INTELLIGENCE BUREAU (MINISTRY OF HOME AFFAIRS) GOVERNMENT OF INDIA

Registration Slip (Private & Confidential)

for the post of ,,JIO-II(EDP)

(Please take a printout in A4 size only, and Note down your registration No for all future references) Registration No. Post Applied. Date Name Email Id Date of Birth Category Religion State of Origin Qualification Marks (%) Passing Year Ex-Serviceman : No Central Govt Employee : No Test Center Address : Hyderabad : HNO 1-12-4/G LBS COLONY MEDAK MEDAK -502110 ,Andhra Pradesh : 230512 : ,,JIO-II(EDP) : 24/10/2011 : MAHESH DHUMALE : maheshd678@gmail.com : 21/02/1989 : OBC : Hindu : Andhra Pradesh : 12th Standard or equivalent (Duration: 2yy 0 mm) : 72.10 : 05mm2006yy J&K Domicile : No

I hereby declare that the above statements are true and complete to the best of my knowledge and brief. In the event, any of the information is found to be false or incorrect, I understand that my candidature/appointment will be cancelled/terminated without any notice. I also declare that I am a citizen of India by birth/domicile. Date : Signature :

Candidate to please note: 1. Please sign at the place provided above. 2. You are advised to take a photocopy of this Registration Slip for your record and future reference. 3. Write your Email Id & Contact No. here : Email Id: Telephone/Mobile No.: 4. Please check on our website www.mha.nic.in from 2nd week of November 2011 onwards to download your admit cards.