9/9/2018

Application for Recruitment to the post of Sub-Inspector in the Subordinate Food & Supplies Service, Grade-III, under Food & Supplies Department, Govt. of
West Bengal,2018 (Advertisement No.26/2018)

REGISTRATION NO: PSCWB02057319165 PAYMENT ID: NOT APPLICABLE

Enrolment No: PSC00735499

Candidate Name: TUHIN DAS
Father's Name: TAPAN DAS
Mother's Name: RINA DAS
Place of Birth: Kolkata
Do you have ability to read, write and YES
speak in Bengali:
Whether your mother tongue is Nepali: NO
State your mother tongue: BENGALI
Date of Birth: 06. September .1998

Sex MALE Physically Challenged: NO

Ex-Serviceman: NO Meritorious Sportsperson: NO
Nationality Indian Were you debarred previously by the NO
Commission from appearing at any
Category SC
examination/selection ?:
Sub-Caste DHOBA
Email Id: dtuhin038@gmail.com
Issuing Authority GOVERNMENT OF WEST BENGAL
Issuing State West Bengal
Issue Date 2013-04-01

Address For Correspondence Permanent Address

Address : 85/4 SELIMPUR ROAD DHAKURIA Address : 85/4 SELIMPUR ROAD DHAKURIA

State: West Bengal State : West Bengal

District : Kolkata District : Kolkata
Pin: 700031 Pin: 700031
Mobile No. 8583930092 Mobile No. 8583930092

Academic Qualifications (Madhyamik or equivalent and onwards)

Examination Examination Year of Name of Subjects Taken Division/Class/Grade Marks % Remarks
Name Passing Board/Council/University
WEST BENGAL BOARD
Class 10th BENGAL,ENGLISH,MATHEMATICS,PHYSICAL SCIENCE,LIFE
or equivalent MADHYAMIK
2013 OF SECONDARY 1ST DIVISION 63.4285714 PASS
SCIENCE,HISTORY,GEOGRAPHY
EDUCATION
WEST BENGAL
Class 12th HIGHER BENGALI,ENGLISH,MATHEMATICS,PHYSICS,CHEMISTRY,COMPUTER
or equivalent SECONDARY 2015
COUNCIL OF HIGHER 2ND DIVISION 58 PASS
SCIENCE
SECONDARY EXAM

Have you at any time been NO

employed ?
Ability to undertake extensive tours in rural areas of west Bengal : YES

Any other information : PURSUING B.TECH DEGREE

Center Preference
Preference Kolkata (South)

I solemnly declare that :

a) I am eligible to apply for the examination as per the notification.
b) All statements made in this application are true, complete and correct.
c) Original documents will be produced on demand.
d) I agree to take this examination on the condition that the Commission may cancel my candidature if at any stage I am
found ineligible.

I have obtained all my certificates (Qualification, Disability Certificate and/or Caste) within the date of submission of my
application.
I have informed the Head of my Office or Department in writing that I am appling for this examination (Please click the box if you are in service of Govt. or Local or Statutory Body).
I agree that all the information provided here, are correct according to my knowledge
PLEASE REVIEW THE ABOVE DETAILS CAREFULLY FOR ANY ERRORS BEFORE CONFIRMING SUBMISSION.

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YOU WILL NOT BE ABLE TO MAKE ANY CHANGE AFTER CONFIRMATION OF SUBMISSION
THE FORM WOULD BE CONSIDERED SUCCESSFULLY SUBMITTED ONLY AFTER PAYMENT OF EXAMINATION FEE ( IF APPLICABLE)
PLEASE DOWNLOAD YOUR ADMIT CARD BEFORE EXAMINATION

Date : 03-09-2018

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