Direct Recruitment of Assistant Sub Inspector (Stenographer/Combatant Stenographer) & Head
Constable (Ministerial/Combatant Ministerial) in Central Armed Police Forces (CAPFs) and Warrant Officer
                                    (Personal Assistant) & Havildar (Clerk) in Assam Rifle Examination -2024
                                                                   Application Form
Post Details
Applied Post / एप्लाइड पोस्ट                          : Head Constable (Ministerial/Combatant Ministerial) and Havildar (Clerk)
Application         : Combat0000472216       Application         : Submitted                   Payment            : Paid
No / आवेदन                                   Status / आवेदन                                    Status / भुगतान
संख्या                                       की स्थिति                                         की स्थिति
Personal Information
Candidate's Name /             : POLAKI BHANUPRAKASH                    Mobile No. / मोबाइल संख्या : 99******48
प्रत्याशी का नाम
Email Id / इ-मेल आई. डी                               : Polakib*******[at]gmail[dot]com
Identity Details
Aadhar No / आधार संख्या                               : xxxxxxxx7001
Additional Information
Date of Birth /     : 13-07-2006             Age / आयु           : 18 Years, 0 Months, 19      Nationality /      : INDIAN
जन्मतिथि                                                         Days                          राष्ट्रीयता
Father Name /       : POLAKI                 Mother's            : POLAKI CHIRANJEEVI          Permanent          : Mole on right hand
पिता का नाम         SATYANARAYANA            Name / माता का                                    Identification     thumb finger
                                             नाम                                               Mark on Body /
                                                                                               शरीर पर स्थायी
                                                                                               पहचान चिह्न
Gender / लिंग       : MALE                   Marital Status /    : UNMARRIED                   Do you have        : No
                                             वैवाहिक स्थिति                                    domicile
                                                                                               certificate?
Category Reservation
Religion / धर्म     : Hindu                  Category / श्रेणी   : OBC                         Do you belong      : Yes
                                                                                               Non-creamy
                                                                                               Layer? / क्या
                                                                                               आप नॉन क्रीमी
                                                                                               लेयर से सम्बंधित
                                                                                               है?
Certificate         : CGC230629262927        Certificate        : ANDHRA PRADESH               Certificate       : Srikakulam
Number / प्रमाण                              Issuing State /                                   Issuing
पत्र संख्या                                  प्रमाणपत्र जारी                                   District /
                                             करने वाले राज्य का                                प्रमाणपत्र जारी
                                             नाम                                               करने वाले जिला का
                                                                                               नाम
Certificate        : Tehsildar                 Certificate Issuing Date / प्रमाणपत्र    : 01-07-2023
Issuing                                        जारी करने की तिथि
Authority /
प्रमाणपत्र किसके
द्वारा जारी किया
गया
Mode of Recruitment / भर्ती का तरीका                    : Direct entry(DE)
Subcategory
Are You Ex-        : NO
Servicemen? /
क्या आप भूतपूर्व
सैनिक हैं?
Departmental /     : No
विभागीय
Permanent Address Details
Permanent          : ANDHARAPRADESH,           PINCODE / पिन       : 532429                        State/UT / राज्य / : ANDHRA PRADESH
Address / स्थायी   SRIKAKULAM, POLAKI,         कोड                                                 कें द्रीय शासित
पता                532429                                                                          प्रदेश
District / जिला    : Srikakulam                Village/City / गांव / शहर                : POLAKI
Police Station /   : POLAKI                    Post Office /       : POLAKI                        Tehsil / तहसील    : POLAKI
पुलिस स्टेशन                                   डाक-घर
Correspondence Address Details
Correspondence : ANDHARAPRADESH,               PINCODE / पिन       : 532429                        State/UT / राज्य / : ANDHRA PRADESH
Address /          SRIKAKULAM, POLAKI,         कोड                                                 कें द्रीय शासित
पत्राचार पता       532429                                                                          प्रदेश
District / जिला    : Srikakulam                Village/City / गांव / शहर                : POLAKI
Police Station /   : POLAKI                    Post Office /       : POLAKI                        Tehsil / तहसील    : POLAKI
पुलिस स्टेशन                                   डाक-घर
Other Details
Is there any criminal case pending against you.?        : No
Is Communal/Gujarat Riots?                              : No
Is Candidate who had ordinarily been domiciled in the   : No
State of Jammu & Kashmir from 01.01.1980 to
31.12.1989?
Do you have(Sport Achievement)? / क्या आपके पास खेल : No
उपलब्धि प्रमाण पत्र है?
Physical Standards
Height / ऊं चाई (in cms)    : 182.00                                       Chest (Male only) / छाती     : 98
                                                                           (के वल पुरुष) (in cms)
Weight / वजन (in Kgs)        : 66
Qualifications Details
Qualification      : SSC/Matric/High         Certificate No. /     : 2105122999                  Year / वर्ष   : 2021
Type / योग्यता     School                    प्रमाण पत्र संख्या
प्रकार
State / राज्य      : ANDHRA PRADESH          Board/University : State Board
                                              / बोर्ड /
                                             विश्वविद्यालय
Qualification      : Intermediate(10+2)      Certificate No. /     : 2301226602                  Year / वर्ष   : 2023
Type / योग्यता                               प्रमाण पत्र संख्या
प्रकार
State / राज्य      : ANDHRA PRADESH          Board/University : State Board
                                              / बोर्ड /
                                             विश्वविद्यालय
Work Experience
Are you employed? / क्या आप सेवारत है?                    : No
Qualification
Candidates must have passed Intermediate or Senior        : Yes
Secondary School Certificate (10+2) examination from
a recognized Board or University or equivalent.
Physical Standard
Physical Category / श्रेणी                                : All candidates belonging to Scheduled Tribes.
Force Preference
Force Preference 1                                        : Central Industrial Security Force (CISF)
Force Preference 2                                        : Indo Tibetan Boarder Police (ITBP)
Force Preference 3                                        : Central Reserve Police Force (CRPF)
Force Preference 4                                        : Boarder Security Force (BSF)
Force Preference 5                                        : Sashastra Seema Bal (SSB)
Force Preference 6                                        : Assam Rifles (AR)
Certificate & Document
                     Photo                                        Signature                        SSC/Matric/High School Certificate
        Intermediate(10+2) Certificate                        Caste Certificate                           Qualification Document
 Transaction Details
 Date              : 04-07-2024 14:07:27         Gateway            : HDFC                       Transaction Id     : 3f68658feb6e5879aa52
 Gateway           : 113359795037                Amount             : 147.20                     Status             : PAID
 Transaction Id
 Centre Preference
 Date              : 04-07-2024                  Place              : POLAKI                     Centre             : Hyderabad-Telengana
                                                                                                 Preference
                                                              Declaration
              1. I hereby declare and confirm that all the entries made in this application form as above are true 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 medical
examination my candidatature will stand cancelled and all my claims for the recruitment forfeited. I also understand that if at any stage I have
violated any of the rules/Regulation governing the conduct of selection process, my candidature can be cancelled or be declared to have failed
by the selection board at its sole discretion.
2.I also declare that I do not stand debarred by SSC/UPSC as on date and have never been convicted by any court of law. I also declared that
no criminal case is pending against me. Further declare that I have never been dismissed or removed from Govt Service or my service been
terminated during probation.
3.I do Hereby also opt/opt out of the disclosure scheme for making available above information filled in the application and total marks with
ranking in the merit if I stand in the final of this examination for publication in the web page of the department.
                                                                                                                             Candidate Signature