FEDERAL PUBLIC SERVICE COMMISSION

Aga Khan Road, Sector F-5/1, ISLAMABAD

Application Form No.
Website: www.fpsc.gov.pk APPLICATION FORM
E-mail: [email protected] FOR RECRUITMENT TO BS-16 & ABOVE POSTS
Fax: 051-9213386-9203410

For Official Use only To be filled by the candidate

Application Fee (Original Treasury Receipt) No….. ….…. Paste
Receiving Stamp FPSC HQ/Provincial/Regional Office
date……….……………….For Rs.……………………… Photograph
for
Name of Bank Branch Code……………………………... (female candidates
Tehsil/ District (Bank Branch Located)………………….. also)
For Official Use Only

Batch No. Diary No.

_____________________________________________________________________________________________________________________
Consolidated Advt. No. Case No. Category (If applicable)
/ 2 0 F.4- / 2 0 -R Subject

Name of Post Applied for:…………………………………………………………………………………………. B.S.

Ministry/Division/Department …………………………………………………………………………………………………………………………………….
1) Name: (Write in capital letters with spelling as per Matriculation Certificate)

2) Father’s Name/Husband’s Name (For female married candidates)

3) d d m m y y y y Exact age on d d m m y y
Date of Birth (exact as per Closing Date
Matric certificate)

4) Computerized (NADRA) National Identity Card (CNIC) No. of Applicant - -

5) Encircle the relevant Code: a) Gender Male M b) Religion Muslim M

Female F Non-Muslim NM
6) Self Domicile: (Encircle the relevant Code of your domicile). District of Domicile: …………………………………
Domicile Balochistan Khyber Sindh (Rural) Sindh Punjab Azad Gilgit Baltistan FATA
Pakhtoonkhwa (Urban) (Including Kashmir (GB)
(KP) ICT)
Code 10 20 30 31 40 60 61 90

7) Encircle the relevant Code separately for Test and Interview Centre.
Test Centre D.I.Khan Gilgit Islamabad Karachi Lahore Multan Peshawar Quetta Sukkur

Code D G I K L M P Q S
Interview Centre Islamabad Karachi Lahore Peshawar Quetta

Code I K L P Q
8) Encircle the relevant Code in case of Age Relaxation:

Age Not claimed Govt. Servant Armed Forces Scheduled Buddhist Azad Gilgit Baltistan Recognized
Relaxation (Within age including serving Released/Retired Caste Community Kashmir (GB) Tribes of
limit) in Armed Forces Commissioned Tribal Areas
Officer/Personnel
CODE 00 01 02 03 04 05 06 07
9) (a) Present Postal Address: (IN CAPITAL LETTERS): ________________________________________________________

____________________________________________________________________________________ District___________________

(b) Permanent/Alternate Address__________________________________________________________________________

____________________________________________________________________________________District___________________
10) Contact Nos:
Contact Phone Office
Nos. with City
Code Residence
Please write
all Nos. Cell No. Applicant’s Signature
Fax No. Date
E-Mail Address
 - 2 -

11). ACADEMIC QUALIFICATIONS:

Do you possess the minimum educational qualification as mentioned in the advertisement as on the closing Date? Yes No

Sr. Advertised Result Declaration Date

Obtained
Div/Grad
No. (Certificate issued only by the Controller of Examination of Board/ University Principal
Minimum

CGPA/

Marks
Board/University will be accepted)
Qualification and Subjects

% of
Day Month Year
higher

e
1 Matriculation

2 Intermediate

12) COURSES/TRAINING (Certificate, Diploma, Post-Graduate Diploma, on job training etc.)

STARTING DATE ENDING DATE Nature of

GRADE

Weeks
Sr. NAME OF INSTITUTION & Day Month Year Day Month Year Training
No. COURSE LOCATION Intern On
ee Job

13) RESEARCH/PUBLICATIONS/PAPERS/ARTICLES:
Mark ‘R’ in the last column of the research report/paper/article/publication, if required in the advertisement.

Sl. Journal/Conferences Publication Date

No. Title (In case of paper/article)
Publisher
Day Month Year
R

3
4

14) Do you fall in the category of a disabled candidate? If yes, then encircle the relevant Code:

DISABILITY Visual impaired (Blind) Physically Impaired Hearing/Speech impaired

(deaf & dumb)
CODE V P H
If you need any assistance for attempting the
Computer

Computer

Computer
Recorder

Recorder

Recorder

question paper in the examination/ test, then

Braille
Writer

Writer

Writer
Audio

Audio

Audio

Mark the relevant Box

Code W C AR B W C AR W C AR
 15) EXPERIENCE: (i) Start from first employment in ascending order (ii) Do you possess relevant Post-Qualification experience for the post as mentioned in the advertisement. Experience (each) claimed here must be authenticated
by providing experience certificate/valid proof of that period with exact dates, job description/specification issued by the Competent Authority.

PERIOD STATUS NATURE OF JOB

Sl NAME OF THE BS ORGANIZATION/
No POST MINISTRY/DIVISION/ From To TOTAL PERIOD

Armed Forces
Fed. Govt.

Semi Govt.

Daily Wages
DEPARTMENT (Write to-date if you are still in service) MAIN DUTIES

Prov. Govt.

Permanent

Temporary

Apprentice
Officiating

Part Time
Honorary
Contract
Private

Adhoc
PERFORMED

Day Month Year Day Month Year Year Month Day

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

4
-3-

10

Attach additional sheet if required on the same pattern.

 - 4 -

16) Check List:

Have you filled/attached attested copies of all required documents as per following sequence?
Yes / No

1. Correct Case No. / Name of post/Department as per Advertisement.

2. Original Treasury Challan with application form.
3. Latest Three (3) Photographs Mentioning your name on backside.
4. Copy of Computerized National Identity Card (CNIC).
5. Copy of Matric/Secondary School Certificate (Proof of Age).
6. Copy of required Degrees/Diplomas/Certificates.
7. Proof of Post-Qualification experience.
8. Copy of self Domicile Certificate.
9. Departmental Permission Certificate (For Govt. Servants)
10. In Case of Disabled Candidates, certificate of Disability from the Competent Authority.

17) Declaration (i): I hereby solemnly declare that I am not in possession of any domicile certificate other than District _______________________
claimed / submitted alongwith this application form for the instant case. I further declare that if I am found in possession of any
domicile certificate other than the one mentioned above, I will be liable to dismissal from service any time with costs or any other
penalty.

Declaration (ii): I certify that the statements made by me in the answers to the foregoing questions 1-17 are true, complete and correct to the best of my
knowledge and belief. Submission of fake/forged documents and any misrepresentation or omission discovered even after appointment
may render my appointment liable to termination in addition to the action decided by the Commission. I have also carefully read the
General Instructions to the candidates and I am bound by the terms and conditions contained therein.

Note:- Attested copies of all the documents should be attached in above order and numbered in continuation of page number of Application Form.

Applicant’s Signature
Date
 - 5 -

ANNEX-A

SPECIMEN OF
EXPERIENCE CERTIFICATE
(To be typed/printed on Letter Head of Ministry/Division/Department/Organization/Firm)

Certified that Mr./Miss/Mrs....................................................................................................................................

has been/is employed in this Ministry/Division /Department / Firm/Organization as..........................................................
from......................................to.................................(dates) whole time/part time/honorary basis/contract
basis/daily wages. The work of Mr./Miss/Mrs....................................................while employed in this Ministry/Division/
Department/Firm/Organization was/is satisfactory. The duties/job specifications are/were as follows:-
(1) ...............................................................................................................................................................

(2) ...............................................................................................................................................................

(3) ….............................................................................................................................................................

(4) ................................................................................................................................................................

(5) ................................................................................................................................................................

Date of Issue..............................
Signature……………………………..
Name of Issuing Authority..................
...........................................................
FOR PRIVATE ORGANIZATION
CNIC - - Designation.......................................
No. BPS (or Equivalent)...........................
(Issuing Authority)
Office Stamp/Seal.............................
Name: …………………………………………………………………………………………
Phone No.……………………………..
Address: ----------------------------------------------------------------------------------
-------------------------------------------------------- Phone No.-----------------------

Note : (i) Experience certificate must be issued under the signature of an officer at least one step higher than
the post applied for. For example in case of a candidate for a post of BS-17, the experience
certificate must be issued under the signature of head of the department/an officer of BPS-18 or
equivalent as the case may be.
(ii) In case of a candidate who served/is serving in a private Firm/Organization, experience certificate
must be issued under the signature of Chief Executive/Head of Private Firm/Organization with CNIC
No. address, Phone Nos.
(iii) Experience certificate must be issued on the official letter pad with reference/file No. and date of
issue and it should be duly stamped with full address. Telephone No. should also be indicated, failing
which the experience certificate will not be acceptable.
(iv) In case of more than one employer each experience certificate must be on the pattern as given
above to derive the authentication/period of relevancy/irrelevancy of the job.
 - 6 -

ANNEX-B

CERTIFICATE TO BE PRODUCED BY CANDIDATES BELONGING

TO THE TRIBAL AREAS

This is to certify that Mr./Miss/Mrs...........................................................................................................................

Son/Daughter of.......................................................................................................................................................
belongs to the recognized tribe of............................................................................................................................
and is a permanent resident of Village/Town...........................................................................................................
of District/Trible Area...............................................................................................................................................
and his/her family have been living in that area since.............................................................................................
belongs to a Gilgit Baltistan,* Federally Administered Tribal Area* Provincially Administered Tribal Area*.

Note :—Tribal Area as defined vide Article 246 of the Constitution of the Islamic Republic of Pakistan.
*Strike out whichever is not applicable.

Dated............................................. Signature...................................

Political Agent
Office stamp/seal must be affixed

…………………………………………………………………………………………………………………………………

ANNEX-C

CERTIFICATE TO BE PRODUCED BY THE CANDIDATE FROM THE KASHMIR AFFAIRS DIVISION,

GOVERNMENT OF PAKISTAN, ISLAMABAD

This is to certify that Mr./Miss/Mrs...........................................................................................................................

Son/Daughter of......................................................................................................................................................
is a permanent resident of Village/Town..................................................................... of District.............................
of Azad Jammu & Kashmir Territory and has been living in the aforesaid areas or any other part of Pakistan.

Dated............................................. Signature.......................................

Designation..............................................
Office stamp/seal must be affixed.
 Bank’s Name……………………………………………………

Date
Bank’s Code…………………………………………………

T.R-6

by the
District of Bank Branch…………………………………..

candidate
Bank Details
Important

Must be filled

For Bank use only

Name of By whom tendered
Candidate …………………………………………………………….

State Bank of Pakistan

Secretary, Name (or designation) & Treasury/Sub-Treasury
Federal Public Service Commission, address of the person on whose
Islamabad behalf money is paid

Case No. F. 4 - /20 -R Full particulars

of the remittance and of authority
Cash paid into the National Bank of Pakistan

Received Payment Rs.…………………/=

Examination Fee for the post of ………………………………………
(if any)
…………………………………………………………………………
(Treasury Rule 29) Chalan No. (BANK’S COPY)

Signature
Rs.………… (Rupees …………………………….only)
To be filled in by the remitter

Amount

(in words) Rupees…………………………………only)

with Stamp
Treasury Officer/Bank Officer
CENTRAL QUARDUPLICATE

C 02101 – Organs of States - Exam Fee Realized by FPSC Head of Account

Bank’s Name……………………………………………………

Date
Bank’s Code……………………………………………………
by the
T.R-6

District of Bank Branch…………………………………..

candidate
Bank Details
Important

Must be filled

For Bank use only

Name of By whom tendered
Candidate …………………………………………………………….

Secretary, Name (or designation) &

Federal Public Service Commission, address of the person on whose
(Treasury Rule 29) Chalan No.

Islamabad behalf money is paid

Treasury/Sub-Treasury

State Bank of Pakistan

Case No. F. 4 - /20 -R Full particulars

of the remittance and of authority

Received Payment Rs.…………………/=

Examination Fee for the post of ………………………………………
Cash paid into the National Bank of Pakistan

(if any)
…………………………………………………………………………

Rs.………… (Rupees …………………………….only)

Signature
Amount
To be filled in by the remitter
CENTRAL TRIPLICATE

(in words) Rupees…………………………………only)

with Stamp
Treasury Officer/Bank Officer
C 02101 – Organs of States - Exam Fee Realized by FPSC Head of Account
(TREASURY’S COPY)

by

Bank’s Name……………………………………………………
Bank’s Code…………………………………………………….

Date
District of Bank Branch…………………………………..
candidate
T.R-6

Bank Details
Must be filled
the
Important

For Bank use only

Name of By whom tendered
Cash paid into the

Candidate …………………………………………………………….

Secretary, Name (or designation) &

Federal Public Service Commission, address of the person on whose
CENTRAL

Islamabad behalf money is paid

(Treasury Rule 29) Chalan No.

Case No. F. 4 - /20 -R Full particulars

Treasury/Sub-Treasury

State Bank of Pakistan

of the remittance and of authority

Received Payment Rs.…………………/=

Examination Fee for the post of ………………………………………

(if any)
…………………………………………………………………………
National Bank of Pakistan

Signature

Rs.………… (Rupees …………………………….only) Amount

(in words) Rupees…………………………………only)
DUPLICATE

with Stamp
Treasury Officer/Bank Officer
To be filled in by the remitter

C 02101 – Organs of States - Exam Fee Realized by FPSC Head of Account

CANDIDATE’S COPY)

Bank’s Name……………………………………………………
Date

Bank’s Code……………………………………………………
by the
T.R-6

District of Bank Branch…………………………………..

candidate
Bank Details
Important

Must be filled

For Bank use only

Name of By whom tendered

Cash paid into the

Candidate …………………………………………………………….
(Treasury Rule 29)

Secretary, Name (or designation) &

Federal Public Service Commission, address of the person on whose
CENTRAL

Islamabad behalf money is paid

Chalan No.

Case No. F. 4 - /20 -R Full particulars

Treasury/Sub-Treasury

of the remittance and of authority

Received Payment Rs.…………………/=
State Bank of Pakistan

Examination Fee for the post of ………………………………………

(if any)
…………………………………………………………………………
National Bank of Pakistan

Signature

Rs.………… (Rupees …………………………….only)

To be filled in by the remitter

Amount
(in words) Rupees…………………………………only)

with Stamp
ORIGINAL

Treasury Officer/Bank Officer

C 02101 – Organs of States - Exam Fee Realized by FPSC Head of Account

(FPSC’S COPY)