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Application Form Draft Print For All

The document is an application form for the Constable (GD) recruitment examination in Central Armed Police Forces to be held in 2024. It contains the applicant's personal details like name, father's name, date of birth, address, educational qualifications and other required information. The applicant is Niraj Kumar from Muzaffarpur, Bihar who has passed 10th standard in 2019 and has applied for the exam to be held in Muzaffarpur as his first preference.

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ranjanraj2143
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19 views

Application Form Draft Print For All

The document is an application form for the Constable (GD) recruitment examination in Central Armed Police Forces to be held in 2024. It contains the applicant's personal details like name, father's name, date of birth, address, educational qualifications and other required information. The applicant is Niraj Kumar from Muzaffarpur, Bihar who has passed 10th standard in 2019 and has applied for the exam to be held in Muzaffarpur as his first preference.

Uploaded by

ranjanraj2143
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
CONSTABLES (GD) IN CENTRAL ARMED POLICE FORCES
(CAPFs), SSF AND RIFLEMAN (GD) IN ASSAM RIFLES
EXAMINATION 2024

REGISTRATION NO: 20002974862

APPLICATION RECEIVED (CONTENTS NOT VERIFIED)

1. NAME AS PER MATRICULATION 2. NEW/CHANGED


3. FATHER'S NAME 4. MOTHER'S NAME
CERTIFICATE NAME
NIRAJ KUMAR - NARESH SAH RANI DEVI
5. DATE OF BIRTH (DD/MM/YYYY) 6. AGE AS ON 01/01/2024 7. GENDER 8. CATEGORY
10/05/2003 20.7 MALE OBC
9. NATIONALITY 10. MARK OF VISIBLE IDENTIFICATION
CITIZEN OF INDIA A MOLE MTHE HAND RIGHT CHEEK
12. MATRICULATION (10th 13. MATRICULATION (10th
11. MATRICULATION (10th CLASS) EXAMINATION BOARD
CLASS) ROLL NO CLASS) YEAR OF PASSING
BIHAR SCHOOL EXAMINATION BOARD 1900073 2019
14.1. WHETHER YOU ARE AN EX-SERVICEMEN (ESM) OR
14.2. DATE OF JOINING THE ARMED FORCES (DD/MM/YYYY)
SERVING IN THE ARMED FORCES?
NO -
14.3. DATE OF DISCHARGE FROM ARMED FORCES
14.4. LENGTH OF SERVICE IN THE ARMED FORCES
(DD/MM/YYYY)
- -
14.5. HAVE YOU ALREADY JOINED A CIVIL POST BY AVAILING
BENEFIT OF RESERVATION FOR EX-SERVICEMEN (ESM) ? 14.6. DATE OF JOINING TO CIVIL POST (DD/MM/YYYY)

- -
15.1. WHETHER SEEKING AGE RELAXATION? 15.2 IF YES, AGE RELAXATION CODE
NO -
16.1. ARE YOU A NATIONAL CADET CORPS (NCC)
16.2. TYPE OF THE NCC CERTIFICATE
CERTIFICATE HOLDER
NO -
17. PREFERENCE OF EXAMINATION CENTRES

EXAMINATION CENTER EXAMINATION CENTER EXAMINATION CENTER


( FIRST PREFERENCE ) ( SECOND PREFERENCE) ( THIRD PREFERENCE)

MUZAFFARPUR ( 3205 ) PATNA ( 3206 ) BHAGALPUR ( 3201 )

18. MEDIUM FOR COMPUTER BASED 19. STATE/ UT OF DOMICILE 20. DISTRICT OF DOMICILE
EXAMINATION (CBE)
HINDI BIHAR MUZAFFARPUR
21.1. HAVE YOU MIGRATED FROM THE STATE/ UT OF 21.2. WHETHER YOU WOULD LIKE TO AVAIL THE BENEFIT OF
YOUR ORIGIN TO ANOTHER STATE/ UT RESERVATION FROM THE STATE/ UT OF YOUR ORIGIN
NO -
21.3. STATE/ UT OF ORIGIN 21.4. DISTRICT OF ORIGIN
- -
22. CANDIDATE BELONGS TO MILITANCY/ NAXAL
23. CANDIDATE BELONGS TO BORDER DISTRICT
AFFECTED DISTRICT
NO NO
24. PREFERENCE OF POST FOR CAPF(S)/ ORGANIZATION(S)
H,B,D,A,C,F,E,
25. HIGHEST EDUCATIONAL QUALIFICATION
MATRICULATION/ 10TH CLASS PASS (1)
26. DETAILS OF QUALIFYING EDUCATION
10TH STANDARD
STATUS PASSING STATE/ UT OF BOARD/ NAME OF BOARD/ ROLL NO PERCENTAGE CGPA
YEAR UNIVERSITY UNIVERSITY
PASSED 2019 BIHAR BIHAR SCHOOL 1900073 41.2 -
EXAMINATION BOARD
27. 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 ?
NO
ADDRESS DETAIL
28. CORRESPONDENCE ADDRESS 29. PERMANENT ADDRESS
VILL-CHAKFIROJ PO-GANIYARIPS-SAKRA DIST- VILL-CHAKFIROJ PO-GANIYARIPS-SAKRA DIST-
MUZAFFARPUR MUZAFFARPUR
DISTRICT: MUZAFFARPUR DISTRICT: MUZAFFARPUR
STATE: BIHAR STATE: BIHAR
PIN: 843119 PIN: 843119
MOBILE NO. : 9031425946 EMAIL ID: [email protected]
30. WHETHER PHOTOGRAPH HAS BEEN TAKEN ON OR AFTER 24-AUGUST-2023?
YES
FEE PAYMENT AMOUNT TRANSACTION NO TRANSACTION DATE

NOT EXEMPTED 100 CPADIBUDZ2 07/12/2023


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.

4. I AGREE TO AUTHORIZE SSC TO USE MY AADHAR DATA FOR VERIFICATION PURPOSE.


PRINT TAKEN ON: 11/12/2023 10:53:16 AM IP ADDRESS: 157.38.11.63

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