HARYANA STAFF SELECTION COMMISSION
One Time Registration Details CET-'C'-01/2025
Acknowledgement
CET-'C' ID 2025
20250870664
Full name as per matriculation SUMAN
Father's name SHANTI SWAROOP
Mother's name KAMLESH
Date of birth as per matriculation 19-01-1992
Gender FEMALE
Marital status MARRIED
Email ID tushar094@gmail.com
Mobile No. 7015495317
Aadhaar number 709130264881
Identification marks 1 MOLE ON FACE
Identification marks 2 MOLE ON FACE
Have you participated in the CET 01/2022 NO
PARIVAR PEHCHAN PATRA (PPP) Details
PPP NO 4YYF6244
Member ID YIZP1707
Form filled by candidate
Have you filled the form by yourself? YES
Address Information
Correspondence Address Permanent Address
WARD NO-5 DEV
WARD NO-5 DEV COLONYJHAJJAR
Address Address COLONYJHAJJAR NEAR NEHRU
NEAR NEHRU CRICKET STADIUM
CRICKET STADIUM
Village/City/Sector JHAJJAR Village/City/Sector JHAJJAR
Post office JHAJJAR Post office JHAJJAR
State HARYANA State HARYANA
District JHAJJAR District JHAJJAR
Pin code 124103 Pin code 124103
Category Information
Are you a Domicile/ Bonafide resident of Haryana ? YES
Domicile certificate number HR/2020/567
Domicile certificate issue date 2020-01-28
Signature of the Candidate
HARYANA STAFF SELECTION COMMISSION
One Time Registration Details CET-'C'-01/2025
Domicile certificate issuing authority name TEHSILDAR JHAJJAR
Category GEN
Have you worked or presently working on
adhoc/contract/workcharged/ daily wages basis in any
Department/ Board Corporation of Haryana Government NO
including Government-aided lnstitutions under Haryana
Government ?
Are you an Ex-Serviceman/Family Member of Ex-Serviceman? NO
Are you a dependent of freedom fighter (DFF)? NO
Are you a PWD (Person with Benchmark Disability) Candidate NO
Are you an eligible sports person (ESP)? NO
Do you have any criminal case against you? NO
Education Qualification
% of
Examination Course Board/university Year of
Duration Stream Rollno Marks/
Passed Type Name passing
CGPA
CENTRAL
BOARD OF
10TH - - - 2007 6166233 58
SECONDARY
EDUCATION
CENTRAL
12TH BOARD OF NON
- - 2009 6259991 51
COMPLETED SECONDARY MEDICAL
EDUCATION
Payment Details
Transaction ID Paid Amount Date & Time
134667122 250 12/06/2025 18:12:41
Uploaded Documents
• Photo Uploaded
• Signature Uploaded
• Aadhaar Uploaded
• Undertaking as per annexure -VII Uploaded
• Domicile Certificate Uploaded
• 10th or Matriculation certificate Uploaded
• 12th completed Uploaded
• Scanned copy of Parivar Pehchan Patra Uploaded
Declaration
I declare that all the information and particulars filled in this application are true, complete, and correct to the best of my
knowledge and belief. I understand that any misrepresentation, omission or concealment of facts may lead to the
cancellation of my candidature at any stage of the recruitment process or termination of my employment, if appointed
Uploaded Signature Acknowledgement Generated Date & Time
Signature of the Candidate
HARYANA STAFF SELECTION COMMISSION
One Time Registration Details CET-'C'-01/2025
12-06-2025 18:14:30
Signature of the Candidate
