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GOVERNMENT OF MAHARASHTRA
MAHAPARIKSHA MUMBAI , MAHARASHTRA
Maharashtra Information Technology Corporation Ltd. (MAHA IT), 514, 5th Floor, Mantralaya,
Hutatma Rajguru Chowk, Madam Cama Road, Mumbai - 400032
E-mail:enquiry@mahapariksha.gov.in

Personal Details
Posts/Services Applied for Junior Engineer (Civil)_Amravati-Non PESA
Application Id RDD_JEC_AMR_0083459
First Name ROHINI
Middle Name SAJJAN
Last Name KHOBRAGADE
Mother's Name MALAN SAJJAN KHOBRAGADE
Father's Name SAJJAN SITARU KHOBRAGADE
Nationality INDIAN
No of Children 0
Whether liable to be disqualified for the Government Services according to the
provisions of Maharashtra Civil Services (Declaration of small family) Rules, 2 No
005?
Gender FEMALE
Date of Birth Nov 25, 1993
Candidate's Name ROHINI KHOBRAGADE
Mobile Number 9764556623
Marital Status SINGLE
Name Change Status NOT CHANGED
Changed First Name NOT APPLICABLE
Changed Middle Name NOT APPLICABLE
Changed Last Name NOT APPLICABLE
Category of the Candidate SC

Note:Candidate opting for reservation category have to provide original caste category certificate during document verification else your reservation benefits will be rejected.

Caste Certificate APPLICABLE

Caste Validity Certificate APPLICABLE
Caste Certificate Number 1019
Place of Issue BHANDARA
Date Of Issue Jul 6, 2006
Are you ST-PESA Candidate ? NOT APPLICABLE

Note: ST PESA vacancy is applicable for local Scheduled Tribe Candidates only, if original documents are not provided by candidate during document verification, then ST PESA reservation benefits will be
rejected for the selected ST PESA district.

Is there sufficient revenue proof that the candidate himself or his mother / father or gr
andfather / grandfather is staying in the Scheduled Areas of the district (ST PESA Di NOT APPLICABLE
strict which the candidate wants to apply for) continuously since January 26, 1950?
Do you want to apply to ST-PESA vacancies? NOT APPLICABLE
Candidate is resident of which scheduled area (District)? NOT APPLICABLE
Physical Disability NOT APPLICABLE

Note:Medical certificate of disability issued by competent authority prior to SADM and the other certificates or SADM will be accepted once verified at the time of document verification by the concerned
ZillaParishad appointing authority.

Do you have disability certificate (minimum 40%)? (SADM, Software for Asses
NOT APPLICABLE
sment of Disability)
One Arm affected(OA) NOT APPLICABLE
One Leg affected(OL) NOT APPLICABLE
Both Leg affected(BL) NOT APPLICABLE
Both Arm affected(BA) NOT APPLICABLE
One Arm and Leg affected NOT APPLICABLE
Low vision NOT APPLICABLE
Hearing Handicapped NOT APPLICABLE
Blind NOT APPLICABLE
Scribe/Assistant Needed NO
Aadhaar Card Number 575951926583
Aadhaar Enrollment Number NOT APPLICABLE
Are you Orphan as per Women and Child Development Department's Governm
NOT APPLICABLE
ent Resolution No. अमुजा- २०११/ . . २१२/ का- ३, िद. २ एि ल २०१८ ?
Project Affected or Dependent on Project Affected? NOT APPLICABLE
Earthquake Affected (Whether death of any family member or the house collap
NOT APPLICABLE
sed in the earthquake has been rebuilt by the government ?)

Are you Anshakalin (Part-time) Employee? (As per reference GR शासन िनणय क्
NOT APPLICABLE
र. प अंक -१००९/ . . २०० /२००९/१६-अ ,िद . २७. १०. २००९)

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Name of Office(for Anshkalin Employee): NOT APPLICABLE
Appointing Authority (for Anshkalin Employee): NOT APPLICABLE
Part Time Experience in Years NOT APPLICABLE
Part Time Experience in Months NOT APPLICABLE
Part Time Experience in Days NOT APPLICABLE
Do you have MSCIT certification or equivalent certification ? APPLICABLE
Marathi Language Proficiency(READ) APPLICABLE
Marathi Language Proficiency(WRITE) APPLICABLE
Marathi Language Proficiency(SPEAK) APPLICABLE
Are you son/daughter of a farmer who committed suicide? NOT APPLICABLE
Non-Creamy layer certificate NOT APPLICABLE
Are you an Ex-Serviceman? NOT APPLICABLE
Retired Ex-Service man NOT APPLICABLE
Years of service (Ex-Servicemen) NOT APPLICABLE
Differently abled Ex-Serviceman NOT APPLICABLE
Are you a Government /Semi-Government /Local bodies employee/Regular em NOT APPLICABLE
ployee of Zilla Parishad?
Name of the Office/Department: NOT APPLICABLE
Joining date: NOT APPLICABLE
Sports Quota NOT APPLICABLE
Meritorious sportspersons Reservation: NOT APPLICABLE
Have you sent all sports certificate from director/deputy director, sport for
NO
verification?
Domicile of Maharashtra YES
Are you an Election employee as per the GR dated 6th Oct, 2010? NO
Are you a census Employee of 1991? NO
Are you a pupil or ward Nominated by freedom fighter? NO
Are you a dependent of Ex-servicemen as per GR mentioned in advertisemen
NO
t?
Do you want to avail the benefit of female Reservation? APPLICABLE
I have read the advertisement and agree with the instruction, terms, Selected district (Zila Parishad Appoi
conditions and eligibility criteria mentioned in the advertisement re
YES nting Authority) you want to apply for JEC
quired for the service/post which I am applying. I agree that I fulfill a
this post :
ll the eligibility criteria required for this Service/post.
Address Details of the Candidate
Address Type Address
Both Permanent and Current Addr
NEWSHESH NAGAR PAUNI NEAR MAIN BUS STAND PAUNI PAUNI,PAUNI, , MAHARASHTRA, 441910
ess
Educational Qualification Details
Name of the B
Educational Name of the Qualified Marks Marks
oard/Universit Passed on Percentage Percentile CGPA GRADE
Qualification course from Obtained Maximum
y Name
B.E/B.Tech_ Sant Gadge Ba
Civil Engineer MAHARASHT NOT APPLI NOT APPLI NOT APPLI
GRADUATE ba Amravati Un Jul 20, 2018 999 1350 74
ing or Equival RA CABLE CABLE CABLE
iversity
ent
Maharashtra St
ate Board of Se
NOT APPLI NOT APPLI NOT APPLI
HSC condary and Hi Feb 15, 2012 362 600 60.33
CABLE CABLE CABLE
gher Secondar
y Education
Maharashtra St
ate Board of Se NOT APPLI NOT APPLI NOT APPLI
SSC condary and Hi Mar 12, 2010 421 550 76.55
CABLE CABLE CABLE
gher Secondar
y Education
Exam Center Details
Preferred Exam Center Location1 Preferred Exam Center Location2 Preferred Exam Center Location3
BHANDARA NAGPUR AMRAVATI
Payment Details
Transaction Type Transaction Id Transaction Status Transaction Date Total Fees
ONLINE MAHAIT_RDD_000000096137 SUCCESS 01/04/2019 09:29 AM 750
Before logging on to the registration portal
Sr.No Undertakings
1. I have read and understood the instruction booklet carefully before filling in the form.
2. I have scanned my photograph and signature ready on my desktop confirming to the specified standards mentioned in the information Brochure.
3. I have downloaded the Online information brochure and read it carefully before filling the form.
4. I have the details for payment (Credit Card / Debit Card / Internet Banking) available with me for making Online payment.
5. I agree that my application form will be treated as complete only if I finally submit the application along with the payment of necessary fees.
6. I agree to bear the payment gateway additional charges
7. I accept to receive messages from MAHA-IT even if my mobile number falls under Opt-in and / or DND (Do Not Distrub)/ DNC(Do Not Call) category.
Before submitting the form
Sr.No Undertakings
1. I fulfill the conditions as specified in the eligibility criteria and registration guidelines.
2. All the particulars provided by me in this application are true, correct and complete to the best of my knowledge and belief.
I shall produce all the original documents along with the attested copies as and when required, failing to which I will be considered as blacklisted
3.
and debarred.
In case any particulars given by me in this application are found to be false, incorrect and /or misleading, I shall be liable for being blacklisted or
4.
debarred from all further examinations and selection processes of the Rural Development Department.
Printed On:01/04/2019 09:33:20 AM

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