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To,

The District Judge


Malda

Name of the Post:………………………………………………………………………………………………………


Name of the Candidate:…………………………………………………………………………………………….
Father’s Name:…………………………………………………………………………………………………………..
Date of Birth:……………………………………………………………………………………………………………..
Age as on:………………………………………………………………………………………………………………….
Name of Community:…………………………………………………………………………………………………

EDUCATIONAL QUALIFICATION:-

QUALIFICATION UNIVERSITY / BOARD YEAR OF PASSING % OF MARKS


M.P.
H.S.
B.A.
OTHERS

ADDRESS:-
Vill.………………………………………………………
P.O………………………………………………………
P.S………………………………………………………
Dist…………………………………………………….
Pin………………………………………………………
DECLARATION:-
All the Statements made in this application are true, complete and correct to the
best of my knowledge and belief.

Date:……………………..

Signature of Candidate

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