10/31/22, 10:44 PM https://dst.bihar.gov.in/oa/(S(mdjilnjja530bqnhqfrvlu1c))/DSTOAD/APP/AppPrint.
aspx
Application Form
Department of Science & Technology, Government of Bihar
Application for Direct Recruitment of Karyalay Parichari
(Advertisement no. 02/2022 )
Application Details
Application ID :
OAD/00426917 Application Date :
31-Oct-2022 Post Applied For :
Karyalay Parichari
Personal Details
Applicant Name SANTOSH KUMAR
Father's Name WAKIL RAY
Mother's Name SITABI DEVI
Marital Status Un-Married
Spouse Name
Ex Serviceman No
Date of Birth 13-Feb-1999
Age as on (01.08.2022) 23 Years 5 Months
Gender Male
State of Domicile Bihar
Home District PATNA
Category BC
Non-Creamy Layer Yes
Nationality Indian
Physically Handicapped No
Category of Physically Handicapped
Percentage of Physically Handicapped
WARD of Freedom Fighter No
Email ID santosh1234kumar123@gmail.com
Mobile No. 6204899404
Phone With STD Code
Identification Marks A MOLE ON RIGHT HAND
Address for Correspondence
Address AKHARA ROAD YADUVANSHI NAGAR DIGHA GHAT PATNA
Pin Code 800011
Permanent Address
Address AKHARA ROAD YADUVANSHI NAGAR DIGHA GHAT PATNA
Pin Code 800011
Educational Qualification
Qualification Board/University Institute/ School/ College Name
Certificate Passing Full Marks % of
No Year Marks Obtained Marks
I.Matric CBSE S D V PUBLIC SCHOOL KURTHOUL PHULWARI 1141414 2014 500 475 95
SHARIF PATNA
Certificate Details
Sl. No. Certificate Name Issuing Authority Certificate No. Issue Date
1 Domicile Certificate CO/RO BRCCO/2022/12201638 29-Oct-2022
2 Caste Certificate CO/RO 44510 07-Nov-2015
3 Disability Certificate
4 Ward of Freedom Fighter Certificate
5 Experience Certificate
Experience Details
Whether worked as a class IV Employee under the world bank polytechnic education
strengthening project in No
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Department of Science & Technology, Government of Bihar,
Patna
Year Experience Claimed 0
Point Details
Educational Point 95
Experience Point 0
Total Point 95
I hereby declare that I am a citizen of India. The entries in this application form
are complete, true and correct to the best of my knowledge and
belief. I have read
carefully all the rules and provisions related to this advertisement and I promise
to follow these and also promise that I will not
use any unfair means during the
selection process. I fulfill all the eligibility criteria i.e. Age limit, educational
qualification as prescribed in the
advertisement. I have all eligibility certificates,
whenever the Department of Science and Technology, Bihar, Patna will ask for it,
i will produce the
same failing which my candidature can be cancelled by the Department
of Science and Technology, Bihar, Patna at any time. In case of any
information
provided by me is found to be false or incorrect before or after the selection,
the Department of Science and Technology, Bihar, Patna
will have the right to cancel
my candidature and take appropriate legal action against me. I declare that I have
filled only one application for this
advertisement.
Date:-
31-Oct-2022
Signature of Applicant (In English) Signature of Applicant (In Hindi)
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