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    Updated Application Form 2301113163

    Uploaded by

    Shivam Kumar

    Copyright:

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

    Updated Application Form 2301113163

    Uploaded by

    Shivam Kumar
    34 views2 pages

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
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    34 views2 pages

    Updated Application Form 2301113163

    Uploaded by

    Shivam Kumar

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    BIHAR STAFF SELECTION COMMISSION


    P.O.-VETERINARY COLLEGE, PATNA - 800014
    ADVERTISEMENT NO. 02/2023
    SECOND INTER LEVEL COMBINED COMPETITIVE EXAM-2023
    PERSONAL DETAILS
    REGISTRATION NO.: 2301113163
    FORM NO. : 3301113163
    NAME OF APPLICANT : SHIVAM KUMAR
    FATHER'S NAME : SANJAY SAW
    MOTHER'S NAME : RENU DEVI
    GENDER : MALE
    MOBILE NO. : 8340636241
    EMAIL ID : SHIVAMKRNRANCHI123@GMAIL.COM
    DATE OF BIRTH : 15-10-2004 LIVE PHOTO

    AGE AS ON 01-08-2023 : 18 YEARS, 9 MONTHS, 17 DAYS


    NATIONALITY : INDIAN
    CATEGORY : EBC
    DO YOU BELONG TO NON-CREAMY LAYER ? : YES
    (EBC/BC-NCLC CERTIFICATE NUMBER) / (SC/ST-CASTE CERTIFICATE
    NCLCO/2023/921499
    NUMBER) / (EWS-CERTIFICATE NUMBER) :
    ISSUE DATE OF CERTIFICATE : 11-10-2023
    CERTIFICATE ISSUING AUTHORITY : RO
    DOMICILE OF BIHAR STATE : YES
    PHOTO
    ISSUE DATE OF DOMICILE CERTIFICATE: 23-08-2022
    ISSUE NUMBER OF DOMICILE CERTIFICATE : BRCCO/2022/9841791
    DOMICILE CERTIFICATE ISSUING OTHER COMPETENT AUTHORITY : RO
    ARE YOU PERSON WITH DISABILITY? : NO
    SIGNATURE IN ENGLISH

    SIGNATURE IN HINDI

    DO YOU HAVE AADHAR CARD? : YES (AADHAR CARD NUMBER: 950719841600)


    ID PROOF : VOTER ID CARD ID PROOF NO : 950719841600
    BIHAR GOVERNMENT EMPLOYEE WHO HAS RENDERED NOT LESS THAN 3 YEARS REGULAR AND
    NO
    CONTINUOUS SERVICE? :
    WHICH ATTEMPT IS OF INTER LEVEL EXAMINATION? : 01
    IDENTIFICATION MARK OF THE CANDIDATE : MOLES IN NECK
    ARE YOU AN EX-SERVICEMAN? : NO
    WARD OF FREEDOM FIGHTER? : NO
    HAVE YOU EVER BEEN DEBARRED FROM ANY COMPETITIVE EXAMINATION (UPSC/BOARD/STATE
    NO
    COMMISSION/ANY OTHER)? :
    WORKED/WORKING AS CONTRACTUAL EMPLOYEE IN BIHAR GOVERNMENT: NO
    ADDRESS DETAILS

    CORRESPONDENCE ADDRESS PERMANENT ADDRESS


    ADDRESS: MAHAVIR NAGAR KOKAR RANCHI ADDRESS: NEERPUR

    VILLAGE/MOHALLA: MAHAVIR NAGAR VILLAGE/MOHALLA: NEERPUR


    POST OFFICE: KOKAR POST OFFICE: BALGUDAR
    POLICE STATION: SADAR POLICE STATION: LAKHISARAI

    DISTRICT: RANCHI DISTRICT: LAKHISARAI


    STATE: JHARKHAND STATE: BIHAR
    PIN CODE: 834001 PIN CODE: 811311
    EDUCATIONAL QUALIFICATIONS
    EDUCATION SUBJECT BOARD / TOTAL MARKS MARKS PERCENTAGE PASSINGDATE CERTIFICATE
    UNIVERSITY / OBTAINED NUMBER
    INSTITUTE
    JHARKHAND
    ENG HNA MTH
    10TH / EQUIVALENT ACADEMIC 500 411 82.20 08-07-2020 006274
    SCI SOC SNK
    COUNCIL RANCHI
    12TH / EQUIVALENT JHARKHAND
    ENA PHY CHE
    12TH/INTERMEDIATE ACADEMIC 500 376 75.20 21-06-2022 001570
    MAT CMS
    (SCIENCE) COUNCIL RANCHI
    TECHNICAL SKILL
    SKILL NAME OF INSTITUTE PASSING DATE CERTIFICATE NUMBER
    HINDI TYPING ABHIYAN TYPING INSTITUTE 15-02-2023 1094
    ENGLISH TYPING ABHIYAN TYPING INSTITUTE 15-02-2023 1094
    HAVE YOU DONE ANY COMPUTER COURSE? NO
    PAYMENT DETAILS:
    PAYMENT BANK : ICICI
    TRANSACTION ID : 301023860394
    TRANSACTION DATE : 30-10-2023 02:52:13
    REGISTRATION FEE (RS.) : 540.0
    VIEW UPLOADED 10TH MARKS SHEET PDF: CLICK HERE TO VIEW DOCUMENT
    VIEW UPLOADED 10TH PASS CERTIFICATE PDF: CLICK HERE TO VIEW DOCUMENT
    VIEW UPLOADED 12TH MARKS SHEET PDF: CLICK HERE TO VIEW DOCUMENT
    VIEW UPLOADED 12TH PASS CERTIFICATE PDF: CLICK HERE TO VIEW DOCUMENT
    VIEW UPLOADED VALID PHOTO ID PROOF PDF: CLICK HERE TO VIEW DOCUMENT
    VIEW UPLOADED BIHAR DOMICILE CERTIFICATE PDF: CLICK HERE TO VIEW DOCUMENT
    VIEW UPLOADED NON CREAMY LAYER CERTIFICATE PDF: CLICK HERE TO VIEW DOCUMENT
    VIEW UPLOADED HINDI TYPING CERTIFICATE PDF: CLICK HERE TO VIEW DOCUMENT
    VIEW UPLOADED ENGLISH TYPING CERTIFICATE PDF: CLICK HERE TO VIEW DOCUMENT
    DECLARATION DETAILS:
    I HEREBY DECLARE THAT THE FINAL INFORMATION FILLED UP ABOVE BY ME ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I ALSO
    DECLARE THAT I HAVE FILLED UP ONLY ONE APPLICATION FORM. I ALSO UNDERTAKE THAT IF ANY INFORMATION IS FOUND OTHERWISE, I SHALL BE
    LIABLE FOR ANY LEGAL ACTION AND CANCELLATION OF MY CANDIDATURE BY THE COMMISSION.
    DATE : 05-02-2024 12:13:13
    NOTE: PLEASE KEEP YOUR REGISTRATION NO.,PASSWORD,MOBILE NO AND EMAIL-ID CAREFULLY FOR FURTHER REFERENCE.

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