O;kie Hkou] ukFkZ CykWd] lsDVj&19] u;k jk;iqj ¼N-x-½

Qksu uEcj ,oa QSDl ua- 0771&2972780

vkWuykbu vkosnu djus dh fof/k

Application Form esa fDyd djrs gh “ON LINE APPLICATION FOR
(FICS17)
ls ,d ist [kqyx
s k** ftlesa nh xbZ tkudkjh vuqlkj dk;Z djsa A

Please clear your browser cache before filling up the application form.
d`i;k vkosnu i= Hkjus ls igys vius czkmtj dk dS”k lkQ djsa A

Please fill up the application form in ENGLISH only.

d`i;k dsoy vaxzsth esa gh vkosnu i= Hkjsa A

**************
D;k vki NŸkhlx<+ ds LFkkuh; fuoklh gSa \ 0 gkWa 0 ugha
^^gkW*a * gksus ij gh vkosnu [kqysxk A
D;k vki foKkfir in ds fy;s visf{kr vgZrk,a j[krs gSa \ 0 gkWa 0 ugha
^^gkW*a * gksus ij gh vkosnu [kqysxk A

blds i'pkr~ vH;FkhZ ds laca/k esa fcUnqokj ekaxh xbZ tkudkjh dks lko/kkuhiwoZd Hkjs]a tks
fuEukuqlkj gS ¼,d ckj vkosnu i= tek djus ds ckn fdlh Hkh izdkj dk dksbZ Hkh =qfV lq/kkj dk
vkosnu fdlh Hkh Lrj ij Lohdkj ugha gksxk½ %&
1- fcUnq Øekad 1 esa Candidates Name- vH;FkhZ viuk uke vaxzsth ds dsfiVy
v{kj esa nloha dh vadlwph esa n”kkZ;s vuqlkj fy[ksa A
2- fcUnq Øekad 2 & Father/Mother/Husband &¼firk] ekrk] ifr½ esa fdlh ,d
dks lsysDV djsa A
Name of Above &¼firk@ekrk@ifr dk uke½ esa ls lacaf/kr ds uke dks mlds
lkeus esa fLFkr ckWDl esa dsfiVy v{kj esa fy[ksaA uke ds igys Jh@Jherh@Lo-
vkfn u fy[ksa A
3- fcUnq Øekad 3 Date of Birth- tUefrfFk dks ¼nloha dh vadlwph esa n”kkZ;s
vuqlkj½ fnukad] ekg ,oa o’kZ esa Mªki Mkmu ckWDl ls lsysDV djsa A
¼tSlk fd 27 fnlacj 1987 dks fnukad ds ckWDl esa 27] ekg ds ckWDl esa fnlacj ,oa
o’kZ ds ckWDl es 1987 lsysDV djs½a
4- fcUnq Øekad 4 & Gender esa ¼fyax½ iq:’k] efgyk ;k r`rh; fyax ftlls vki
lacaf/kr gSa] lsysDV djsAa
5- fcUnq Øekad 5 & Category (Caste) ¼Js.kh½ esa tujy@,l-lh-@,l-Vh-@
vks-ch-lh- ftlls vki lEcaf/kr gS] lsysDV djsaA
6- fcUnq Øekad 6 & Are you Ex-Servicemen ¼HkwriwoZ lSfud½ esa ;fn vki HkwriwoZ
lSfud ls lEca/k j[krs gSa rks Yes lsysDV djsaA
7- fcUnq Øekad 7 & Physically Handicapped (PH) esa fodykax oxZ ¼fnO;kax½
ls lEcaf/kr gSa] rks Yes lsysDV djsa A Yes lsysDV djus ls fu%”kDrrk dk izdkj
(a) n`f’V ckf/kr] (b) Jo.k ckf/kr] (c) vfLFk ckf/kr iznf”kZr gksxk A vki

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 ftlls lEcaf/kr gSa] mls lsysDV djsa A Yes or No lsysDV djrs gSa] rks fu/kkZfjr
“kqYd iznf”kZr gksxkA

uksV & iw.kZ n`f’V ckf/kr vH;FkhZ [kk| ukxfjd vkiwfrZ fujh{kd in gsrq ik= ugha gS A vr%
vkosnu u djsa A
8- fcUnq Øekad 8 &Height (cms) ÅWpkbZ & viuh ÅWapkbZ lsaVhehVj esa fy[ksa A
9- fcUnq Øekad 9 &Weight (kgs) otu& viuk otu fdyksxzke esa fy[ksa A
fcUnq Øekad 10& ¼QksVks] flXuspj] uke] vaxwBs dk fu”kku ds lEca/k es½a &
¼Download Image Format)
3.5 x 4.5

jpeg SCAN
50 kb 40 kb

Upload

11- fcUnq Øekad 11 &esa Marital Status: ¼oSokfgd fLFkfr½ & ;fn vki fookfgr gS
rks gkWa Yes vU;Fkk ugha No dks lsysDV djsa A
If Yes fookg dh rkjh[k Marriage Date – vius fookg dh rkjh[k dks frfFk]
ekg ,oa o’kZ esa vafdr djsa A
12- fcUnq Øekad 12& ¼Two Identification Marks) igpku fpUg & vH;FkhZ vius
“kjhj ds n`f’Vxkspj Hkkx ij nks igpku fpUg ¼fry] elk vkfn½ ;gka ij vafdr
djsAa
13- fcUnq Øekad 13& ¼Contact Information) i=kpkj gsrq iwjk irk & vH;FkhZ
viuk Mkd dk irk dks House No. esa edku uacj ¼;fn gks rks½ Street Name
esa lM+d@eksgYyk dk uke] City/Village esa “kgj@xkWao dk uke] Post Office
esa vius Mkd?kj vafdr djsaA District esa fuokl ftys dk uke lsysDV djsa A
State esa ;fn vki NŸkhlx<+ jkT; esa fuokl djrs gSa rks NŸkhlx<+ dks lsyDs V djsa
vU;Fkk Other dks lsysDV dj ml jkT; dk uke vkSj ftys dk uke vafdr djsa A
fiu esa vius Mkd?kj dk fiu dksM vafdr djsa A ;g tkudkjh vR;ar egRoiw.kZ gSA
d`i;k Li"V ,oa lqlaxr tkudkjh nsosa] ftlls lacaf/kr dk;kZy; ls Hkstk x;k i=
vkidks izkIr gks ldsA
14- fcUnq Øekad 14 &¼Mobile No.) esa viuk 10 fMftV dk eksckby uacj vafdr
djuk vfuok;Z gSA eksckby uacj ds igys “kwU; ¼0½ u fy[ksa A
15- fcUnq Øekad 15& esa ¼E-mail)- izR;sd vkosnd dk bZesy vkbZ-Mh gksuk vfuok;Z gSA
;fn ugha gS rks viuk bZey s vkbZ-Mh- vo”; cuk ysa rFkk bl oS/k bZesy vkbZ Mh dks
bl [kaM esa vafdr djsa A
iksLV vkWfQl ds ek/;e ls ,MfeV dkMZ ;k dksbZ Hkh tkudkjh ugha Hksth tkosxh A
16- fcUnq Øekad 16& ¼Exam District) ijh{kk ftyk & ijh{kk gsrq fu/kkZfjr 05 laHkkxh;
eq[;ky;ksa esa ls tgkWa vkidks ijh{kk nsuk gS mls lsysDV djsAa

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17- fcUnq Øekad 17& (Declaration) ?kks’k.kk & blesa ;g fn;k x;k gS fd &
^^ eSa ;g ?kks’k.kk djrk@djrh gWw fd] esjs }kjk vkWuykbu vkosnu i= esa Lo;a ds
uke] Js.kh] oxZ] “kS{kf.kd ;ksX;rk] tUefrfFk] Mkdirk ,oa vU; nh xbZ lwpuk esjh
tkudkjh ,oa fo”okl esa lgh gS] ftlds lR;rkiwoZd vkSj lgh gksus dh eSa ?kks’k.kk
djrk@djrh gWw A eSaus foHkkx }kjk tkjh foKkiu esa nf”kZr fu;eksa ,oa O;kie ds
fu;eksa dks i<+k gS ,oa le>k gS A ;fn Åij nh xbZ dksbZ Hkh tkudkjh vlR; ik;h
tkrh gS rks p;u izfØ;k ds fdlh Hkh Lrj ij eq>s iwoZ lwpuk fn;s fcuk esjh
vH;fFkZrk lekIr dh tk ldrh gSA** dks i<+ ysosaA
18- fcUnq Øekad 18& esa mijksDr fcUnq Øekad 17 esa nh xbZ Declaration ?kks’k.kk dks
i<+dj le>us ds ckn viuh lgefr izdV djrs gq, I Agree ij fDyd djsa A
19- fcUnq Øekad 19 & Please enter the code shown below -
mijksDr lHkh [k.Mksa dks Hkjus ¼fcuk [kkyh NksMs+½ ds i”pkr flD;wfjVh dksM dks
mlds Åij okys ckWDl esa mlh izdkj ,aVj djsa ¼vFkkZr dsfiVy ysVlZ dks dsfiVy
ysVlZ es]a Leky ysVlZ dks Leky ysVlZ esa rFkk vadks dks vadks esa fy[ksa½ A blds
i”pkr Submit esa fDyd djus ij Please Confirm uke dk ,d
foUMksa [kqysxk ftlesa fy[kk gksxk **d`i;k /;ku nsa fd] ,d ckj miyC/k djk;h
xbZ tkudkjh ckn esa la”kksf/kr ugha dh tk ldrh gS A D;k vki vkxs c<+uk
(Continue) pkgrs gSa ;k la”kks/ku (Edit) djuk pkgrs gS \
;fn vkosnu i= esa dh xbZ izfof"V;ksa ls vki lger gSa rks Continue ¼vkxs
c<+½s dks fDyd djsa A ;fn vlger gS vkSj fdlh izfof"V dks cnyuk pkgrs gS
rks Edit ¼la”kks/ku½ dks fDyd djs]a Edit ¼la”kks/ku½ dks fDyd djus ij fQj
ls iwoZ vkosnu i= esa pys tk;sx a s tgka tks la”kks/ku ;k lq/kkj djuk pkgrs gSa]
vki dj ysosaA /;ku jgsa fd ,d ckj vkosnu i= Hkjdj “kqYd tek djus ds
ckn vkosnu i= esa fdlh Hkh Lrj ij fdlh Hkh izdkj dk la ”kks/ku@lq/kkj
laHko ugha gS rFkk lq/kkj laca/kh dksbZ Hkh vH;kosnu Lohdkj ugha fd;k tk,xkA
Continue ¼vkxs c<+½s dks fDyd djus ij ,d u;k foUMks [kqysxk] ftlesa
Application Verification fy[kk gksxk A blesa fy[ks x;s funsZ”kksa dks lko/kkuh
ls i<+s ,oa uhps n”kkZ;s x;s ^Hkqxrku vuqHkkx esa tkus ls igys uhps viuh izfof"V;ksa
dh iqf’V djs*a ds vuqlkj vkids }kjk vkosnu i= esa Hkjh xbZ lHkh izfof’V;ksa ls
larq’V gksus ds i”pkr Pay ij fDyd djsaA ;fn vius }kjk nh xbZ tkudkjh esa
=qfV ikrs gSa ,oa mlls larq’V ugha gksrs gSa rks u;s fljs ls vkosnu i= dks Hkjuk
gksxk] ftlds fy, Åij esa ^^fQj ls QkeZ Hkjus ds fy, ;gkWa fDyd djsa ** dk
mi;ksx dj ldrs gSaA
Pay ij fDyd djus ij ,d u;k foUMks [kqysxk ftlesa Registration
Initiated fy[kk gksxk ,oa blesa vkidk Registration ID ,oa vkids }kjk
Hkqxrku dh tkus okyh jkf”k fy[kk gksxk A d`i;k vius Hkqxrku dh izfØ;k iwjh
djus ds ckn VªkWUtsD”ku fLFkfr dh tkWap djsa A ijh{kk “kqYd isesaV ds fy, rhu
isesaV xsVos miyC/k gS A (1) ICICI BANK (2) HDFC BANK
(3) STATE BANK OF INDIA A ;fn ICICI BANK esa fDyd djrs gSa
rks isesaV ds fy, vkWuykbu fo/kk miyC/k gksxk A bl fo/kk ls fdlh Hkh cSad dk
MsfcV dkMZ] ØsfMV dkMZ] baVjusV cSafdx dh lqfo/kk esa ls fdlh ,d dks vki pqu
ldrs gSaA ijh{kk “kqYd ds lkFk vko”;d cSad VªkWaUtsD”ku pktsZl ns; gksxkA
;fn vki ijh{kk “kqYd ds Hkqxrku gsrq STATE BANK ds iseVsa xsVos
dks pqurs gSa] rks STATE BANK MOPS iseaVs flLVe [kqysxk] ftlesa
STATE BANK dk usV cSafdx] fdlh Hkh cSad dk MsfcV dkMZ rFkk ØsfMV dkMZ
dk mi;ksx dj ijh{kk “kqYd ¼cSad pktsZl lfgr½ dk Hkqxrku fd;k tk ldrk gSA
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