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Uttar Pradesh Subordinate Services Selection Commission,Lucknow

,
I Declare that i have Read the detailed User Manul & Notification.

Notification Details ( Examination )

Advertisement Number :

05-Exam/2014-15

Type of Recruitment :

General

Applied For :

Chakbandi Lekhpal Examination 2015,

Candidate Personnel Details

Application ID :

200029503051533

Registration No. :

50330773507

Candidate Name :

ASHUTOSH RAI

Father's/Husband's Name :

RAM MANOHAR RAI

Gender - Date of Birth :

Male -01/06/1994

Domicile of UP / Category :

Yes /GENERAL

Are you Married?

No

Contact No./ Email-ID :

9125800462 /agriashutoshrai@gmail.com

State Bank Of India - STATE BANK INB

Fees, Transaction ID - Date:

Rs. 160.00 , DU19481516 -18/05/2015

Bank Transaction Details

Bank Name - Payment Mode :

Other Details of Candidate

Are you Dependent of UP Freedom Fighter?

No

Service Duration (Day-Month-Year) :

0
0

Are you UP Ex. Army?

-0

No

Retirement Date(Date/Month/Year) :

___

Are you ECO/SSCO/CO of Army ? No

Have you complete 5 year service ? No

Have your services been extended for rehabilitation and no disciplinary action is
pending against you ?

No

Have you ever been Debarred from U.P. Subordinate Services Selection
Commission? :

No

Completion Date of Debarment (DD/MM/YYYY) :

../../....

Are You Handicap of UP?

No

Are you Blind Or Have Vision problem? :

No

Are you Deaf or Have hearing problem? :

No

Have you any physical Problem? :

No

Are You Skilled Player Of UP? :

No

Are You Govt./Ex-Govt. State Employee of Uttar Pradesh ?

No

High School & Intermediate Board,Year of passing & Roll Number Details
Sr.No Examination Passed

Board Name

Year of Passing

Roll Number

Obtained Marks

Total Marks

1.

High School

2.

Intermediate

UTTAR PRADESH BOARD OF HIGH SCHOOL AND INTERMEDIATE EDUCATION

UTTAR PRADESH BOARD OF HIGH SCHOOL AND INTERMEDIATE EDUCATION

2009
2011

2954637
1879383

401
320

600
500

Essential Qualification Details

Sr
No.

Qualification

Acquired

Is Grade
System

Obtain
Marks

Total
Marks

Percentage
(%)

Secondary Education Council of UP Intermediate examination or an examination recognized by the Government to be

equivalent

Yes

No

320.00

500.00

64.00

Preferential Qualification Details

Sr
No.

Qualification

Acquired

A candidate who has (1) served in the Territorial Army for a minimum period of two years or (2) Obtained B certificate of National Cadet Corps Shall other things being equal be given
preference in the matter of direct recruitment

No

Candidate's Address, Photo Signature Details

Address Details

Candidate's Permanent Address

Candidate's Correspondence/Mailing Address

Address /Name :

ASHUTOSH RAI

ASHUTOSH RAI

House no./Village :

KARKATPUR

KARKATPUR

Street No./PO :

BHARAULIKALN

BHARAULIKALN

City Name :

GHAZIPUR

GHAZIPUR

State / District Name :

Uttar Pradesh / GHAZIPUR

Uttar Pradesh / GHAZIPUR

PIN :

233228

Photo&Signature

233228

I accept the following declaration : Yes

1. I here by declare that I have read all term & condition accroding advertisement and I accept it.
2. I here by declare that all the entires/statements made in this application are true, complete and correct to the best of my knowledge and belief.
3. In the event of any information being found false or incorrect or ineligibility being detect before or after Selection, the commission can take action against me as per rule incase it is detected that I have misled UPSSSC on
any issue then I will solely responsible for all penel consequences thereof.
CURRENT STATUS OF APPLICATION
Your application is under processing.
Application Form Submission Date : 20/05/2015 , Time : 12:28:13 PM
Application Form printing Date & Time : [ 20/05/2015 ,12:29:56 PM ]

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5/18/2015 12:35 PM