You are on page 1of 2

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY


WEST BENGAL POLICE RECRUITMENT BOARD
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
APPLICATION FORM FOR THE POST OF LADY CONSTABLES IN WBP 2018
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
5D48EF2B8B9BF6359D90051CBA22F426E4289B42FF8145CEC99B9E7A673B09B2
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY


10098087FC940219A
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
Application C940219NSY
Sl. No. 10098087

C940219NSY
To C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
The Chairman
C940219NSY
West BengalC940219NSY C940219NSY
Police Recruitment Board C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
POLICE RECORDS BHAVAN, ARAKSHA BHAVAN, BLOCK -DJ , SECTOR -II,
SALTLAKE, KOLKATA-700091
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
Sir,
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
I hereby apply for the post of Lady Constables in WBP 2018. Necessary particulars are furnished below:-
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
Post applied for : Lady Constables in WBP 2018
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY


Name in FullC940219NSY C940219NSY
C940219NSY : SIMA ROY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
Gender : Female Category : SC Date of Birth : 19/02/1994
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
Father's Name : ROBINDRANATH ROY Husband's Name :
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
Mother's Name : NIRODA ROY Marital Status : Un-Married
C940219NSY C940219NSY
HG in WBP/NVF / CV in WBP C940219NSY C940219NSY
: Not Applicable ServiceC940219NSY C940219NSY
Experience Details : YearC940219NSY
Month C940219NSY
Days C940219NSY
00 00 00
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
Mobile : 9093913375 Email : chandansarkar737@gmail.com
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
Complete Mailing Address :
C940219NSY C940219NSY C940219NSY C940219NSY
BATABARI PO C940219NSY
BATABARI DIST JALPAIGURI C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY


PO : MATELLI

POLICE STATION
C940219NSY C940219NSY C940219NSY : MATELI C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
C940219NSY
DISTRICT : JALPAIGURI
C940219NSY C940219NSY C940219NSY C940219NSYPIN :C940219NSY
735223 C940219NSY C940219NSY C940219NSY C940219NSY
STATE : WEST
C940219NSY C940219NSY C940219NSY BENGAL
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
Permanent Address :
BATABARI PO
C940219NSY C940219NSY C940219NSY BATABARI DIST
C940219NSY JALPAIGURI C940219NSY C940219NSY C940219NSY C940219NSY
C940219NSY
PO : MATELLI
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
POLICE STATION : MATELI
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
DISTRICT : JALPAIGURI PIN : 735223
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
STATE : WEST BENGAL
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
Educational Qualification : Class X Pass : Yes
C940219NSY C940219NSY C940219NSY
Name of Examination
C940219NSY C940219NSY Name
Year of Passing (YYYY)
C940219NSY C940219NSY C940219NSY C940219NSY
of the Board / Council / University
Madhyamik
C940219NSY 2011C940219NSY C940219NSY
(Class X) C940219NSY
C940219NSY WEST BENGAL BOARD OF
C940219NSY SECONDARY EDUCATION
C940219NSY C940219NSY C940219NSY
Higher Secondary (10+2) 2013 WEST BENGAL BORRD OF HIGHER SECONDARY EDUCATION
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
Graduation
C940219NSY
Post C940219NSY
Graduation C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY Page


C940219NSY
1 of 2

5D48EF2B8B9BF6359D90051CBA22F426E4289B42FF8145CEC99B9E7A673B09B2
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY
Application Sl. No. 10098087C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
10098087FC940219B
Name : SIMAC940219NSY
ROY 5D48EF2B8B9BF6359D90051CBA22F426E4289B42FF8145CEC99B9E7A673B09B2
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY


Do you belong to exempted category? : NO Registration & NCO No. issued by the
C940219NSY C940219NSY C940219NSY C940219NSYlabour department, Govt.
C940219NSY of W.B. :
C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY


Your Community C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
: RAJBANSI

C940219NSY
Religion : C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
: HINDUISM
C940219NSY
Have you ever C940219NSY
been subjected to aC940219NSY
criminal C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
: NO
investigation as an accused involving moral
turpitude?
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
Details :
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
Police Station Name in Full FIR No. FIR Date Sections of Law
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY


Application Fees : Rs. 0.00
C940219NSY C940219NSY C940219NSY
Bank Charge C940219NSY
: Rs. 0.00 C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
Processing Charge : Rs. 20.00
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
Total Fees paid : Rs. 20.00
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY Transaction


C940219NSYID :C940219NSY C940219NSY
LUR25985568805 C940219NSY
[ Online Payment C940219NSY
through Bill Desk ] C940219NSY C940219NSY
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
Transaction Date C940219NSY
: 20/01/2018 17:43:38 C940219NSY C940219NSY C940219NSY
(Rupees Twenty only)
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY


Declaration :
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
(i) I possess all the Essential Qualifications for the Post.
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
(ii) I solemnly declare that all statements made in this application form are true, complete and correct to the best of my knowledge
and belief. In the event of any information being found suppressed / false or incorrect, or if my ineligibility is detected before,
C940219NSY C940219NSY
during or after the tests C940219NSY C940219NSY
and medical examination, C940219NSY
my candidature C940219NSY
/ appointment C940219NSY
will stand cancelled andC940219NSY C940219NSY
my claim to recruitment
will stand forfeited. I also declare that I have submitted no other application form for this examination.
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
(iii) I have never been debarred from any examination conducted by any Service Commission / Recruitment Board of the Government
of West Bengal.
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
(iv) I have not been subjected to a criminal investigation involving moral turpitude.
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
Place : BATABARI Yours faithfully,
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY
Date : 20 Jan 2018 17:43:38
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY


Full signature of the candidate (only in Long Hand)
C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY

C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY C940219NSY Page


C940219NSY
2 of 2

5D48EF2B8B9BF6359D90051CBA22F426E4289B42FF8145CEC99B9E7A673B09B2