Application Forms CA4I_0
Application Forms CA4I_0
Paste photograph
blue B/G
here
_____________________________________________________________________________
3) Father’s Name:
_____________________________________________________________________________
4)
d d m m y y y y
Date of birth (exact as
per Matric certificate)
_________________________________________________________________ District__________________
(b)Permanent/Alternate Address__________________________________________________________
_________________________________________________________________ District__________________
Declaration: I certify that the statements made in the answers to the foregoing questions 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 Authority.
I also certify that above mentioned information is correct that I have never been involved in
any criminal activity /arrest/Challaned/or convicted and I have never suffered from any acute
disease/ailment.
________________
Applicant’s Signatures
Date __________________