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UNION PUBLIC SERVICE COMMISSION

DETAILED APPLICATION FORM
ENGINEERING SERVICES (MAIN) EXAMINATION, 2025

OTR ID. : 124000003750810

RID: 12500120451
Branch : CIVIL ENGINEERING
E-mail : MEENAHEMANT438@GMAIL.COM
Alt E-mail : minajibamanwas5343@gmail.com
Mobile : 9413186922
Alt Mob No. : 9024714564

1. Name (As per Matriculation) | HEMANT KUMAR MINA

Have you ever changed your name?: | NO

2. (a) Address for correspondence to which | LADA KA JHOPDA BAMANWAS PATTI KALAN
TEHSIL - BAMANWAS
communication is to be sent |
Post Office: | BAMANWAS POST OFFICE
City: | BAMANWAS
District: | SAWAI MADHOPUR
State : | RAJASTHAN
Pin Code : | 322211
(b) Telephone No. with STD Code | -
(c) Mobile No. | 9413186922
(d) Fax No. |
(e) E-mail address | MEENAHEMANT438@GMAIL.COM
(f) Permanent Postal Address | LADA KA JHOPDA BAMANWAS PATTI KALAN
TEHSIL - BAMANWAS
|
Post Office: | BAMANWAS POST OFFICE
City: | BAMANWAS
District: | SAWAI MADHOPUR
State : | RAJASTHAN
Pin Code : | 322211

3. Nationality | INDIAN

4. Gender | MALE

5. Marital Status | UNMARRIED

6. Citizenship | A CITIZEN OF INDIA(1)

7. State of Domicile | RAJASTHAN

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8. (a) Date of Birth | 2003-10-29
(b) Age Relaxation claimed | NO

9.(a) Mother tongue : | HINDI

(b) Identification Mark : | CUT ON LEFT HAND

10.Place of Birth :
If born in India: | YES
Post Office | BAMANWAS
City/Town/Village | BAMANWAS PATTI KALAN
District | SAWAI MADHOPUR
State | RAJASTHAN
Pincode | 322211

11. (a) Community | ST (2)

Note 1: In case you are a SC or ST category candidate, upload a scanned copy of certificate in prescribed format in
support of your claim. The certificate must be issued latest by the date of closure of online
application form for Engineering Service (Preliminary) Examination, 2025 (i.e. 08.10.2024).
Note 2: In case you are EWS Category candidate, upload a scanned copy of ‘Income and Asset Certificate’ in
prescribed format based on the income for Financial Year 2023-24 (i.e. for the period from 1st April,
2023 to 31st March, 2024) in support of your claim. Certificate based on the income of any other Financial
Year shall not be treated as valid. The Certificate must be issued on/after 01.04.2024 (after the
completion of FY 2023-24) but not later than the closing date of online application for
Engineering Service (Preliminary) Examination-2025 i.e. 08.10.2024. Such candidates must
meet the Income and Asset criteria issued by the Central Government.
Note 3: In case you are an OBC Category candidate, upload a scanned copy of OBC (Non-Creamy Layer) certificate
in prescribed format based on the income for the Financial Years (FYs) 2023-24, 2022-23 and 2021-22.
The Certificate must be issued on/after 01.04.2024 (after the completion of FY 2023-24) but not later
than the closing date of online application for Engineering Service (Preliminary) Examination-2025 i.e.
08.10.2024
(b) Certificate No. | 24611826986
(c) Date of issue | 2024-07-01
(d) Designation of issuing authority | SUB-DIVISIONAL OFFICER OR THE AREA WHERE
THE CANDIDATE AND/OR HIS FAMILY
NORMALLY RESIDES
(e) Full address of issuing authority | OFFICE OF THE SUB DIVISIONAL
OFFICER,BAMANWAS, GANGAPUR CITY
GANGAPUR CITY,RAJASTHAN

(f) Name of the Caste as mentioned in | MINA (MINA)

the Community Certificate and | RAJASTHAN
Name of the issuing State
[For SC/ST/OBC Candidates]
(g) State your religion if you belong to SC
/State your creamy layer if you
belong to OBC |
(h) State if you belong to any of the
minority Communities notified by the
Government(Muslim/Christians/Sikhs
/Buddhists/Zoroastrians[Parsi]/Jains) | NO

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(i) If yes, mention the name of the
Minority community |

12. What Languages(including Indian Languages) can you read/write or speak ? Give particulars and state the
examination(s) passed, if any, for each :-

Read Only Speak Only Read & Speak Read, Write & Examination(s)
Speak passed
HINDI HINDI HINDI HINDI 10TH

13. (a) Do you possess the prescribed Educational

Qualification (Vide Rule-6 of the Rules of the examination).
Please upload a scanned copy of the Certificate
if answer is "YES" | YES
(b) Certificate No. | 20ESKCE041
(c) Date of issue | 2024-06-06
(d) Designation of issuing authority | CONTROLLER OF EXAMINATION
(e) Full address of issuing authority | RAJASTHAN TECHNICAL UNIVERSITY KOTA
RAJASTHAN

Note : If you do not possess the prescribed educational qualification as mentioned in Rule – 6 of
the Examination Rules, your candidature is liable to be cancelled. The proof of passing the
requisite examination should be dated earlier than the due date (closing date) of Detailed
Application Form of the Engineering Services Examination 2025.

14. Educational Qualifications : Commencing with Matriculation or equivalent examination till Graduation:-
Examination Class/ Percentage CGPA Year of Subject(s) Name of Name of
Passed Division of Score Out of School/College Board/University
/Grade Marks(%) Passing /Institution
10th or Equivalent 1ST 87.33 2018 SCIENCE SANKRIT APEL ACADEMY SR RAJASTHAN
MATHEMATICS SEC SCHOOL BOARD OF
SOCIAL SCIENCE LALSOT DAUSA SECONDARY
HINDI ENGLISH RAJASTHAN EDUCATION
12th or Equivalent 1ST 76.20 2020 SCIENCE DSS ACADEMY SR RAJASTHAN
MATHEMATICS SEC SCHOOL BOARD OF
GANGAPUR CITY SECONDARY
RAJASTHAN EDUCATION
Stream at Graduation Level :-- ENGINEERING
B. TECH. 1ST 8.46 10 2024 CIVIL SWAMI OTHER
ENGINEERING KESHVANAND UNIVERSITY
INSTITUTE OF
TECHNOLOGY
MANAGEMENT
AND GRAMOTHAN
JAIPUR

15.(a) Have you ever been employed? : | NO

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16. (a) Name of Father | RAJENDRA KUMAR MEENA
(b) Name of Mother | SUNITA MEENA
(c) Nationality of Father | INDIAN
(d) Nationality of Mother | INDIAN
(e) Father's present postal Address | LADA KA JHOPDA BAMANWAS PATTI KALAN
TEHSIL - BAMANWAS
(If deceased give last address) |
Post Office: | BAMANWAS POST OFFICE
City: | BAMANWAS
District: | SAWAI MADHOPUR
State : | RAJASTHAN
Pin Code : | 322211
(f) Mother's present postal Address | LADA KA JHOPDA BAMANWAS PATTI KALAN
TEHSIL - BAMANWAS
(If deceased give last address) |
Post Office: | BAMANWAS POST OFFICE
City: | BAMANWAS
District: | SAWAI MADHOPUR
State : | RAJASTHAN
Pin Code : | 322211
(g) Father's Profession: | TEACHING
(h) Mother's Profession: | OTHERS [PLEASE SPECIFY]
Others: | HOUSEWIFE
(i) If your Father is in service,the post held
by him (if retired, indicate the post held
by him at the time of his retirement) | LECTURER
(j) If your Mother is in service,the post held
by her (if retired, indicate the post held
by her at the time of her retirement) | NOT APPLICABLE
(k) Annual income of your Father | RS.1000000
(l) Annual income of your Mother | RS.0
(m) State to which your Father originally | RAJASTHAN
belongs
(n) District to which your Father originally | SAWAI MADHOPUR
belongs
(o) State to which your Mother originally | RAJASTHAN
belongs
(p) District to which your Mother originally| SAWAI MADHOPUR
belongs

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17. Have you claimed age relaxation
and/or fee exemption as Person
with Benchmark Disability Candidate?
(If Yes,upload a scanned copy of
prescribed certificate in support
of your claim). | NO

18. Your order of preference against the Services/Posts given below,for which you would like to be
considered for appointment. (Please write your first preference as 1 and second preference as 2 and so on ) .
In case no preference is exercised,then '0' shall be filled against each service(s).

Category : | CIVIL ENGINEERING

Name of Services/Posts Order of Preference

CENTRAL ENGINEERING SERVICE (CIVIL) 1
CENTRAL ENGINEERING SERVICE (ROADS), GROUP-A (CIVIL ENGINEERING POSTS) 4
SURVEY OF INDIA GROUP 'A' SERVICE. 8
*AEE (CIVIL) IN BORDER ROADS ENGINEERING SERVICE. 7
INDIAN DEFENCE SERVICE OF ENGINEERS. 6
AEE (QS&C) IN MES SURVEYOR CADRE. 9
INDIAN SKILL DEVELOPMENT SERVICE. 10
CENTRAL WATER ENGINEERING (GROUP ‘A’) SERVICE. 3
INDIAN RAILWAY MANAGEMENT SERVICE(CIVIL) 2
INDIAN RAILWAY MANAGEMENT SERVICE (STORES)- CIVIL ENGG. POSTS 5

Note 1 : No request for addition/alteration in the preferences indicated by a candidate in this application
form will be entertained by the Commission.

Note 2 : Candidate is advised to indicate all the Services/Posts (as given in para 2 of Notice) for which he/she is
eligible in terms of the Rules in the order of preferences in Col. 18 of his/her application form.In case he/she does
not give any preference for any Services/Posts or does not include certain Services/Posts in Col. 18 of the application
form, it will be assumed that he/she has no specific preference for these Services/Posts and in that event he/she shall
be allocated to any of the remaining Services/Posts in the order as appearing in the notification and in which there
are vacancies after allocation of candidates according to the Services/Posts of their preference.

19. Whether you have ever applied for/been

selected for U.P.S.C. Examination
/Recruitments earlier?(Excluding
current examination) | NO

20.(a) Whether any action was/has been initiated

against you as per Rule 11 of
Engineering Service Examination-2025
by Commission/Hospital/Govt.? | NO

(b) Have you ever been debarred by UPSC/

any Public Service Commission
or SSC from any of their
Examinations/Selections? | NO

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21. Please give Particulars at the University/State/National Level in respect of :-

(a) Prizes, medals, scholarships,etc |

(b) Sports / N.C.C. etc. |
(c) Position(s) of distinction /leadership |
held in School/College
(d) Other extra curricular activities and |
interests (Such as hobbies etc.)

22.1.(a) Whether you are a PwBD/PwD | NO

candidate

22.2(a) Are you a PwBD/PWD candidate [as | NO

per column 22.1.(a)] having physical
limitation to write? (If Yes, upload
scanned copy of the requisite certificate
as per Appendix-IV (for
PwBD)/Appendix-VI (for PwD) of the
Notice of Engineering Service
Examination, 2025 dated 08.10.2024)

(b) Whether you want to avail |

Compensatory Time

(c) Whether you require Scribe |

22.3 (a) Have you ever been recommended as a | NO
PwBD candidate in the examinations
conducted by the UPSC in the past?

(b). If yes, mention name and year of the examination(s) with Roll No.
Name of the Examination Year of the Roll No.
Examination

(c) Whether such recommendation was on | NO

the basis of the Certificate of Disability
NOW UPLOADED by you for the
Engineering Services Examination,
2025?
(d) After any such recommendation by the | NO
UPSC were you ever found UNFIT/
NOT RECOMMENDED by the Central
Standing Medical Board or any other
Medical Board constituted by the
Government with regard to your
physical disability?
(e) If yes, provide details thereof |

23. Photo-ID Proof | AADHAR CARD (XXXXXXXX1404)

24. List of scanned copies uploaded by the candidate:-

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Note 1: The documents/certificates uploaded with DAF only will be accepted.
Note 2: The documents/certificates submitted through any other mode or after closing date of DAF will NOT be
accepted under any circumstances.
--->A Scanned Copy of Matriculation Certificate / School Leaving Certificate as proof of birth or any other
certificate / document as prescribed in Rule 5 of the Rules of Engineering Services Examination 2025
--->A Scanned copy of the certificate(s) showing his/her educational qualification as prescribed in Para
3(iii) of the Notice of the Examination uploaded on the website of the Commission and Rule 6 of the Rules
of Examination published in the Gazette of India
--->A Scanned Copy of Certificate in Support of claim to belong to Scheduled Castes/Scheduled
Tribes/Other Backward Classes (Non Creamy Layer) / Economically Weaker Section/PwBD (wherever
applicable).
--->A Scanned Copy of Certificate in support of claim for age concession (wherever applicable).
--->Any of the following photo ID proofs (Viz. Aadhar card, Voter ID card, PAN card, Passport, Driving
License, Educational Institution/Office ID Card or any other photo ID issued by Central/State Government).

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DECLARATION TO BE SIGNED BY THE CANDIDATE

I, hereby declare that all statements and entries made in column 1 to 24 of this application are true, complete and correct to
the best of my knowledge and belief. In the event of any information being found false or incorrect or ineligibility being
detected before or after the examination,action can be taken against me by the Commission under rule 11 of the Examination
Rules notified and published in the Gazette of India.

I further declare that I fulfill all the eligibility conditions regarding age limits, educational qualifications etc. prescribed
for admission to the Examination.

I have not withheld any information required as per this Detailed Application Form.

I have thoroughly scrutinized the list of scanned documents as enumerated in Column 24 of the DAF and uploaded scanned
copies of all the documents relevant for me.

I have read the Rules and the instruction carefully and I hereby undertake to abide by them.

* I have informed my Head of Office/Department in writing that I have applied for this examination.

Signature of the Candidate

Place: Name : HEMANT KUMAR MINA

Date: Branch : CIVIL ENGINEERING
RID : 12500120451

* Strike off this sentence,if not applicable.

RID No. :- 12500120451 |

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