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Staff Selection Commission: Combined Higher Secondary (10+2) Level Examination, 2021

Vikas Patel's application for the Combined Higher Secondary (10+2) Level Examination, 2021 is incomplete. He has provided some information such as his name, father's name, date of birth, gender, category, education details. However, he has not paid the application fee and the photograph was taken after the stipulated date of November 1, 2021. The application requires him to complete the payment and update his photograph to be considered complete.

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Vikas Patel
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18 views

Staff Selection Commission: Combined Higher Secondary (10+2) Level Examination, 2021

Vikas Patel's application for the Combined Higher Secondary (10+2) Level Examination, 2021 is incomplete. He has provided some information such as his name, father's name, date of birth, gender, category, education details. However, he has not paid the application fee and the photograph was taken after the stipulated date of November 1, 2021. The application requires him to complete the payment and update his photograph to be considered complete.

Uploaded by

Vikas Patel
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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STAFF SELECTION COMMISSION

BLOCK NO. 12, CGO-COMPLEX, LODHI ROAD, NEW DELHI


110003

COMBINED HIGHER SECONDARY (10+2) LEVEL


EXAMINATION, 2021

REGISTRATION NO: 30002349043

APPLICATION IS INCOMPLETE
1. NAME AS PER 2. NEW/ CHANGED 3. FATHER'S NAME 4. MOTHER'S NAME
MATRICULATION CERTIFICATE NAME
VIKAS PATEL - RAM ACHAL PATEL NAGINA PATEL
6. AGE AS ON
5. DATE OF BIRTH (DD/MM/YYYY) 7. GENDER 8. CATEGORY
01/01/2022
22/11/1998 23.1 MALE OBC
9. WHETHER PERSON WITH DISABILITY (PWD) ? 9.1 IF YES, TYPE OF DISABILITY (OH, HH,VH, OTHERS)

NO -

10. NATIONALITY 11. MARK OF VISIBLE IDENTIFICATION


CITIZEN OF INDIA CUT MARK ON MY LEFT EYEBROW
12. MATRICULATION (10th CLASS) EXAMINATION 13. MATRICULATION (10th 14. MATRICULATION (10th
BOARD CLASS) ROLL NO CLASS) YEAR OF PASSING
BOARD OF HIGH SCHOOL AND INTERMEDIATE
3428036 2012
EDUCATION UTTAR PRADESH
15. PREFERENCE OF EXAMINATION CENTERS
EXAMINATION CENTRE EXAMINATION CENTRE EXAMINATION CENTRE
(FIRST PREFERENCE ) (SECOND PREFERENCE ) (THIRD PREFERENCE)
VARANASI ( 3013 ) PRAYAGRAJ ( 3003 ) KANPUR ( 3009 )
17. WHETHER 12TH STANDARD PASS IN SCIENCE STREAM WITH
16. MEDIUM FOR TYPING TEST: MATHEMATICS AS A SUBJECT FROM A RECOGNIZED BOARD OR
EQUIVALENT(FOR C&AG AS DATA ENTRY OPERATOR):
ENGLISH YES
18.1. WHETHER YOU ARE AN EX- 18.2. DATE OF JOINING THE ARMED 18.3.DATE OF DISCHARGE/ LIKELY
SERVICEMAN (ESM) OR SERVING IN FORCES (DD/MM/YYYY) DATE OF DISCHARGE FROM ARMED
THE ARMED FORCES? FORCES (DD/MM/ YYYY)

NO - -
18.4. LENGTH OF SERVICE IN THE 18.5. HAVE YOU ALREADY JOINED A 18.6. DATE OF JOINING TO CIVIL
ARMED FORCES CIVIL POST BY AVAILING BENEFIT POST (DD/MM/YYYY)
OF RESERVATION FOR EX-
SERVICEMAN (ESM) ?
- - -
19.1. WHETHER SUFFERING FROM CEREBRAL-PALSY ?
-
19.2. DO YOU HAVE A PHYSICAL LIMITATION TO WRITE AND SCRIBE IS REQUIRED TO WRITE ON YOUR BEHALF
(CERTIFICATE TO THIS EFFECT FROM THE CHIEF MEDICAL OFFICER/ CIVIL SURGEON & MEDICAL
SUPERINTENDENT OF A GOVERNMENT HEALTH CARE INSTITUTION AS PER NOTICE OF THE EXAMINATION
WOULD BE REQUIRED AT THE TIME OF EXAMINATION) ?
-
19.3. WHETHER SCRIBE IS REQUIRED 19.4. WILL YOU MAKE YOUR OWN 19.5. IF SCRIBE IS TO BE ARRANGED
? ARRANGEMENT OF SCRIBE ? BY SSC, INDICATE MEDIUM
- - -

20.1. WHETHER SEEKING AGE RELAXATION ? 20.2. IF YES, AGE RELAXATION CODE

NO
-
21. HIGHEST EDUCATIONAL QUALIFICATION
B. TECH (14)
22. DETAILS OF QUALIFYING EDUCATIONAL QUALIFICATION
12TH STANDARD
STATE/ UT OF NAME OF BOARD/
STATUS PASSING YEAR ROLL NO PERCENTAGE CGPA
BOARD/ UNIVERSITY UNIVERSITY
BOARD OF HIGH
SCHOOL AND
PASSED 2014 UTTAR PRADESH INTERMEDIATE 2598783 67.8 -
EDUCATION
UTTAR PRADESH
23. 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
24. CORRESPONDENCE ADDRESS 25. PERMANENT ADDRESS
BUDHIYAPUR BIDAURI MARIYAHU JAUNPUR BUDHIYAPUR BIDAURI MARIYAHU JAUNPUR

DISTRICT: JAUNPUR DISTRICT:JAUNPUR


STATE: UTTAR PRADESH STATE: UTTAR PRADESH
PIN : 222136 PIN : 222136
MOBILE NO: 8787287192 EMAIL: patelvikas.srk786@gmail.com
27. WHETHER THE PHOTOGRAPH HAS BEEN TAKEN ON OR AFTER 01-NOV-2021?
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.
PRINT TAKEN ON: 14/02/2022 9:32:13 AM IP ADDRESS: 47.15.15.221

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