, date of birth, contact information, educational qualifications, and address. It also includes bank transaction details for the application fee and declarations signed by the applicant accepting the terms and conditions of the advertisement and confirming the truthfulness of the information provided in the application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    23 views2 pages

    Public Service Commission U.P., Allahabad लोक से वा आयोग उ0 0, इलाहाबाद

    Uploaded by

    Joshua Walsh
    This document is an application form submitted by Rupak Kumar for the position of RAJASVA NIRIKSHAK EXAMINATION -2014 under the Public Service Commission U.P., Allahabad. The form provides details of the applicant such as application ID, name, date of birth, contact information, educational qualifications, and address. It also includes bank transaction details for the application fee and declarations signed by the applicant accepting the terms and conditions of the advertisement and confirming the truthfulness of the information provided in the application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    You are on page 1of 2

    10/3/2014

    Public Service Commission U.P., Allahabad



    0 0,
    I Declare that i have Read the detailed User Manul & Notification.

    Notification Details ( Examination )

    1. Advertisement Number :
    2. Applied For :
    3. Type of Recruitment :

    A-3/E-1/2014
    RAJASVA VIBHAG U.P. - RAJASVA NIRIKSHAK EXAMINATION -2014,
    GENERAL RECTT.
    Candidate Personnel Details

    4. Application ID :
    5. Candidate Registration No. :
    6. Candidate Name :
    7. Father's/Husband's Name :
    8. Gender - Date of Birth :
    9. Domicile of UP / Category :
    10. Are you Married?
    11. Contact No./ Email-ID :

    205999707001534
    70713294917
    RUPAK KUMAR
    KRISHNAKANT SHARMA
    Male - 10/01/1993
    No / General
    No
    9934608106 / singhccafe@gmail.com
    Bank Transaction Details

    12. Bank Name - Payment Mode :


    13. Fees, Transaction ID - Date:

    State Bank Of India - IC


    Rs. 115.00 , 6956177 - 28/09/2014
    Other Details of Candidate

    14. Are you Dependent of UP Freedom Fighter?


    15.a. Are you UP Ex. Army?

    No
    No

    15.a.1 Service Duration (Day-Month-Year) : 0


    - 0
    15.a.2 Retirement Date(Date/Month/Year) : _ _ _
    No
    15.b Are you ECO/SSCO/CO of Army ?
    15.b.1 Have you complete 5 year service ? No
    15.b.2 Have your services been extended for
    rehabilitation and no disciplinary action is pending No
    against you ?
    No
    15.c. Have you ever been Debarred from U.P. Public Service Commission? :

    15.c.1 Completion Date of Debarment (DD/MM/YYYY)


    ../../....
    :
    No
    16. Are You Handicap of UP?
    16.1 Are you Blind Or Have Vision problem? : No
    16.2 Are you Deaf or Have hearing problem? : No
    16.3 Have you any physical Problem? : No

    17. Are You Skilled Player Of UP? :

    No

    17.1. Are You Govt./Ex-Govt. State Employee of Uttar Pradesh ?

    No

    18. High School & Intermediate Board,Year of passing & Roll Number Details
    Sr.No Examination
    Passed
    1.
    High School

    Board Name

    Year of Passing

    Roll Number

    BIHAR SCHOOL EXAMINATION BOARD

    2007

    0111

    2.

    BIHAR INTERMEDIATE EDUCATION


    COUNCIL

    2009

    10322

    Intermediate

    19.1 Essential Qualification Details


    Sr
    Qualification
    No.

    Acquired
    1/2

    10/3/2014

    Yes

    19.2 Preferential Qualification Details


    Sr No.
    1
    2

    Qualification

    Acquired

    No
    No

    Candidate's Address, Photo Signature Details

    20. Address :

    VILLAGE AND POST BELSAR POLICE STATION MEHANDIA DISST


    ARWAL PIN 824127 BIHAR

    20.1 House no./Village :

    BELSAR

    20.2 Street No./PO :

    BELSAR

    20.3 City Name :

    ARWAL

    20.4 State / District Name :

    Bihar / ARWAL

    20.5 PIN :

    824127

    21.Photo&Signature

    I accept the following declaration : Yes


    1. I here by declare that I have read all term & condition accroding advertisement and I accept it.
    2. I here by declare that all the entires/statements made in this application are true, complete and correct to the best of my knowledge and belief.
    3. In the event of any information being found false or incorrect or ineligibility being detect before or after Selection, the commission can take action
    against me as per rule incase it is detected that I have misled UPPSC on any issue then I will solely responsible for all penel consequences thereof.

    Current status of application


    Your application is under processing.
    Application Form Submission Date :

    03/10/2014 , Time : 22:57:09


    Application Form printing Date & Time : [ 03/10/2014 ,22:58:35 ]

    2/2

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