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UNION PUBLIC SERVICE COMMISSION

DETAILED APPLICATION FORM - II
CIVIL SERVICES EXAMINATION, 2024
[To be filled online by candidates qualified for Personality Test / Interviews]

RID. : 12413048401
Roll No. : 0327311
Name : MANOJ G S
Email : manojgshekar2017@gmail.com
Mobile : 7899401223

1. Mother tongue : | KANNADA

2. (a) Address for correspondence to which | GURJENAHALLI SAKLESHPUR

Communication is to be sent |
Post Office: | KUMBARADI
City: | SAKLESHPUR
District: | HASSAN
State : | KARNATAKA
Pin Code : | 573134
(b) Telephone No. (with STD Code) | -
(c) Mobile No. | 7899401223
(c.1) Alternate Mobile No. |
(d) Fax No. |
(e) E-mail address | MANOJGSHEKAR2017@GMAIL.COM
(f) Permanent Postal Address | GURJENAHALLI SAKLESHPUR
|
Post Office: | KUMBARADI
City: | SAKLESHPUR
District: | HASSAN
State : | KARNATAKA
Pin Code : | 573134

(g) Do you possess Aadhaar card? | YES

(h) Aadhaar card No. | 641417053712
(i) Do you possess PAN card? | YES
(j) Pan card No. | MDTPS9861D

3. Place of Birth :
If born in India: | YES
Post Office |
City/Town/Village | SAKLESHPUR
District | HASSAN
State | KARNATAKA

Roll No. :- 0327311 |

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Pincode | 573134

4. Marital Status : | UNMARRIED

(If Married, Nationality of spouse) |

5. (a) Have you ever been recommended as a | NO

PwBD candidate in the examinations
conducted by the UPSC in the past?

(b). If yes, mention name and year of the examination(s) with Roll No.
Name of the Examination Year of the Roll No.
Examination

(c) Whether such recommendation was on | NO

the basis of the Certificate of Disability
NOW UPLOADED by you for the
CS(M) Exam, 2024?
(d) After any such recommendation by the | NO
UPSC were you ever found UNFIT/
NOT RECOMMENDED by the Central
Standing Medical Board or any other
Medical Board constituted by the
Government with regard to your
physical disability?
(e) If yes, provide details thereof |

6. (a) Name of Father | SOMASHEKAR G K

(a.1) Status | ALIVE
(b) Name of Mother | THIRTHAVATHI
(b.1) Status | DECEASED
(c) Nationality of Father | INDIAN
(d) Nationality of Mother | INDIAN
(e) Father's Profession: | AGRICULTURE
(f) Does your Father possess Aadhaar card?| YES
(g) Aadhaar card of your Father | 691054732978
(h) Does your Father possess PAN card? | YES
(i) Pan card of your Father | KQAPS2412A
(j) Mother's Profession: | DECEASED
(k) Does your Mother possess Aadhaar card? | NO
(l) Aadhaar card of your Mother |
(m) Does your Mother possess PAN card? | NO
(n) Pan card of your Mother |
(o) If Father is in service, post held by him | NOT APPLICABLE
(o)(i) if retired indicate the post held
by him at the time of his retirement,
otherwise fill 'NOT APPLICABLE' | NOT APPLICABLE
(p) If Mother is in service, post held by her | NOT APPLICABLE
(p)(i) if retired indicate the post held
by her at the time of her retirement,
otherwise fill 'NOT APPLICABLE' | NOT APPLICABLE
(q) Annual income of your Father | RS.50000
(r) Annual income of your Mother | RS.0

Roll No. :- 0327311 |

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(s) State to which your Father originally | KARNATAKA
belongs
(t) District to which your Father originally | HASSAN
belongs
(u) State to which your Mother originally | KARNATAKA
belongs
(v) District to which your Mother originally| HASSAN
belongs
(w) Father's present postal Address | GURJENAHALLI
(If deceased give last address) |
Post Office: | KUMBARADI
City: | SAKLESHPUR
District: | HASSAN
State : | KARNATAKA
Pin Code : | 573134
(x) Mother's present postal Address | GURJENAHALLI
(If deceased give last address) |
Post Office: | KUMBARADI
City: | SAKLESHPUR
District: | HASSAN
State : | KARNATAKA
Pin Code : | 573134

(y) Whether your family owns or possesses

any of the following assets.
i. 5 acres of agricultural land and above;
ii. Residential flat of 1000 sq ft. and above;
iii. Residential plot of 100 sq. yards and
above in notified municipalities;
iv. Residential, plot of 200 sq. yards and
above in areas other than the notified
municipalities. | NO

7. Educational Qualifications : Commencing with Matriculation or equivalent examination till Graduation:-

Examination Class/ Percentage CGPA Year of Subject(s) Name of Name of

Passed Division of Score Out of School/College Board/University
/Grade Marks(%) Passing /Institution
10th or Equivalent X 10 10 2017 ENGLISH JAWAHAR CBSE
KANNADA NAVODAYA
MATHEMATICS VIDYALAYA
SCIENCE SOCIAL HASSAN
SCIENCE HINDI KARNATAKA
12th or Equivalent XII 95.00 2019 PHYSICS JAWAHAR CBSE
MATHEMATICS NAVODAYA
CHEMISTRY VIDYALAYA
BIOLOGY HASSAN
ENGLISH KARNATAKA
Stream at Graduation Level :-- ENGINEERING
B. TECH. ECE 75.1 2023 ELECTRONICS NATIONAL NATIONAL
AND INSTITUTE OF INSTITUTE OF
COMMUNICATION TECHNOLOGY TECHNOLOGY,
ENGINEERING SURATHKAL SURATKAL,

Roll No. :- 0327311 |

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KARNATAKA KARNATAKA

8. Higher Educational Qualifications : Commencing with Post Graduation or equivalent examination :-

Examination Class/ Year of Date of Likely date CGPA Percentag Subject(s) College/Institution Board/
Passed/ Division Passing Joining of Score Out of e University
Appeared/ /Grade Completion of
Appearing Marks(%)

9. Having regard to answers given against

columns 1, 3, 6, 7 & 8 which is the State
/Union Territory that you would claim
as your home State/U.T. | KARNATAKA
Note: Having regards to the answers given against columns related to Mother Tongue, Place of Birth,
Parental Details, Educational Qualifications & Higher Educational Qualifications please indicate the
State/Union Territory which you want to claim as your home State/U.T.

10.(i) Have you ever been employed? : | NO

10.(ii) Have you been self-employed?: | NO

11. Have you ever been debarred by

the UPSC from any of its
Examinations/Selections? | NO

12. Whether you have ever applied for

U.P.S.C. Examination /Recruitment
(Excluding Current Examination): - | YES
Details of other application for Examination/Recruitment held/to be held by UPSC :-
Name of Examination/Post Month and Roll. No. Whether Whether Whether you Whether you Whether
year of appeared at appeared at were recomm havejoined/a continuing
Examination the the Interview ended for ppointed till date or re
/Advt. Examination appointment signed(with
No./Item No. date)
for
Recruitment
CIVIL SERVICES (MAIN) 2023 SEPTE 7303613 YES NO
MBER

13. Have you ever accepted allocation

to a Service/Post on the basis
of Civil Services Examination
held in earlier years? | NO
(a). Year of the Civil Services
Examination on the basis of which
you had been last allocated to
service/post |
(b). Name of service/post to which
allocated |
(c). Your Roll No. for the examination |

Roll No. :- 0327311 |

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(d). Whether you were appointed/joined
Service? |

(e). Whether you are continuing in that

Service/Post? |

(f). If you have resigned from such post/service

Mention date of acceptance of the resignation
by the Competent authority |

14. Please give Particulars at the University/State/National Level in respect of:-

(a)Prizes, Medals, Scholarships etc. | 1. FIRST PLACE IN STATE-LEVEL ESSAY

WRITING COMPETITION BOOKBRAHMA 2.
INDIAN NATIONAL MATHEMATICS
OLYMPIAD PARTICIPANT
(b) Sports/N.C.C. etc. | 1. GOLDEN RANK AND BEST CADET, NCC
GROUP BATTALION. 2. NCC C CERTIFICATE
WITH ALPHA GRADE
(c) Position(s) of distinction Leadership held in | 1. LED TWO EDUCATIONAL INITIATIVES AT
School/College THE COLLEGE LEVEL - BEACH SCHOOL AND I-
CARE. 2. CHIEF COORDINATOR AND
OPERATIONS HEAD, INCIDENT 2023.
(d) Other extracurricular activities and interests (Such | 1. PLAYING CHESS 2. WATCHING
as hobbies etc.) BIOGRAPHICAL MOVIES 3. PRACTICING
CALISTHENICS

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15. (A)Indicate below your order of preference for Zone and State Cadre within zones for which you would like to be
considered for allotment in case you are selected for Indian Administrative Service. No change in preference of Zones and
Cadres once submitted by a candidate would be permitted. [Refer Rule 14(3) of the Rules of CSE, 2024].

Note 1 : For allocation to Home cadre against an Insider vacancy, a candidate is mandatorily required to click 'Yes'
otherwise he/she shall not be considered for his/her Home cadre at all in case he/she opted 'No'.
Note 2 : Candidates are advised to visit the website of Department of Personnel & Training at the link
https://cseplus.nic.in/Home/CadreAllocation for perusing the Cadre Allocation Policy-2017. They are also advised to
go through the details of the Cadre Allocation Policy 2017 extremely carefully before submitting their preference for
Zones as well as Cadres thereunder. The preferences once opted and submitted cannot be modified or changed at a
later stage. Therefore, the candidates are advised to exercise due diligence while filling up the preferences for Zones
as well as Cadres thereunder.
Note 3 : A candidate claiming benefit of reservation under Persons with Benchmark Disabilities quota has an
additonal option to indicate his/her preference for any one state/cadre(other than Home cadre) of his/her first
preferred Zone as per the para 5 of Cadre Allocation Policy issued vide OM no. 13013/2/2016-AIS.I dated 5.9.2017.

Whether you want to consider your Home State Karnataka as your first preference as Home Cadre? - YES

Zones(with Order of Order of Preference for State Cadre within Zone

State Cadres) preference for
Zones
Zone I 4 AGMUT Haryana Himachal Punjab Rajasthan Uttarakhand
Pradesh
2 3 5 4 1 6
Zone II 3 Bihar Jharkhand Odisha Uttar
Pradesh
4 3 2 1
Zone III 2 Chhattisgarh Gujarat Madhya Maharastra
Pradesh
4 3 2 1
Zone IV 5 Assam- Manipur Nagaland Sikkim Tripura West Bengal
Meghalaya
1 6 5 4 3 2
Zone V 1 Andhra Karnataka Kerala Tamil Nadu Telangana
Pradesh
3 1 5 4 2

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15. (B)Indicate below your order of preference for Zone and State Cadre within zones for which you would like to be
considered for allotment in case you are selected for Indian Police Service. No change in preference of Zones and Cadres
once submitted by a candidate would be permitted. [Refer Rule 14(3) of the Rules of CSE, 2024].

Note : For allocation to Home cadre against an Insider vacancy, a candidate is mandatorily required to click 'Yes'
otherwise he/she shall not be considered for his/her Home cadre at all in case he/she opted 'No'.

Whether you want to consider your Home State Karnataka as your first preference as Home Cadre? YES

Zones(with Order of Order of Preference for State Cadre within Zone

State Cadres) preference for
Zones
Zone I 4 AGMUT Haryana Himachal Punjab Rajasthan Uttarakhand
Pradesh
2 3 5 4 1 6
Zone II 3 Bihar Jharkhand Odisha Uttar
Pradesh
4 3 2 1
Zone III 2 Chhattisgarh Gujarat Madhya Maharastra
Pradesh
4 3 2 1
Zone IV 5 Assam- Manipur Nagaland Sikkim Tripura West Bengal
Meghalaya
1 6 5 4 3 2
Zone V 1 Andhra Karnataka Kerala Tamil Nadu Telangana
Pradesh
3 1 5 4 2

Roll No. :- 0327311 |

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16. Your order of preference against the Services/Posts given below , for which you would like to be
considered for appointment.
Note 1 : It is clarified that the below order of services does not reflect their relative importance in the eyes of the
Government and the candidates are advised to use their own discretion while indicating preference for various
services.
Note 2: A candidate shall be required to mandatorily indicate order of preferences only for those services
participating in the Civil Services Examination for the year, for which he is interested to be allocated to. No
change in preferences for Services once submitted by a candidate would be permitted . In case preference for
none of the Services is indicated, the candidate will not be considered for Service Allocation [Refer Rule 14(2)
of Rules of CSE, 2024].
Note 3: The services which are not required to be opted have been shown as 'NOT OPTED.'
Note 4: A candidate who is appointed to the Indian Police Service on the basis of the results of an earlier
examination and continues to be a member of that service shall not be eligible to opt for the Indian Police
Service in Civil Services Examination, 2024.

S.N. Name of Services/Post Order of Preference

1. Indian Administrative Service 01
2. Indian Foreign Service 05
3. Indian Police Service 02
4. Indian Audit and Accounts Service, Group "A" 06
5. Indian Civil Accounts Service ,Group "A" 14
6. Indian Corporate Law Service ,Group "A" 11
7. Indian Defence Accounts Service ,Group "A" 15
8. Indian Defence Estates Service, Group "A" 9
9. Indian Information Service, Group "A" 8
10. Indian Postal Service,Group "A" 13
11. Indian Post & Telecommunication Accounts and Finance Service, Group "A" 12
12. Indian Railway Protection Force Service, Group "A" 16
13. Indian Railway Management Service, Group "A" 7
14. Indian Revenue Service (Customs & Indirect Taxes) Group "A" 3
15. Indian Revenue Service, (Income Tax) Group "A" 4
16. Indian Trade Service, Group "A" (Gr. III) 10
17. Armed Forces Headquarters Civil Service , Group 'B'(Section Officer's Grade) 20
18. Delhi , Andaman and Nicobar Islands, Lakshadweep, Daman & Diu and Dadra & 17
Nagar Haveli Civil Service (DANICS), Group "B"
19. Delhi , Andaman and Nicobar Islands, Lakshadweep, Daman & Diu and Dadra & 19
Nagar Haveli Police Service (DANIPS), Group "B"
20. Pondicherry Civil Service (PONDICS), Group "B" 18
21. Pondicherry Police Service (PONDIPS), Group "B" 21

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17. Do you want make available your Personal

Information for accessing job opportunity in
terms of DoP&T's O.M. No. 39020/1/2016
-Estt.(B) dated 21.06.2016 & 19.07.2017? | YES

Note: As per policy notified by the Government and decision taken by the Commission, information of
candidates who appeared in the final stage of Examination (Interview) but not recommended, will be
made accessible to any registered private company, Public Sector Undertaking, Statuary and Autonomous
organisations of Government of India on the dedicated portal on the website of the Commission to identify
suitable candidates in line of their requirements for providing employment. Short biodata of the
candidates with their educational qualifications, contact numbers, details including their percentile
(not absolute or percentage marks), etc will be made accessible on this dedicated portal. These
list will be made available after the Reserve List is utilized/exhausted after declaration of final
result. It may be noted that there is no option for partial disclosure and choice once opted cannot
be change.

18. List of documents uploaded by the candidate:

Roll No. :- 0327311 |

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DETAILED APPLICATION FORM - II

DECLARATION

1. I have carefully read all the provisions under the Civil Services Examination Rules, 2024 and the guidelines for
filling up this Detailed Application Form-II and understand the same.

2. I, hereby declare that all the entries made in all the columns of this Detailed Application Form-II are my
conscious decision and I shall not request subsequently for any change in the order of preferences for the services
and the preferences for Zones/Cadres submitted by me in this Application Form.

Signature of the Candidate

Place : Name : MANOJ G S

Date : Roll No. : 0327311
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EWS ANNEXURE

1. Name of the Candidate | MANOJ G S

2. Roll No | 0327311

3. Income Details
Relations Name of Date of PAN No. Profession Name and Annual income of the Whether
hip with Candidate and Birth Address of candidate and his family the
the his/her Family Employer members for the financial candidate
candidate members year 2022-2023 from all and their
sources i.e. salary, family
agriculture, business, members,
profession, other sources etc. whose
names
are
(ii) mentione
d in Col.
3(ii) file
ITRs
(iii) (iv) (v) (viii)
(i)
(vi) (vii)
FATHER SOMASHEKAR G 01-01-74 KQAPS2 AGRICUL NIL SALARY :0 NO
K 412A TURIST AGRICULTURE : 50000
BUSINESS :0
PROFESSION :0
OTHER SOURCE : 0
TOTAL INCOME : 50000
TOTAL FAMILY INCOME : 50000

4(A) Whether the family# of the candidate owns | YES

or possesses agricultural land
# family for this purpose will include the person
who seek benefits of reservation, his/her
parents, and siblings below the age of 18 years
as also his/her spouse and children below the
age of 18 years.

(B) If yes,

(i) Whether the agricultural land held by the | NO

family of the candidate is equal to or more than 5
acres

(ii) Area of the agricultural (irrigated as well |

as un-irrigated) land owned family of the candidate
Note:- If answer to 4(B)(i) is ‘Yes’: The
candidate must mention clearly how many acres
of land are held by him and his family members
separately and also the total area of the

Roll No. :- 0327311 |

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agricultural land.. Eg. Father – 3 acres, Mother-
2 Acres, Brother [Name]-1 Acre, Total – 6 acres
etc.

(iii) Address of agricultural (irrigated as well |

as un-irrigated) land owned by family of the
candidate
# Note:- Complete Address including
location[village, Block, Tehsil, District, State
etc.] of all agricultural (irrigated as well as un-
irrigated) land owned by family of the candidate
must be mentioned separately.

5(A) Whether the family# of the candidate own | NO

residential flat(s) of 1000 Sq. ft. and above
# family for this purpose will include the person
who seek benefits of reservation, his/her
parents, and siblings below the age of 18 years
as also his/her spouse and children below the
age of 18 years.

(B) Area of the residential flat(s)# owned by the |

family of the candidate
# Note:- If answer to 5(A) is yes:- The candidate
must mention the area of all flats owned by the
family of the candidate separately. For eg. Flat 1:
1200 Sq. ft., Flat 2:- 800 Sq. ft. etc.

(C) Address of residential flat(s)# owned by the |

family of the candidate
# Note:- Complete Address[village, Block, Tehsil,
District, State etc.] of all flat(s) owned by the
family of the candidate must be mentioned
separately. For eg. Flat 1:- ABC Colony, XYZ
State; Flat 2: PQR Colony, STU State etc.

6(A) Whether the family# of the candidate own | NO

residential plot(s) of 100 Sq. yards and above in
notified municipalities
# family for this purpose will include the person
who seek benefits of reservation, his/her parents,
and siblings below the age of 18 years as also
his/her spouse and children below the age of 18
years.

(B) Area of the residential plot(s)# owned by the |

family of the candidate
# Note:- If answer to 6A is ‘Yes’: The candidate
must mention the area of all residential plot(s)
owned by the family of the candidate separately.
For eg. Plot 1: 150 Sq. yards., Plot 2:- 80 Sq.
Yards. etc.

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(C) Address of residential plot(s)# owned by the |
family of the candidate
# Note:- Complete Address[village, Block, Tehsil,
District, State etc.] of all plot(s) owned by the
family of the candidate must be mentioned
separately. For eg. Plot 1:- ABC Colony, XYZ
State; Plot 2: PQR Colony, STU State etc.

7(A) Whether the family# of the candidate own | NO

residential plot(s) of 200 Sq. yards and above in
areas other than notified municipalities
# family for this purpose will include the person
who seek benefits of reservation, his/her parents,
and siblings below the age of 18 years as also
his/her spouse and children below the age of 18
years.

(B) Area of the residential plot(s)# owned by the |

family of the candidate in areas other than notified
municipalities
# Note:- If answer to para 7A is ‘Yes’: The
candidate must mention the area of all
residential plot(s) owned by the family of the
candidate in areas other than notified
municipalities separately. For eg. Plot 1: 150 Sq.
yards., Plot 2:- 80 Sq. Yards. etc.

(C) Address of residential plot(s)# owned by the |

family of the candidate in areas other than notified
municipalities
# Note:- Complete Address[village, Block, Tehsil,
District, State etc.] of all plot(s) owned by the
family of the candidate in areas other than
notified municipalities should be mentioned
separately. For eg. Plot 1:- ABC Colony, XYZ
State; Plot 2: PQR Colony, STU State etc.

8. Any other relevant information the candidate |

wish to submit relating to his/her EWS status

Roll No. :- 0327311 |

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UNDERTAKING

I MANOJ G S son/daughter of Shri SOMASHEKAR G K Resident of village/town/city

GURJENAHALLI KUMBARADI SAKLESHPUR district HASSAN state KARNATAKA Pin Code
573134 hereby declare that I belong to Economically Weaker Section(EWS) Category . It is also declared
that I have read and understood the instructions mentioned in the Ministry of Social Justice &
Empowerment’s O.M. No.20013/01/2018-BC-II dated 17.01.2019, Department of Personnel & Training’s
O.M.s No.36039/1/2019-Estt.(Res.) dated 19.01.2019 and 31.01.2019 and I have reason to declare that I fall
under Economic Weaker Section(s) and eligible in all respects for getting reservation under EWS quota in
direct recruitment in civil posts and services in the Government of India.

DECLARATION OF EWS ANNEXURE

Information furnished above is true to the best of my knowledge and I have not concealed any relevant information. The
same information was submitted before the ‘Income and Asset Certificate’ issuing authority for getting this certificate and
availing myself of this benefit of reservation under EWS category. I swear that if it is found at any stage the information
furnished by me is false or that I have concealed some relevant information, I will forfeit the claim for appointment to any
service on the basis of Civil Services Examination 2024 and also be liable for all or any civil or criminal proceedings under
the law of the land.

Place: (Signature of the Candidate)

Date: Name of Candiate: MANOJ G S

Roll No. : 0327311

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