Candidate User / Registration ID:                          OP00168900
Post Applied For:                                          S.I. POLICE , S.I. POLICE (ARMED) , ASST. JAILOR,
                                                           STATION OFFICERS (FIRE SERVICE)
Personal Details
Candidate Name:               ANKIT KUMAR BISHOYI
Date of Birth:                04/01/2002
Father’s Name: (As
recorded in 10th class        JAYADEVA BISHOYI
certificate )
Mother’s Name : (As
                              MITA RANI BISHOYI
recorded in 10th class
certificate )
Gender:                       MALE
Email ID:                     ankitkumarbishoyi123@gmail.com
Mobile Number:                7789974883                   Aadhar Card Number:           819741360369
Category:                     UNRESERVED (UR)              Special Category:             NOT APPLICABLE
Religion:                     HINDU                        Nationality:                  INDIAN
Permanent Address                                          Present Address
JAYADEV BIHAR, BHANJANAGAR                                 JAYADEV BIHAR, BHANJANAGAR
District: GANJAM                                           District: GANJAM
Village/Town/City:                                         Village/Town/City:
                                  PIN code: 761126                                         PIN code: 761126
BHANJANAGAR                                                BHANJANAGAR
State: ODISHA                     Country: INDIA           State: ODISHA                   Country: INDIA
                                        Employment Details (if applicable)
Criteria                                                                                          Response
Are you presently in Govt. Service ?                                                                 NO
Name of the Employer ?                                                                               ---
Name of the Office ?                                                                                 ---
Selected status of availing “No Objection Certificate” ?                                             ---
Selected Defence Services Wherein Served/Serving ?                                                   ---
Selected Defence Services Retirement Status ?                                                        ---
Date of Joining :                                                                          ---
Date of Discharge :                                                                        ---
Period of Service rendered in Armed Forces ?                                               ---
Are you to retire within six months from the last date of submission of application ?      ---
Reference No of your NOC ?                                                                 ---
Date of issue :                                                                            ---
Name of issuing Authority ?                                                                ---
I hereby declare that I have not utilized the benefit of Ex-Serviceman for employment
purpose till date either in State Govt./Central Govt. or any Govt. undertaking             ---
organization.
                                                           OR
I hereby declare that at present I am under employment under State Govt./Central
Govt. or any Govt. undertaking organization and I have already utilized under the
                                                                                           ---
benefit of Ex-Serviceman. My candidature for the said post may be considered on
merit under own category i.e UR / SEBC / SC / ST if applicable.
                                                  Other Information
Criteria                                                                                Response
Whether the candidate possesses NCC Certificate?                                          NO
Type of NCC certificate.
                                                   Marriage Details
Whether the candidate is married?                                                         NO
Whether he/she has more than one spouse living?                                            ---
Is it permissible under the personal law ?                                                 ---
Whether the candidate is involved in any criminal case ?                                  NO
Whether any FIR has been lodged or registered ?                                            ---
Case Number ?                                                                              ---
Name of the Police Station where case is registered ?                                      ---
Name of the district ?                                                                     ---
Under section ?                                                                            ---
Whether any prosecution is pending in any court of law against you ?                      NO
Whether any charge-sheet has been filed against you ?                                      ---
Have you convicted for any criminal offence ?                                              ---
                                       Sports Person Details (if applicable)
Criteria                                                                                Response
Does the candidate possess the identity card for Sports person issued by director of
Sports, as per Resolution No. 24808 / Gen.Dt.18th Nov.1985 of G.A Department, as           ---
amended from time to time?
I Card reference Number :                                                                  ---
Date of Issue :                                                                                             ---
Name of issuing Authority ?                                                                                 ---
                                                 Educational Details
         Level of Education                     Name of the               Passing Year               Result Status
                                               Subject/Stream
HIGH SCHOOL CERTIFICATE (CLASS                 HSC/EQUIVALENT                  2017                       PASS
10TH)/ EQUIVALENT
COUNCIL OF HIGHER SECONDARY                         SCIENCE                    2019                       PASS
EDUCATION (+2)/ EQUIVALENT
GRADUATION                                       ENGINEERING                   2024                       PASS
Have you passed Odia language subject ?                                                                    YES
                                                                                               Have passed the written
                                                                                              test in Odia in M.E. School
Selected Odia language eligibility standard as applicable.                                    standard conducted by the
                                                                                                 Board of Secondary
                                                                                                   Education,Odisha
Language proficiency: Odia language                                                                 Read, Write, Speak
                                           Selected Preferred Post Option
Preferred Post Option 1                                                               S.I. POLICE
Preferred Post Option 2                                                   STATION OFFICERS (FIRE SERVICE)
Preferred Post Option 3                                                               ASST. JAILOR
Preferred Post Option 4                                                           S.I POLICE (ARMED)
                                   Selected Preferred Test Center City Location
Preferred Test City Location 1                                                      BHUBANESWAR
Preferred Test City Location 2                                                        BERHAMPUR
Preferred Test City Location 3                                                  GANJAM (CHATRAPUR)
Note : Please note that while allocating centers to appear the test, attempts shall be made to allocate you to the
centers of your preference. However, in case of emergencies or unavoidable circumstances and non-availability of the
sufficient test centers allocation shall be done in other centers based on availability of such centers at the sole
discretion of the board.
Declaration- I do hereby solemnly declare that I have carefully read the instructions and rules as mentioned in the
recruitment advertisement of the Board and I fulfill all the conditions of eligibility prescribed for admission to the
examination. I further declare that all the statements made in the application are true, complete and correct to the
best of my knowledge and belief. Copies of the documents uploaded are genuine and relevant. I undertake that in
case of any such information or uploaded documents are found to be incorrect, false or irrelevant during or after the
selection process, my candidature / selection for the post will be cancelled and I shall be liable to penal action as per
law. I accept all the terms and conditions as mentioned in the advertisement and the recruitment rules notified by
Government.
Place:                 BHANJANAGAR
Date:                  10-Feb-2025 18:01:55
                                                                                               ANKIT KUMAR BISHOYI