Preview

Indian Coast Guard Application for Enrolled Personnel CGEPT-02/2023

  Application Status
NAME Ashwani Kumar

REGISTRATION NO 2302NGC0024752

DATE OF BIRTH 01-Mar-2003

APPLIED BRANCH Navik(GD)

CATEGORY Scheduled Caste (SC)

PAYMENT STATUS Exempted

DATE OF APPLICATION FORM 09-Feb-2023

SUBMITTED

  Personal Information
Note/Instructions:
1. Name (Applicant name, father’s name, mother’s name) in this application and all documents like matriculation
certificate, category certificate (SC/ST/OBC/EWS), Id card, educational certificates should be same or else the
candidature will be cancelled.
2. Please do not use any prefix such as Mr. or Ms.
3. The Email id of profile cannot be changed further so please use working email id.
4. Id provided here will have to be presented in all stages of examination.
5. Birthmark, Mole, Burn/Injury mark to be entered as identification mark by the candidate.
6. The candidates are to scan the original documents (neither photocopy nor self-attested photocopy is to be scanned)
as applicable for the post applied and upload in the online application. Applications with blurred photograph,
signature, uploaded documents and uploaded thumb impression will be rejected during document verification at
Stage-I, II and III and result in cancellation of candidature. If the proper photograph is not uploaded by a candidate,
his candidature will be cancelled. Specimen of photographs available on website.
7. All Documents uploaded must be in Hindi or English. Candidate to upload both original and English translation of
document as one file/document (after merging both documents) if the document is in any language other than
English or Hindi.
8. All document files must be in .jpg and .jpeg format and file size should be between 50KB to 150KB.
9. Candidates to upload class 10th passing certificate with date of birth mentioned on certificate. If date of birth is not
mentioned in 10th passing certificate, then Birth certificate to be uploaded (Original certificate be produced in all
stages of recruitment).
10. OBC/EWS/SC/ST candidates claiming relaxation must ensure that all certificates should have been issued earlier
than the closing date of the online application.
11. Any discrepancy or anomaly in clarity of images of uploaded documents in the online application will lead to
cancellation of candidature.
12. Click here for various examples of document verification for all posts. The documents will be verified by ICG as per
the examples mentioned during all stages of CGEPT examination.

NAME Ashwani Kumar FATHER'S NAME Dileep Chand MOTHER'S NAME Phoolpari Devi

EMAIL ID XXXXXXXXXXXXXXX MOBILE XXXXXXXXXX NATIONALITY Indian

Unmarried Male ID CARD Aadhaar Card
MARITAL GENDER
STATUS

ID CARD NO. XXXXXXXX5731 IDENTIFICATION A Mole On Head IDENTIFICATION No Mark

MARK 1 MARK 2

CATEGORY Scheduled DATE OF ISSUE 22-Oct-2021 DATE OF BIRTH 01-Mar-2003

Caste (SC) OF CATEGORY
CERTIFICATE

DATE OF BIRTH 10th Class AGE RELAXATION No FEE WAVIER Yes

PROOF TYPE Marksheet/Certi CLAIMED
ficate
EMPLOYMENT Unemployed COMMUNITY Always valid (no
TYPE CERTIFICATE validity date
VALIDITY
mentioned on
certificate)

  Class 10th Details

Note/Instructions:
1. 10th marksheet and certificate need to be uploaded at Stage-II.
2. In case of two or more candidates scores same marks in Stage-I, then ICG will be calculating the percentage of the
candidates as per the tie breaking rule mentioned in CGEPT advertisement.

EDUCATION U.P. Board of GRADING Percentage DO YOU HAVE No

BOARD High School & SYSTEM ADDITIONAL
INDICATED IN MARKSHEET
Intermediate MARKSHEET
Education
10TH H71023085 YEAR OF 2018
CERTIFICATE PASSING
NUMBER

Subject Hindi English Mathematics Science Social science Drawing

Marks Obtained 83 69 75 81 75 90

Total Marks 100 100 100 100 100 100

  Class 12th Details

Note/Instructions:
1. 12th marksheet and certificate need to be uploaded at Stage-II.
2. In case of two or more candidates scores same marks in Stage-I, then ICG will be calculating the percentage of the
candidates as per the tie breaking rule mentioned in CGEPT advertisement.

EDUCATION U.P. Board of GRADING Percentage DO YOU HAVE No

BOARD High School & SYSTEM ADDITIONAL
INDICATED IN MARKSHEET
Intermediate MARKSHEET
Education
12TH CERTIFICATE 71017235 YEAR OF 2020
NUMBER PASSING

Subject Physics Mathematics Hindi English Chemistry

Marks Obtained 78 79 75 66 63

Total Marks 100 100 100 100 100

  Additional Details
1) Have you been Discharged from the Indian Army / Indian Navy / Indian Air No
Force or any government organization ?
2) Has any warrant or summons for your appearance as witness been issued and No
pending before a court of law for the time being in force ?
3) Are any proceedings in respect of an offence alleged to have been committed No
by you pending before a criminal court in India ?
4)Has any warrant or summons for your offence been issued and pending before No
a court of law for the time being in force ?
5) Has a warrant for your arrest been issued by a court under any law for the time No
being in force ?
6) Have you, at any time preceding the date of this application, been convicted by No
a court of India for any offence and sentenced in respect thereof to imprisonment
?
7) Have you applied in higher court for acquittal against the conviction of lower No
court ?
8) Have you ever been debarred by ICG / Army / Navy / Air Force / UPSC / No
Central or State govt. during any recruitment process ?

  Communication Details

Note/Instructions:
1. In case of reserved category applicants, either current or permanent address of online application should be same as
the address mentioned in caste/category certificate (SC, ST, OBC(Non-Creamy Layer) & EWS).

Permanent Address
HOUSE/STREET Vill And Post Barahua LANDMARK Near POST OFFICE Barahua
district Basti
COUNTRY India STATE/ UT UTTAR PRADESH DISTRICT BASTI

PIN CODE 272123 PHONE NO WITH N.A

AREA CODE

Present/Current Address
HOUSE/STREET Vill And Post Barahua LANDMARK Near POST OFFICE Barahua
district Basti
COUNTRY India STATE/ UT UTTAR PRADESH DISTRICT BASTI

PIN CODE 272123 PHONE NO WITH N.A

AREA CODE

Domicile Details
DOMICILE STATE Uttar Pradesh

  Photo And Signature

Note/Instructions:
1. Passport size recent colour photograph (should not be older than three months prior to the date of opening of
application) (front portrait in light background without head gear (except for Sikhs).
2. The photograph should be without cap, spectacles and both ears should be visible.
3. The photographs is to be taken with candidate holding a black slate in front of his chest with his name and date of
photograph taken, clearly written on it with white chalk in capital letters.
4. File must be in .jpg / .jpeg format and file size should be between 10KB to 100KB.
5. Any discrepancy or anomaly in clarity of images of uploaded documents in the online application will lead to
cancellation of candidature.
PHOTO LEFT HAND THUMB IMPRESSION SIGNATURE

  Stage - I - Exam City Preferences

Note/Instructions:
1. Candidates are to fill first choice within 30 kms from the present residence. In case if no centre is available within 30
kms then the other choices should be nearest to the present address.
2. Your next 4 preferences nearest to present address in increasing order of distance.
3. Non-compliance to these instructions may lead to cancellation of your candidature during document verification.

1. GORAKHPUR 2. PRAYAGRAJ 3. KANPUR 4. LUCKNOW 5. VARANASI

  Stage - II - Exam City Preferences

1. NOIDA 2. KOLKATA 3. VISAKHAPATANAM 4. GOA 5. GANDHINAGAR

  List Of Uploaded Documents

Note/Instructions:
1. Uploading of documents/additional documents is restricted upto prior downloading of E-admit card for Stage-II. No
documents can be uploaded by the candidate after downloading Stage-II E-admit card. Failure of uploading of
documents within the time promulgated by ICG will lead to the cancellation of candidature. Any request for
uploading new document after downloading of E-admit card for Stage-II will not be entertained.
2. Affidavits duly signed by the candidate accepting their mistake of false information in online application will not be
considered at various stages of examination and their candidature will be cancelled.
3. Documents in Digilocker will not be accepted at any stage of the examination as electronic devices are not permitted
in examination premises. Candidates to bring their original documents at all stages of CGEPT examination.
4. All candidates will be compulsorily subjected to identity check prior commencement of the examination of Stage- I,
II, III of CGEPT. The identity check will include verification/matching of Photograph, biometric, signature and
identification marks as mentioned in this application.

Stage-I
1. ID Proof (Aadhaar Card)
2. Date of Birth Proof (10th Class Marksheet/Certificate)

Checking for Print Preview

Note/Instructions:
You are directed to completely check the print preview of the application and certify that your application is correct in
all aspects as per the advertisement. You are directed to go through the common reasons for rejection as published on
the website and certify that your application is correct and does not fall for rejection in document verification as per the
rules prescribed in the advertisement for Stage-I, II & III as published on the website. You may edit the application and
the uploaded documents if there is any mistake or error before submitting the application. Once the application is
submitted, no changes are allowed.
a. HAVE YOU SEEN THE PRINT PREVIEW BEFORE SUBMITTING THE APPLICATION ? YES

b. DO YOU WANT TO EDIT THE APPLICATION OR THE UPLOADED DOCUMENTS IF THE DETAILS IN YOUR APPLICATION ARE NO
INCORRECT OR THE DOCUMENTS ARE INCORRECTLY UPLOADED ?

c. DID YOU UTILIZE THE "EDIT" OPTION AFTER SEEING THE PRINT PREVIEW PRIOR FINAL SUBMISSION ? NO

d. DO YOU WANT TO SUBMIT THE APPLICATION FINALLY ? YES

IF YOU CHECK YES, YOUR APPLICATION WILL BE SUBMITTED AND NO CHANGES WILL BE ALLOWED FURTHER.
  Declaration
a. I hereby declare that all the above information provided by me is correct.
b. I owe allegiance to the sovereignty, unity and integrity of India. I have not lost, surrendered or been deprived of the
citizenship of India.
c. I affirm that the information and particulars given by me in this form are true and correct. I further state that I am not
suppressing any material information in this regard. I further affirm that the certificates (DOB, Matriculation, 10th marks
sheet, Cast Certificate, ID proof) of documentary proof uploaded in support of my application for recruitment of Navik
(GD)/ Navik (DB) are authentic and solely pertain to me and I am fully responsible for the accuracy of the same. I am
liable to be penalized or prosecuted and my candidature will be cancelled if found otherwise. I am also aware that my
candidature will be cancelled, if the documents are not found genuine by the issuing authority during subsequent
verification by Indian Coast Guard even if I clear computer based written examination, PFT, document verification and
Medical conducted at Stage-I/ Stage-II / Stage-III and inducted into service.
d. I have read the complete advertisement for the said post of Navik (GD)/ Navik(DB) of Coast Guard website and I am
eligible to apply. I have also read the FAQ section on Coast Guard Website before filling the online application.
e. I understand that Indian Coast Guard reserves the right to conduct re-assessment of candidates at Stage II and also at
any stage of the recruitment process prior issue of appointment letter to avoid impersonation. I understand that my
candidature can be cancelled on account of impersonation and the decision of Indian Coast Guard will be final and
binding on me in this regard.
f. I have also understood and read the remarks on Coast Guard Website regarding common observation for cancelling
the candidature during document verification. I certify that all my documents meet the criteria as mentioned on CG
Website.
g. I understand that Coast Guard will be communicating the result of Stage-I, Stage-II and Stage-III on the CG Website
and my login dashboard. I will not claim for re-examination if I fail to see the requisite communication on CG Website
and my login dashboard.
h. I understand that Biometric impression is mandatory for appearing in the Stage-I, Stage-II and Stage-III. Only left
thumb biometric will be captured during Stage-I of examination. The biometric during subsequent stages is to match
with the biometric of Stage-I. In case the biometric of left thumb is not captured then the biometric of right thumb will
be captured and will be used for subsequent verification. Apart from left and right thumb, no other finger will be
considered for the biometric. If I am not able to establish biometric with left or right thumb impression, then I shall not
be allowed to appear for the examination and my candidature will be cancelled. It is my responsibility to check
beforehand that the biometric machines are able to capture the fingerprint image. In case, if the biometric machine is
not able to capture the fingerprint image due to Mehndi, wax, etc then, I will not be allowed to appear in the
examination. I will make no further claim in this regard as biometric fingerprinting is one of the most important access
control security system implemented in Indian Coast Guard and cannot be waived off under any circumstances to rule
out impersonation. I understand that if I am not allowed by Coast Guard for appearing in Stage-I/ Stage-II / Stage-III
owing to non-capture of Biometric due to mehndi, wax, etc. then the application fees will not be refunded under any
circumstances.
i. NO CLAIM / RISK UNDERTAKING I am a candidate for recruitment in Indian Coast Guard. I give my full and free
consent at my own risk and that I shall not be entitled to claim any compensation or other relief from the government
in respect of any injury or disability which I may sustain in the course of or as the result of any of the tests (both
physical fitness test and medical test) administrated to me or attended by me during the recruitment procedure,
whether due to my own negligence or any other person or otherwise.
j. I understand that my candidature will be cancelled and I will be debarred from future Coast Guard Recruitment
examinations in case I am found to be involved in malpractice during process computer based written examination,
PFT, document verification and Medical conducted at Stage-I/ Stage-II / Stage-III of the current recruitment process.
k. I understand that I can apply for only one post in one recruitment cycle i.e. Navik (GD) or Navik (DB). I have not
submitted multiple applications in one recruitment cycle. In case if multiple applications are detected by ICG then all
my applications will be rejected and the application fees for all the submitted application forms will not be refunded
by ICG.
l. I understand that I have to upload the correct document as directed in the online application form. Non-upload/
wrong upload/ interchanged upload of the document in online application will lead to cancellation of candidature.
m. I understand that non-upload/wrong upload/interchanged upload of the additional documents prior Stage-II will
also lead to cancellation of candidature during document verification at Stage-II, Stage-III and Stage-IV.
n. I declare to remember my mobile number and e-mail id entered during filling of the online application as the
correspondence will be through e-mail id only. Post submitting the application, I will see the e-mail id and mobile
number only in encrypted form. No request for retrieving the e-mail or mobile number will be entertained.
 o. I understand that uploading of documents/additional documents is restricted upto downloading of E-admit card for
Stage-II. No documents can be uploaded by me after downloading Stage-II E-admit card. Failure of uploading of
documents within the time promulgated by ICG will lead to the cancellation of my candidature. Any request for
uploading new document after downloading of E-admit card for Stage-II will not be entertained.
p. I declare to visit ICG website and candidate’s dashboard on a daily basis to see various announcements on ICG
website. Failure to comply with instructions on ICG website will result in non-compliance of the recruitment process
and lead to cancellation of candidature. The notification for downloading E-admit card for Stage-I, Stage-II & Stage-III
and the result of various stages will be announced/published on ICG website through my login dashboard and I will
daily visit the website and comply with all instructions. ICG will not be responsible if I fail to visit ICG website on a daily
basis and comply with the instructions therein given from time to time. The primary mode of communication with me
will be through ICG website or E-mail.
q. I declare that uploaded SC/ST/OBC (non-creamy layer)/EWS certificate comply with the instructions given in the
advertisement regarding the format of certificate for appointment to the post under Government of India. If my
candidature is cancelled on account of incorrect category document then I shall not be considered against
unreserved vacancy as I have submitted false information.
r. I understand that any false or incorrect information in the online application not duly supported with the uploaded
documents will lead to cancellation of candidature.
s. I understand that any false or incorrect information in the online application will lead to cancellation of candidature.
t. I certify that I am in possession of originals of all the documents uploaded in the online application.
u. I understand that I will not lose the original documents due to either theft or negligence as uploaded in online
application. Failure to present the original document as uploaded in online application on account of loss of
documents will lead to cancellation of candidature. I understand that no request in this regard will be entertained by
ICG even if I produce an F.I.R. w.r.t. theft of my documents and my candidature will stand cancelled.
v. I have completely checked the print preview of the application and I certify that my application is correct in all aspects
as per the advertisement. I have gone through the common reasons for rejection as published on the website and I
certify that my application is correct and does not fall for rejection in document verification as per the rules prescribed
in the advertisement for Stage-I, II & III as published on the website.
w. I declare that the form is filled by myself and not any other person, and for any mismatch/wrong
information/incorrect photo/signature/thumb image uploads, I will be responsible. I am aware that, my candidature
can be Cancelled, in case of any mismatch/wrong information.

Candidate Upload Candidate Signatue Verified by (ICG Candidate Signatue Verified by (ICG
Signature for Stage II Officer) at Stage II for Stage III Officer) at Stage III

STAMP STAMP

Name: Name:

Rank: Rank:

Note:- Candidate will have to bring the same application form which is verified at Stage II by ICG while reporting at INS
Chilka Stage III or else the candidature will be cancelled.
STAGE-I UPLOADED DOCUMENT : ID PROOF (AADHAAR CARD)
STAGE-I UPLOADED DOCUMENT : DATE OF BIRTH PROOF (10TH CLASS
MARKSHEET/CERTIFICATE)
COMMON REASONS FOR REJECTION DURING DOCUMENT VERIFICATION
COMMON REASONS FOR REJECTION DURING DOCUMENT VERIFICATION
COMMON REASONS FOR REJECTION DURING DOCUMENT VERIFICATION

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