MUNICIPAL SERVICE COMMISSION
149, A.J.C. Bose Road, Kolkata-700 014
Application Form For Recruitment to the post of
.. under the Kolkata Metropolitan Development Authority
TO BE FILLED UP BY
THE CANDIDATE
FOR OFFICE USE
Paste a passport
size recent
Photograph of
the Candidate
duly signed by
him/her on the
front side of the
photograph.
Application No :
Name of United Bank of
India Branch where fee/
and processing charge
deposited in account
No.0088050006798
AmountDate..
Roll No. :
Spl Attention :
Fee /charges be
deposited
In UBI account No.
0088050006798
otherwise
application may
not be entertained
Transaction ID No.
...............
1. NAME OF THE POST APPLIED FOR
2. Advertisement No.
: _____________________________________________
: 5 of 2013
3. Name of the Candidate (In Capital letters) : _________________________________________
4. Sex (Male/ Female)
5. Fathers/Husbands Name
6. Nationality
7. Date of Birth(In Christian era)
8. Age (as on 01.01.2013)
9. Address for Communication
(PIN CODE must be mentioned)
: _________________________________________
: _________________________________________
: _________________________________________
: _________________________________________
: _________________________________________
: _________________________________________
_________________________________________
__________________________________________
________________ Pin
10. (i)Do you belong to S.C./S.T./O.B.C.-A/O.B.C.-B
of West Bengal ? (State Yes or No)
: _________________________________________
(ii)If yes, specify the Category
(Put tick mark in appropriate box)
SC
ST
OBC-A
OBC-B
(iii) Mention the name of sub-caste/Tribe/Community : _____________________________
(As the case may be)
11. Whether Physically Handicapped [State Yes or No] : _____________________________
12. If yes, specify the Category
: _________________________________________
Contd.P/2
13. Whether belongs to Ex. Serviceman [State Yes or No] : __________________________
14. Educational Qualifications (Madhyamik examination onwards)
Name of the
Examination
Year of
Passing
Division/
Class
Percentage
of marks
obtained
Subjects taken
Board/University
15. If employed previously or at present, the details thereof :
Name of the
Organisation (s)
Position/Designation
held
Nature of
duty (ies)
Period of Service
From
To
16. List of attested documents enclosed : (i)_______________________ (ii)___________________
(iii)_______________________(iv)__________________
(v) _______________________(vi)__________________
DECLARATION
I solemnly declare that (a) All statements made in this application are true, complete and correct (b) Original
documents will be produced on demand (c) I agree to undergo the selection process on the condition that the
Commission may cancel my candidature if I am found ineligible at any stage and (d) I have submitted no other
application for the concerned post.
** I have informed the head of my Office or Department .in writing that I am applying for this post (**Strike off this
sentence if the candidate is not in service of Government or Local or Statutory Body).
Place :
Date :
Signature of the Candidate in full
Bank Branch Copy
Bank Challan Form
(For General / OBC candidates)
Bank Challan Form
(For General / OBC candidates)
UNITED BANK OF INDIA
UNITED BANK OF INDIA
Name : Municipal Service Commission
Account No.0088050006798
Home Branch : Entally (0088)
MSC Advertisement No. 5 of 2013 for recruitment to the post of
..
under Kolkata Metropolitan Development Authority.
Name : Municipal Service Commission
Account No.0088050006798
Home Branch : Entally (0088)
MSC Advertisement No. 5 of 2013 for recruitment to the post of
..
under Kolkata Metropolitan Development Authority.
UBI Branch where deposited .Date...
UBI Branch where deposited .Date..
Applicants Name
Applicants Name
Fathers /Husbands Name
Fathers /Husbands Name
Date of birth..
Date of birth.
Category [ General / OBC(A) / OBC (B) ]
Category [ General / OBC(A) / OBC (B) ]
Application fee
Rs.150.00
Application fee..
Rs.150.00
Processing charge.
Rs. 50.00
Processing charge..
Rs. 50.00
Service charge for bank..
Rs. 20.00
Total Rs. 220.00
(Rupees two hundred twenty) only
Service charge for bank..
Rs. 20.00
Total
Rs .220.00
(Rupees two hundred twenty) only
_________________
Transaction ID to be
noted by receiving official
_________________
Transaction ID to be
noted by receiving official
___________________
Bank seal
__________________
Signature of depositor
____________________
Signature of receiving official
MSCS Copy
Applicants Copy
___________________
Bank seal
_________________
Signature of depositor
_________________
Signature of receiving official
Bank Challan Form
(For General / OBC candidates)
UNITED BANK OF INDIA
Name : Municipal Service Commission
Account No.0088050006798
Home Branch : Entally (0088)
MSC Advertisement No. 5 of 2013 for recruitment to the post of
..
under Kolkata Metropolitan Development Authority.
UBI Branch where deposited .Date..
Applicants Name
Fathers /Husbands Name
Date of birth.
Category [ General / OBC(A) / OBC (B) ]
Application fee..
Rs.150.00
Processing charge..
Rs. 50.00
Service charge for bank..
Rs. 20.00
Total
Rs .220.00
(Rupees two hundred twenty) only
____________________
Transaction ID to be
noted by receiving official
_______________
Bank seal
___________________
Signature of depositor
____________________
Signature of receiving official
MSCs Copy
Applicants Copy
Bank Branch Copy
Bank Challan Form
(For S.C / S.T candidates only)
Bank Challan Form
(For S.C / S.T/ candidates only)
UNITED BANK OF INDIA
UNITED BANK OF INDIA
Bank Challan Form
(For S.C / S.T candidates only)
UNITED BANK OF INDIA
Name : Municipal Service Commission
Account No.0088050006798
Home Branch : Entally (0088)
MSC Advertisement No. 5 of 2013 for recruitment to the post of
..
under Kolkata Metropolitan Development Authority.
Name : Municipal Service Commission
Account No.0088050006798
Home Branch : Entally (0088)
MSC Advertisement No. 5 of 2013 for recruitment to the post of
..
under Kolkata Metropolitan Development Authority.
Name : Municipal Service Commission
Account No.0088050006798
Home Branch : Entally (0088)
MSC Advertisement No. 5 of 2013 for recruitment to the post of
..
under Kolkata Metropolitan Development Authority.
UBI Branch where deposited Date..
UBI Branch where deposited .Date..
UBI Branch where deposited .Date..
Applicants Name
Applicants Name
Applicants Name
Fathers /Husbands Name
Fathers /Husbands Name
Fathers /Husbands Name
Date of birth.
Date of birth.
Date of birth.
Category [ SC/ ST / PH ]..
Category [ SC/ ST/ PH].
Category [ SC / ST/ PH].
Application fee
Application fee.
Application fee...
Processing charge..
NIL
Rs. 50.00
Service charge for bank.
Rs. 20.00
Total Rs. 70.00
(Rupees seventy) only
________________
Transaction ID to be
noted by receiving official
___________________
Bank seal
_______________
Signature of depositor
____________________
Signature of receiving official
Processing charge..
NIL
Rs. 50.00
Service charge for bank..
Rs. 20.00
Total Rs. 70.00
(Rupees seventy) only
______________
Transaction ID to be
noted by receiving official
___________________
Bank seal
______________
Signature of depositor
_____________________
Signature of receiving official
Processing charge..
NIL
Rs. 50.00
Service charge for bank.
Rs. 20.00
Total
Rs. 70.00
(Rupees seventy) only
_____________
Transaction ID to be
noted by receiving official
_______________
Bank seal
_______________
Signature of depositor
______________________
Signature of receiving official
