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Application Report

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Durgesh Kumar Tiwari
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10 views

Application Report

Frcrvj tcrch tvrvhvn

Uploaded by

Durgesh Kumar Tiwari
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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APPLICATION FOR THE POST OF ASSISTANT

GRADE III
YEAR OF - 2023

Application No:- CGHCAG31600158802023

1. Full Name of the applicant DURGESH KUMAR

2. Father's Name JAGDAMBA PRASAD

3. Date of Birth 10/10/1992

4. Age as on 01/01/2023 Year 30, Month 2, Day


22

5. Sex Male

6. Nationality Indian

7. Whether, bonafide resident of Yes


Chhattisgarh. Certificate Issuing
Date :- 15/06/2010

8. Educational qualification
Percentage
/ Grade /
Name of Year of Obtain Total CGPA /
S.No. Exam Board / University passing Marks Marks Other

1 High CGBSE RAIPUR 2008 384 600 64.00


School

2 Higher CGBSE RAIPUR 2010 247 500 49.40


Secondary
School

3 Graduation BILASPUR 2016 1115 1900 58.68


VISHWAVIDYALAYA,

4 Post
Graduation

9. Computer & Other Infromation


Whether you have undergone any certificate/diploma course in computer Yes
operation from a recognized Institute ? -

Name Percentage /
of Board / Year of Obtain Total Grade / CGPA /
S.No. Exam University passing Marks Marks Other

1 ITI NCVT 2015 325 400 81.25


COPA
Whether you have passed any typing examination ? - No

Typing examination passed ? -

10. Experience (if any) N/A

11. Category UR

12. Postal address H.N. 138 SHASTRI CHOWK MANDIR


PARA ,LOHARSI SON , BILASPUR,
Chhattisgarh, 495551

13. Permanent address H.N. 138 SHASTRI CHOWK MANDIR


PARA ,LOHARSI SON , BILASPUR,
Chhattisgarh, 495551

14. Phone / Mobile no. +91-9109348472

15. Email [email protected]

16. Whether, Physically Disabled No

17. Whether, the candidate is serving in No


govt./semi govt. organization

18. Are you married? No

19. Characteristics Information

1 Have you ever been arrested? NO

2 Have you ever been prosecuted? NO

3 Have you ever been kept under detention? NO

4 Have you ever been bound down? NO

5 Have you ever been Fined by a Court of Law? NO

6 Have you ever been debarred from any Examination or rusticated NO


by any University or any other educational authority/Institution ?

7 Have you ever been debarred/disqualified by any Public Service NO


Commission from appearing at its Examination/Selection?

8 Is any case pending against you in any court of law at the time of NO
filling up this application form?

9 Is any case pending against you in any University or any other NO


educational authority/Institution at the time of filling up this
application form ?

10 Whether you were ever convicted by a Criminal Court? NO

11 Whether the candidate is under financial debt? NO


12 Whether, he/she has been dismissed or removed from service by NO
any high court, government or statutory authority or local
authority

13 Whether, he has been convicted of any offense involving moral NO


turpitude, or has been permanently deferred or disqualified by
any high court or union public service commission or state public
service commissions or any service selection board or staff
selection commission

14 Whether, he/she has good character and is of sound mind and Yes
body and free from any bodily or mental defect.

15 Whether he/she has more than one spouse. NO

20. List of uploaded documents

Domicile Certificate Computer Certificate High School Higher Secondary School

Graduation Other Certificate (APPRENTICESHIP TRAINIG)

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© 2023 High Court Of Chhatiisgarh

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