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Haryana Public Service Commission

The document is an application form for a candidate named Bikram Jeet Singh who is applying for the post of HCS(Ex. Branch)& Other Allied Services Examination 2017(1) with the Haryana Public Service Commission. The form contains details such as the candidate's personal information like name, father's name, date of birth, contact details, educational qualifications, category information, employment details, and a declaration signed by the candidate.

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Bikramjeet Singh
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47 views

Haryana Public Service Commission

The document is an application form for a candidate named Bikram Jeet Singh who is applying for the post of HCS(Ex. Branch)& Other Allied Services Examination 2017(1) with the Haryana Public Service Commission. The form contains details such as the candidate's personal information like name, father's name, date of birth, contact details, educational qualifications, category information, employment details, and a declaration signed by the candidate.

Uploaded by

Bikramjeet 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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11/02/2019 hpsconlinenew.in/PrintApplicationFrom.

aspx

HARYANA PUBLIC SERVICE COMMISSION


For Office Use
Advertisement, Post and Fee Details
Only
Registration Number : 2219155149 Space for Marking
Advertisement Number : 3/2018
: HCS(Ex. Branch)& Other Allied Services
Name of the Post
Examination 2017(1)
Amount : 1000.00
Transaction Number : 0044164847
Signature of
Transaction Date : 11/02/2019
Marking Officer

Candidate Particulars :
1 Candidate Name bikram jeet singh
2 Father's Name sukhmohinder singh
3 Mother's Name harvinder kaur
4 Date of Birth 23-11-1993
5 Age as per Advt i.e as on 01-01-2018 24 Years 8 Months 10 Days
Correspondence Address:
6 Address h.no 75,shiv enclave,deep nagar,jalandhar cantt jalandhar cantt
Punjab 144005
Permanent Address:
7 Address h.no 75,shiv enclave,deep nagar,jalandhar cantt jalandhar cantt
Punjab 144005
Personal Details:
8 Contact Number 7589048292
9 Email [email protected]
Do you possess a degree of
Arts/Science/Commerce or an
10 Yes
equivalent degree from a recognised
University.
11 Post Claim Category General
If you are (PwD) Physical
12 Handicapped of Haryana please select Not Applicable
your Physical Handicapped Category
13 Are you ESP of Haryana? No
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11/02/2019 hpsconlinenew.in/PrintApplicationFrom.aspx

14 Do you belong to ESM/DESM/None None


Are you children or grand children of
15 No
Freedom Fighter* :
16 Fee Claim Category General
17 Age Claim Category General
18 Nationality Indian
19 Gender Male
20 Marital Status Un-Married
21 Are you domicile of Haryana? No
Have you ever been debarred by
22 UPSC/HPSC/OTHER State PSC or No
any other Govt. Department?
Have you ever been convicted by
23 No
Criminal Court?
Are you employed in Govt/Public
Sector Undertaking* (If yes and you
24 are in regular service then give details No
and have to submit NOC from the
Employer at the time of interview
Details of extra Co-curricular / sports
25
activities if any
Give details of other distinctions like
26
NCC, NSS, cultural activities etc.
Declaration : (To be signed by the candidate)

I. All statements made in this application form 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 (Preliminary, Main or on selection), my candidature may be cancelled and action can be
taken against me by the Commission.
II. I have read the advertisement, instructions to candidates and provisions in the Brochure of the Commission
related to this examination carefully and I hereby undertake to abide by them. I fulfill all the conditions of
eligibility regarding age limit, educational qualifications etc. prescribed for admission to the examination in the
advertisement, instructions for candidates, provision of Brochure and other relevant rules and instructions.

Candidate Signature:

BIKRAM JEET SINGH


Name in Capital Letters

Place:
Date:

Note: Incomplete and unsigned application form shall be rejected.

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