Application Form

Department of Revenue & Land Reforms, Govt. of Bihar

Application for Contractual Recruitment of Different Post
Application Details
Application ID :     SSO/00114608 Application Date
Post Applied For : Special Survey Assistant Settlement Officer
: 01-Apr-2019

Personal Details
Applicant Name AKASH SINGH
Father's /Husband's Name UPENDER NARAYAN SINGH
Mother's Name Sarita devi
Date of Birth 15-Sep-1990
Age as on (01.01.2019) 28 Years 3 Months
Gender Male
Category GEN
Nationality Indian
Physically Handicapped No
Catagory of Physically
Handicapped
Percentage of Physically No
Handicapped
Grand Children of Freedom No
Fighter
Email ID atulcivil13@rediffmail.com
Mobile No. 7070709798
Phone With STD Code
Aadhar No XXXXXXXX7281
Identification Marks Cut mark on left eyebrow

Address for Correspondence

Address Home garud mode,behind animal husbandry,katira,arrah,Bhojpur,Bihar
Pin Code 802301

Permanent Address
Address Home garud mode,behind animal husbandry,katira,arrah,bhojpur,Bihar
Pin Code 802301
State of Domicile Yes
Home District BHOJPUR

Educational Qualification
  Board/University Institute State Specialization Passing Marks Full Marks Marks
Type Year Obtained (Excluding Obtained
(Excluding Extra Subject)  (%)
Extra Subject)
I.Matric CBSE Private Bihar 2005 360 500 72
II.Intermediate BSEB Gevernment Bihar Science 2008 427 900 47.44
III.Degree DR M.G.R Private Tamil Degree In Civil 2012 4347 6300 69
UNIVERSITY Nadu Engineering
IV.Post Private 0 0 0 0
Graduation

Experience
 p
Nature of
Organization Designation From To Organization Type
Job
NETAJI SUBHAS INSTITUTE OF ASSISTANT 05-Sep- 28-Feb- TEACHING Registered Non-
TECHNOLOGY BIHTA PATNA PROFESSOR 2012 2019 Government Institution

Document Upload Checklist

Matric Certificate Matric Marks Sheet Diploma Certificate
Diploma Marks Sheet ITI Certificate ITI Marks Sheet
Caste Certificate Physically Handicapped Freedom Fighter Certificate
Certificate
Residential Certificate Intermediate Certificate Intermediate Marks Sheet

Points
Total Point   68.82

I declare that all the above information is correct to the best of my knowledge and that I shall be liable for punishment if
information is found incorrect. I also declare that I have understood the guideline for engagement and will fully abide by
the same including any further guideline issued by Department of Revenue & Land Reform, Government of Bihar in this
regard. I categorically declare that there is no pending Criminal case or serious complaint against myself.

Place:-

Date:-
Signature of Applicant