APPLICATION FORM

(DAVP Advertisement No___________________________)

To,

______________________________ Recent Passport

size
______________________________
photograph of
______________________________
the
applicant
______________________________

1. Post applied for (along with Unit as : ______________________ Unit:___________________________________

mentioned at para 1 of advertisement)
2. Name of the candidate : ________________________________________
(IN BLOCK LETTERS)
3. (a) Father’s /Husband’s Name : ________________________________

(b) Mother’s Name : ___________________________________________

4. Date of Birth (DD/MM/YYYY) / /

5. Age as on last date of receipt : Years_________Months__________Days__________

of application
6. Nationality : _________________________

7. Religion : _________________________

8. Correspondence address 9. Permanent home address :

______________________________________________ ________________________________________________

______________________________________________ ________________________________________________

Pin-_______________State________________________ Pin-________________State________________________

Contact/Mobile No _______________________________ Contact/Mobile No ________________________________

Email ID _______________________________________ Email ID ________________________________________

10. Category (UR/ SC/ ST/ OBC/ EWS(UR)/ ESM): _______________________________

(Please enclose photocopy of relevant certificate)
Abbreviations used:UR- Un-reserved, SC- Schedule Caste, ST- Schedule Tribe, OBC- Other Backward Class,
EWS- Economically Weaker Section, PwBD- Person with Benchmark Disability, ESM- Ex-Serviceman

11. If applied for the post in “Physically Handicapped” category:

Type of disability (B, LV, D, HH, OA, OL, OAL, CP,LC, Dw, Percentage of disability (40 % and above)
AAV, ASD (M, MoD), SLD (M), MI(M))

(Please enclose photocopy of disability certificate issued by CMO/Civil Surgeon of Government hospital certifying
the disability duly self attested)
Abbreviations used:B- Blindness, LV- Low Vision, D- Deaf, HH- Hard of Hearing, OL- One leg, OA- One Arm, OAL-
One Arm and One Leg, CP- Cerebral Palsy, Dw- Dwarfism, AAV- Acid Attack Victim, LC- Leprosy Cured, ASD(M,
MoD)- Autism Spectrum Disorder (M-Mild, MoD- Moderate), SLD(M)- Specific Learning Disability(M-Mild), MI(M)-
Mental Illness (Mild), MD- Multiple Disability
12.. Length of Combatant Service (applicable for ESM only):Years___________Months__________Days__________
Date of enrolment (In Army/Navy/Air Force):______________________ Date of retirement:__________________
(Please enclose photocopy of discharge certificate)

13. Details of age relaxation required ________________________________________________________________

(Applicable as per Central Govt Policy)

14 Qualifications:
(i) Educational:
Name of Year Board/University/Institution Percentage of Grade/Division
examination marks obtained

(Please enclose photocopy of educational/qualification certificate)

(ii) Experience:
Organization Whether Govt/ Post/Appointment From To
PSU/Private

15. List of enclosures :-

Ser Enclosures
(a)
(b)
(c)
(d)
(e)
(f)
(g)

17. Details of any Identity proof (Enclose copy):-

Aadhar Card No : PAN Card No :

Driving Licence No : Passport No :

DECLARATION
I hereby certify that above particulars mentioned in the application are correct and true to the best of my
knowledge and belief. There is no criminal proceeding pending/ contemplated/ held against me. I understand that in the
event of my information being found false or incorrect at any stage or not satisfying the eligibility criteria according to the
advertisement, my candidature/ appointment is liable to be cancelled/ terminated. I am willing to serve anywhere in India.
I agree that Department has the right to transfer me anywhere in India.

Place :

Date: (Signature of the applicant)

________________________________________________________________________________________________
Note: Candidate to ensure the following are enclosed:-
(i) One self-addressed envelope duly affixed with Rs 5/- postal stamp.
(ii) Self-attested photocopies of certificates (________) sheets.
(iii) Two self –attested Photographs (Name and Mother’s/Father’s name on the back side of photo)
(iv) Acknowledgement/ Admit card
 ACKNOWLEDGEMENT/ ADMIT CARD

1. Post applied for ____________________________________________

2. Unit applied for_____________________________________________ Recent

Passport size
3. Name of candidate _________________________________________ photograph of
(IN BLOCK LETTERS) the
applicant
4. Date of Birth_______________________________________________

5. Mother’s Name_____________________________________________

6. Father’s/ Husband’s Name_____________________________________________

7. Category applied for_________________________________________________________

8. Correspondence address
House No./Street /Village______________________________________________________

Post Office______________________ Tehsil___________________

District_______________________ State____________________ Pin Code_________________

9. Tele/Mob No________________________ E Mail ID ________________________________

FOR OFFICE USE ONLY

Your application is hereby accepted

10. Index No______________________

11. Written test (a) Date______________________(b) Reporting Time________________________

(c) Place___________________________________________________________

Date: (Signature of controlling officer)

_________________________________________________________________________________________

Note:- (i) Candidates will report for written test along with original documents / certificates i.e. Educational,
Caste, Domicile, Birth, Discharge certificate/NOC and Physically Handicapped certificate. Only after verification
of original documents and Biometric Attendance, candidates will be allowed to appear for written test. The safe
custody of the documents is the responsibility of the individual.
(ii) Candidates should reach at least one hour before the scheduled time at examination centre on
aforementioned date. No candidate will be allowed for examination after scheduled time.
(iii) The candidates should bring their pen, pencil and clipboard for Written Examination. Candidates will
also carry any two proof of identity (Aadhar Card/PAN card/Passport/Driving Licence)
(iv) The candidate should not keep Mobile, Calculator, Electronic item, paper and other material otherwise
he/she will not be allowed for examination and his/her candidature will automatically deemed to be rejected.