APPLICATION FORM FOR Permanent Commission (PC)Logistics Jun-12 BATCH Paste your recent colour photograph (Do not

staple) (UNMARRIED MALE CANDIDATES ONLY) FOR INDIAN NAVY OFFICE USE ONLY CODE NO. VALIDITY STATUS ONLINE ROLL NO. PGG1220511892 Vaild Invaild 1. CHOICE OF ENTRY- [1] PC(LOG) 2. PERSONAL PARTICULARS AS IN MATRICULATION CERTIFICATE:NAME MOHIT KWATRA FATHER'S NAME SH RAMESH LAL KWATRA DATE OF BIRTH GENDER 1988/12/06 Male

3.FATHER'S OCCUPATION/DESIGNATION:GOVERNMENT EMPLOYEE 4.NATIONALITY: INDIAN 5.DOMICILE: Punjab 6.MARITIAL STATUS:Unmarried 7. ADDRESS: . CORRESPONDENCE ADDRESS PERMANENT ADDRESS ADDRESS DISTRICT STATE PINCODE TELEPHONE MOBILE H.NO 1187 URBAN ESTATE PHASE 2 PATIALA PATIALA Punjab 147002 0175 - 2283339 9781017070 H.NO 1187 URBAN ESTATE PHASE 2 PATIALA PATIALA Punjab 147002 0175 - 2283339 --NA--

EMAIL --NA-kwatramohit@gmail.com 8.EDUCATION PARTICULARS: 8(a).QUALIFICATION: MBA 8(b).STREAM: NA 8(c).YEAR OF EXAM PASSED: 2011 8(d).PERCENTAGE: 70.41% Maximum Marks Marks Obtained 1st Year 1600 1109 2nd Year 1600 1144 9.NAME AND ADDRESS OF COLLEGE WHERE STUDIED :GYAN JYOTI INSTITUTE OF MANAGEMENT AND TECHNOLOGY 10.NAME OF UNIVERSITY TO WHICH COLLEGE AFFILIATED AND ADDRESS:PUNJAB TECHNICAL UNIVERSITY JALANDHAR 11. I HAVE NOT ATTEND ANY SSB TILL TO DATE WITH THE ARMY/NAVY OR THE AIR FORCE. 12.Details of service under central/state Govt. if any (Candidates already in service should apply through proper channel and obtain NOC from the present employer.):NOT APPLICABLE
DECLARATION 1.I, hereby declare that I am unmarried male/female, governed by nationality condition as laid down by the Government of India and have never been

debarred from appearing at any examination. I have never been arrested/prosecuted and convicted by a criminal court or involved in any other case registered by the Police. 2. I, hereby, solemnly declare that all the statements made in the above application are true and correct to the best of my knowledge and belief. 3. 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 Applicant: .............................. October 24, 2011, 8:24 pm