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Application Form

The document is an application form for the recruitment of Assistant Sub Inspector and Head Constable positions in Central Armed Police Forces and Assam Rifles for the year 2024. It includes personal details, qualifications, physical standards, and preferences for the candidate, PAL RAJEEV RANJAN RAJKUMAR. The application has been submitted with payment confirmed and includes declarations regarding the accuracy of the information provided.

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0% found this document useful (0 votes)
24 views5 pages

Application Form

The document is an application form for the recruitment of Assistant Sub Inspector and Head Constable positions in Central Armed Police Forces and Assam Rifles for the year 2024. It includes personal details, qualifications, physical standards, and preferences for the candidate, PAL RAJEEV RANJAN RAJKUMAR. The application has been submitted with payment confirmed and includes declarations regarding the accuracy of the information provided.

Uploaded by

y7710848
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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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 : Combat0500016842 Application : Submitted Payment : Paid


No / आवेदन संख्या Status / आवेदन Status / भुगतान
की स्थिति की स्थिति

Personal Information

Candidate's Name / : PAL RAJEEV RANJAN RAJKUMAR Mobile No. / मोबाइल संख्या : 84******91
प्रत्याशी का नाम

Email Id / इ-मेल आई. डी : raju89******[at]gmail[dot]com

Identity Details

Aadhar No / आधार संख्या : xxxxxxxx9488

Additional Information

Date of Birth / : 05-10-1996 Age / आयु : 27 Years, 9 Months, 27 Nationality / : INDIAN


जन्मतिथि Days राष्ट्रीयता

Father Name / : RAJKUMAR PAL Mother's : REETA RAJKUMAR PAL Permanent : CUT OF HEAD
पिता का नाम Name / माता का Identification
नाम Mark on Body /
शरीर पर स्थायी
पहचान चिह्न

Gender / लिंग : MALE Marital Status / : UNMARRIED Do you have : Yes


वैवाहिक स्थिति domicile
certificate?

Domcile issuing : BIHAR Domicile : BRCCO/2021/9743994


state certificate
number

Category Reservation

Religion / धर्म : Hindu Category / श्रेणी : OBC Do you belong : Yes


Non-creamy
Layer? / क्या आप
नॉन क्रीमी लेयर से
सम्बंधित है?

Certificate : BOBCCO202415700 Certificate : BIHAR Certificate : Bhojpur


Number / प्रमाण Issuing State / Issuing
पत्र संख्या प्रमाणपत्र जारी करने District /
वाले राज्य का नाम
प्रमाणपत्र जारी करने
वाले जिला का नाम

Certificate : Tehsildar Certificate Issuing Date / प्रमाणपत्र : 13-02-2024


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 : RAJKUMAR PAL PINCODE / पिन : 802158 State/UT / राज्य : BIHAR


Address / स्थायी KAHATHU JAGDISHPUR कोड / कें द्रीय शासित प्रदेश
पता

District / जिला : Bhojpur Village/City / गांव / शहर : KAHATHU

Police Station / : JAGDISHPUR Post Office / : KAHATHU Tehsil / तहसील : JAGDISHPUR


पुलिस स्टेशन डाक-घर

Correspondence Address Details

Correspondence : A10 DIVYA NAGAR PINCODE / पिन : 382405 State/UT / राज्य : GUJARAT
Address / NEAR RANGOLI NAGAR कोड / कें द्रीय शासित प्रदेश
पत्राचार पता NAROL

District / जिला : Ahmedabad Village/City / गांव / शहर : AHMEDABAD

Police Station / : NAROL Post Office / : NAROL Tehsil / तहसील : AHMEDABAD


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) : 165.00 Chest (Male only) / छाती : 79
(के वल पुरुष) (in cms)

Weight / वजन (in Kgs) : 58

Qualifications Details

Qualification : SSC/Matric/High School Certificate : 1132883 Year / वर्ष : 2011


Type / योग्यता No. / प्रमाण पत्र
प्रकार संख्या

State / राज्य : GUJARAT Board/University : State Board


/ बोर्ड /
विश्वविद्यालय

Qualification : Intermediate(10+2) Certificate : G0183257 Year / वर्ष : 2013


Type / योग्यता No. / प्रमाण पत्र
प्रकार संख्या

State / राज्य : GUJARAT Board/University : State Board


/ बोर्ड /
विश्वविद्यालय

Qualification : Graduate Certificate : 0497221 Year / वर्ष : 2016


Type / योग्यता No. / प्रमाण पत्र
प्रकार संख्या

State / राज्य : GUJARAT Board/University : Gujarat University,


/ बोर्ड / Navarangpura,
विश्वविद्यालय Ahmedabad

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 : other candidates.

Force Preference

Force Preference 1 : Central Industrial Security Force (CISF)

Force Preference 2 : Central Reserve Police Force (CRPF)

Force Preference 3 : Boarder Security Force (BSF)

Force Preference 4 : Indo Tibetan Boarder Police (ITBP)

Force Preference 5 : Assam Rifles (AR)

Force Preference 6 : Sashastra Seema Bal (SSB)


Certificate & Document

Photo Signature SSC/Matric/High School Certificate

Intermediate(10+2) Certificate Graduate Certificate Caste Certificate

Qualification Document

Transaction Details

Date : 08-07-2024 15:39:29 Gateway : HDFC Transaction Id :


844ae1707c4dd0155ec8

Gateway : 113366402401 Amount : 147.20 Status : PAID


Transaction Id

Centre Preference

Date : 08-07-2024 Place : AHMEDABAD Centre : Gandhinagar-BSF


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

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