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13/3/2014

Registration Slip

DEPARTMENT OF POST : (Registration Slip)


Online Application Form for Postal / Sorting Assistant Direct Recruitment Examination Registration No. DOP006900094

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Personal Information & Educational Qualification (10+2)


1 2 3 4 5 5.1 5.2 6 7 8 9 10 11 12 13 14 15.1 15.2 15.3 15.4 15.5 15.6 16 (i) Applicant's Name: Father's Name: Sex : Applicant Category : Applicant Sub-Category : Total length of Service rendered in Armed Force : Serving Govt. Employee With (at least 3 yrs. of service) : Date of Birth (As per 10+2 Certificate)(DD/MM/YYYY): Year of Passing (As per 10+2 Certificate): Percentage of Marks (As per 10+2 Certificate): Name of Recognisad Board / University from where qualification mentioned : Whether Studied English in 10+2 Std. : Whether Studied local Language of the State / U.T. of the Postal Circle concerned or Hindi as a subject atleast in Matriculation Level : Nationality Indian : Mobile No. (Only 10 digits, don't prefix '0') : Email ID : Address Line1 : Address Line2 : Address Line3 : City / Town : PincCode : State / U.T. : Postal Circle Applied For : PACO-RO (ii) PAPO CHANDAN BARUAH BIPUL BARUAH MALE GENERAL NOT APPLICABLE YEARS 0 MONTHS 0 DAYS 0 NO 05/09/1993 2012 69.33 AHSEC YES YES YES +91 8876743634 baruahchan05@gmail.com VILL:- CHINATOLY P.O.- KACHARIHAT P.S.- GOLAGHAT GOLAGHAT 785621 ASSAM 12-ASSAM
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15- Address for all Future Correspondence

17- Post Applied (Preference)


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(iii)

PAMMS

(iv)

PASBCO

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(i) (v)

PACO-RO SARMS

(ii) (vi)

PAPO

Registration Slip

(iii) (vii)

PAMMS

(iv)

PASBCO

18- Division / Unit (Preference)


(i) Sivsagar(1202) (iv) Nagaon(1203) (vii) (x) (ii) Dibrugarh(1201) (v) Tinsukia(1206) (viii) (iii) Guwahati(1208) (vi) (ix) .

19- Examination City (Preference)


(i) Guwahati (ii) Dibrugarh 20- Declaration (iii) Silchar

YES

i. I have not Registered any other application for this examination. I am given to understand that if I contravene this rule, all my applications registered will be rejected summarily by the Department. ii. I have carefully read the provisions / instructions in the Notification / Advertisement displayed & Advertisement of this examination issued by the Postal Circle concerned to which I applied and I hereby undertake to abide by those instructions. iii. I further declare that I have fulfilled all the eligibility criteria regarding age limit, educational qualifications etc. prescribed for registering my application to the examination. iv. I also further declare that I have not been debarred by any recruiting authority / Department / Ministry of Central Govt./ State Govt as on the date of registration. And have never been convicted by any court of law. v. For Govt. Civilian Employee seeking age relaxation for Direct Recruitment I declare that I am a Govt. Civilan Employee and completed 3 years regular service or regular length of service stipulated in the Notification / Advertisement of the examination as on the closing date of Registration of online application form and that I have kept informed my immediate superior authority about registration of my application for this recruitment. vi. For applicant belonging to SC/ST (Scheduled Caste/ Scheduled Tribe) I declare that I belong to the caste/tribe which is included in the lists of Scheduled Caste & Scheduled Tribe notified by the Govt. of India as revised from time to time. I further declare that I am possessing a caste certificate prescribed in the Ministry of Home Affairs OM No 42/41/49-N.G.S dated 28-01-1952, as revised in Dept of Personnel & Administrative Reforms letter no 36012/6-76-Estt. (S.C.T.), dated 29-10-1977. I am prepared to submit my original Caste certificate issued by the competent authority in the prescribed format and prepared to submit the same whenever demanded /called for. vii. For applicant belonging to OBC (Other Backward Classes) I declare that I belong to the community which is recognized as a backward class by the Govt. of India for the purpose of reservation in services as per orders contained in Department of Personnel and Training Office Memorandum No. 36012 / 22 / 93-Estt. (S.C.T) dated 8.9.1993 and that my community is included in the list of OBC notified in the resolution number 12011/68/93-BCC (C ) dated 10.9.93 of Govt. of India Ministry of Social Affairs as amended from time to time. I also declare that I do not belong to the person / sections (creamy layer) mentioned in column 3 of the schedule of the OM mentioned above and modified vide Govt. Of India. DOPT OMs mentioned in the Notice. I further declare that I am in possession of an Original certificate issued by a competent authority to the effect that I belong to OBC in the prescribed format vide Govt of India DOP&T vide OM no 36033/28/94-Estt. (Res.) dated 2.7.1997 and prepared to submit the same whenever demanded /called for.

vi i i . For a ppl i ca nt bel ongi ng to Ex-Servi cemen


I declare that I am an Ex-Servicemen and having Original Discharge Certificate issued by the armed forces of the Indian Union. I declare that I have fulfilled the eligibility criteria particulary w.r.t. age limit notified in the notification. ix. For applicant belonging to Physically Impaired category I declare that I belong to a Physically Impaired category and issued with a disability certificate issued by competent Medical authority / Board and I am having the Original disability certificate in the prescribed format vide Govt of India DOP&T OM No 30635/3/2004-Estt.(Res) dated 29.12.2005. And I am prepared to submit the same whenever demanded /called for. x. In the event of not getting the post in the division / unit of my preference I undertake to accept appointment in any other division subject to availability of vacancy in the division. The concerned Postal Circle reserves the right for allocation subject to availability of vacancies. I hereby declare that the particulars furnished in this application form are true, complete and correct to the best of my knowledge and belief and original documents will be submitted when demanded. I also declare that I am a citizen of India. I fully understand that in case of furnishing any False / Incorrect Information discovered at any later stage, my candidature / appointment will be summarily rejected / terminated without assigning any reasons and appropriate action would be taken against me.

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