APPLICATION FOR REGISTRATION

FOR ASST COMDT (GD, GD (P/N/ GD(W)SSA/ CPL-SSA AND TECH)

MUMBAI/ CHENNAI/ KOLKATA/ NOIDA

Roll No.
Name & Signature of CG Staff……………………………
Affix self-
(For official use only)
attested passport
size colour
photograph

(1) Name of the post applied for:…………………………..

(2) Name of the candidate (as in Matriculation/ Degree certificate)

First Name Middle Name Surname

(3) Present Address……………………………………………………….
…………………………………………………………………………
…………………………………………………………………………
(4) Father’s Name:……………………………………………………….
(5) Category: GEN/ OBC/ SC/ ST:…………………………
(Attach photocopy of certificate as per format, in case OBC/ SC/ ST)
(6) (i) Date of Birth

Day Month Year

(7) Educational Qualification:
Percentage of
Exam Name of the Year Subject Division Marks Obtained
Passed Institution
10th
10+2
Degree

(8) Whether employed in Central/ State Govt/ Public sector undertaking, if so, details
there of………………………………………………………
(9) Declaration:
I hereby solemnly declare that all the statements made above are truse and
correct to the best of my knowledge and belief, I fully understand that in the event
of any information being found false or incorrect, appropriate action can be taken
against me.

Place: ……………. Signature…………..

Date:……………………. Name of the Applicant…………