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Registration Slip

Intelligence Bureau
Ministry of Home Affairs, Govt. of India Registration Slip
Registration No : Post Applied For : MHA200083645 BOTH ACIO-II/TECH & ACIO-II/WT First preference : 2 - ACIO-II/WT Second preference : 1 - ACIO-II/TECH Personal Information: Applicant's First Name: Applicant's Middle Name: Applicant's Last Name: Father's /Mother's First Name: Father's /Mother's Last Name: Relationship: Gender: Date Of Birth: Are you a Central Govt. Employee with 3 or more years of Continuous Service? : If Yes, Please fill in the details : JATIN KUMAR SIHMAR SURINDER SINGH FATHER MALE 9/10/1990 NO Designation : Department in which Serving : Are you seeking age relaxation? : Category: Religion: Nationality: State of Domicile: Are you an Ex-Serviceman? SC HINDU INDIAN HARYANA NO Date of Joining : Total period of Service:
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Domicile of J&K during the period 01.01.1980 to NO 31.12.1989 : Qualification Details (ACIO-II/TECH):
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Registration Slip

Name of Graduation Degree: Branch/Name of the Course: Month & year of Passing: Duration of the Course: Division/Class of Passing: Enter Percentage of Marks: College/Institute Name Name of Affiliated University Additional Qualification (if any) : Qualification Details(ACIO-II/WT): Name of Graduation Degree: Branch/Name of the Course: Month & year of Passing: Duration of the Course: Division/Class of Passing: Enter Percentage of Marks: College/Institute Name Name of Affiliated University Additional Qualification (if any) : Additional Information: Contact No. (Only Digits): Alternate Mobile No. (if any): Email ID: Alternate Email ID (optional): Choice of Examination Centre: Test Centre: Address for all Future Correspondence: Address Line 1: Address Line 2: Address Line 3: City/Town: PIN: State: Home State to which candidate belong to: Declaration/Confirmation: Are you prepared to serve anywhere in India?
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B.E / B.TECH (INFORMATION TECH.) INFORMATION TECHNOLOGY Month: AUGUST Year: 2012 Years: 4 Months: 0 SECOND 58 BMIET SONEPAT HARYANA MDU ROHTAK NO

B.E / B.TECH (INFORMATION TECH.) INFORMATION TECHNOLOGY Month: AUGUST Year: 2012 Years: 4 Months: 0 SECOND 58 BMIET SONEPAT HARYANA MDU ROHTAK NO

+919466691354 +919466291354 jatinsihmar9@gmail.com jatins.it@gmail.com DELHI HOUSE NO.-2485 (H.B.C) SECTOR-15 SONEPAT 131001 HARYANA HARYANA YES
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Registration Slip

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