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UNION PUBLIC SERVICE COMMISSION

DETAILED APPLICATION FORM
ENGINEERING SERVICES (MAIN) EXAMINATION, 2025

OTR ID. : 122000001615486

RID: 12500772544
Branch : ELECTRICAL ENGINEERING
E-mail : [email protected]
Alt E-mail : [email protected]
Mobile : 9720092601
Alt Mob No. : 7078982353

1. Name (As per Matriculation) | VIKASH KUMAR

Have you ever changed your name?: | NO

2. (a) Address for correspondence to which | 167, PRITI VIHAR COLONY RAYA ROAD LAXMI
NAGAR MATHURA
communication is to be sent |
Post Office: | LOHBHAN
City: | LAXMI NAGAR MATHURA
District: | MATHURA
State : | UTTAR PRADESH
Pin Code : | 281204
(b) Telephone No. with STD Code | -
(c) Mobile No. | 9720092601
(d) Fax No. |
(e) E-mail address | [email protected]
(f) Permanent Postal Address | 167, PRITI VIHAR COLONY RAYA ROAD LAXMI
NAGAR MATHURA
|
Post Office: | LOHBHAN
City: | LAXMI NAGAR MATHURA
District: | MATHURA
State : | UTTAR PRADESH
Pin Code : | 281204

3. Nationality | INDIAN

4. Gender | MALE

5. Marital Status | UNMARRIED

6. Citizenship | A CITIZEN OF INDIA(1)

7. State of Domicile | UTTAR PRADESH

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8. (a) Date of Birth | 1998-01-03
(b) Age Relaxation claimed | NO

9.(a) Mother tongue : | HINDI

(b) Identification Mark : | A SMALL RED SPOT ON RIGHT SIDE OF FORE

10.Place of Birth :
If born in India: | YES
Post Office | LOHBHAN
City/Town/Village | LAXMI NAGAR
District | MATHURA
State | UTTAR PRADESH
Pincode | 281204

11. (a) Community | SC (1)

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. | 142224000819
(c) Date of issue | 2022-05-05
(d) Designation of issuing authority | TEHSILDAR
(e) Full address of issuing authority | MAHAVAN MATHURA

(f) Name of the Caste as mentioned in | JATAVA (24)

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

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examination(s) passed, if any, for each :-

Read Only Speak Only Read & Speak Read, Write & Examination(s)
Speak passed
HINDI HINDI HINDI HINDI HIGH SCHOOL AND
INTERMEDIATE

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. | 1506520036
(c) Date of issue | 2019-10-16
(d) Designation of issuing authority | VICE CHANCELLOR
(e) Full address of issuing authority | LUCKNOW UTTAR PRADESH

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 80.16 2013 HINDI ENGLISH DR PANNI LAL H UP BOARD
SCIENCE SOCIAL SECONDARY
SCIENCE SCHOOL MATHURA
MATHEMATICS
DRAWING
12th or Equivalent 1ST 82 2015 HINDI ENGLISH CHAMPA UP BOARD
PHYSICS AGARWAL INTER
CHEMISTRY COLLEGE
MATHEMATICS MATHURA
Stream at Graduation Level :-- ENGINEERING
B. TECH. 1ST 72.5 2019 ELECTRICAL BSA COLLEGE OF GAUTAM
ENGINEERING ENGINEERING AND BUDDHA
TECHNOLOGY TECHNICAL
MATHURA UNIVERSITY,
LUCKNOW, U.P.

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

16. (a) Name of Father | JEEVAN SINGH

(b) Name of Mother | GANGA DEVI
(c) Nationality of Father | INDIAN
(d) Nationality of Mother | INDIAN
(e) Father's present postal Address | 167, PRITI VIHAR COLONY RAYA ROAD LAXMI

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NAGAR MATHURA
(If deceased give last address) |
Post Office: | LOHBHAN
City: | LAXMI NAGAR MATHURA
District: | MATHURA
State : | UTTAR PRADESH
Pin Code : | 281204
(f) Mother's present postal Address | 167, PRITI VIHAR COLONY RAYA ROAD LAXMI
NAGAR MATHURA
(If deceased give last address) |
Post Office: | LOHBHAN
City: | LAXMI NAGAR MATHURA
District: | MATHURA
State : | UTTAR PRADESH
Pin Code : | 281204
(g) Father's Profession: | INDUSTRY/OWN BUSINESS/SELF EMPLOYED
(h) Mother's Profession: | OTHERS [PLEASE SPECIFY]
Others: | HOUSE WIFE
(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) | NOT APPLICABLE
(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.80000
(l) Annual income of your Mother | RS.0
(m) State to which your Father originally | UTTAR PRADESH
belongs
(n) District to which your Father originally | MATHURA
belongs
(o) State to which your Mother originally | UTTAR PRADESH
belongs
(p) District to which your Mother originally| MATHURA
belongs

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

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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 : | ELECTRICAL ENGINEERING

Name of Services/Posts Order of Preference

INDIAN DEFENCE SERVICE OF ENGINEERS. 9
INDIAN NAVAL MATERIAL MANAGEMENT SERVICE (ELECTRICAL ENGINEERING POSTS) 8
INDIAN NAVAL ARMAMENT SERVICE (ELECTRICAL ENGINEERING POSTS) 7
DEFENCE AERONAUTICAL QUALITY ASSURANCE SERVICE/SSO-II (ELECTRICAL). 4
CENTRAL POWER ENGINEERING SERVICE GR ‘A’ (ELECTRICAL ENGINEERING POSTS). 3
INDIAN SKILL DEVELOPMENT SERVICE. 10
IEDS/ASSISTANT DIRECTOR GRADE-I (IEDS) ELECTRICAL TRADE 5
IEDS/ASSISTANT DIRECTOR GRADE-II (IEDS) ELECTRICAL TRADE 6
INDIAN RAILWAY MANAGEMENT SERVICE (ELECTRICAL) 1
INDIAN RAILWAY MANAGEMENT SERVICE (STORES)- ELECTRICAL ENGG. POSTS 2

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

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

(a) Prizes, medals, scholarships,etc |

(b) Sports / N.C.C. etc. |

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(c) Position(s) of distinction /leadership | SERVED AS A VOLUNTEER IN COLLEGES
held in School/College ANNUAL SPORTS WEEK. ORGANIZED A PPT
SEMINAR ON SOLAR ENERGY AND ITS
SIGNIFICANCE IN BSACET, MATHURA.
(d) Other extra curricular activities and | LISTENING 90S SONGS MORNING WALK
interests (Such as hobbies etc.) INTERNET SURFING PLAYING CHESS

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 (XXXXXXXX8393)

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

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.

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--->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).
--->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 : VIKASH KUMAR

Date: Branch : ELECTRICAL ENGINEERING
RID : 12500772544

* Strike off this sentence,if not applicable.

RID No. :- 12500772544 |

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