Application of Job: SAILOR [AA],SAILOR [SSR] - 02/2020

Application No: SSA202350270026 Application Date: 08/07/2019

PRIORITY

1. SAILOR [AA] 02/2020

2. SAILOR [SSR] 02/2020
Considered for AA Submarine specialisation : Yes

PERSONAL PARTICULARS

Name: GAUTAM YADAV

Father's/Mother's Name: TRIVENI YADAV
Guardian's Name: TRIVENI YADAV
Nationality: INDIAN
Identification Mark 1: A MOLE ON FACE
Identification Mark 2: ---------
Pancard: ---------
Date of Birth: 01/03/2002

EDUCATION PARTICULARS

Details of 12th Science

Subjects Total Marks Obtained Marks

English 100 57

Physics 100 73

Chemistry 100 75

Maths 100 84

Computer Science 100 60

Total Marks: 500 Marksheet Serial Number: 164828

Obtained Marks: 349 State Conduct: JHARKHAND
Percentage: 69.80 Board Conduct: Jharkhand Academic Council

Details of 10th

Total Marks: 500 Marksheet Serial Number: 1487647

Obtained Marks: 446 State Conduct: BIHAR
Percentage: 89.20 Board Conduct: Central Board of Secondary Education (CBSE)
 MILITARY RECORD

Have you ever been enrolled in

NO
Armed Forces before?:
Have you been
discharged from
NO
Armed forces
before?:

COMMUNICATION PARTICULARS

Details of Permanent Address

Address 1: VILL-JATHA, POST-GALWATI Address 2: PS-DHANWAR

State: JHARKHAND District: GIRIDIH Pincode: 825418
Domicile: JHARKHAND Phone No.: 8409724903 Mobile No.: 8409724903
Email id: gautamyadav01032002@gmail.com Alternate Email id: ---------

Details of Correspondence Address

Same as Permanent Address

Alternate Mobile Number: ---------

A. I hereby declare that I am unmarried, governed by nationality condition as laid down by the Government of Indian and
have never been debarred from appearing at any examination. I have never been arrested/ prosecuted and convicted by a
criminal court or involved in any other case registered by the Police.
B. I hereby, solemnly declare that all the statements made in the above application are true and correct to the best of my
knowledge and belief.
C. I fully understand that in the event of my information being found false or incorrect, appropriate action can be taken
against me.
D. Eligibility criteria will be verified on reporting at the selection centres. I found ineligible, I understand that criminal
proceedings can be initiated against me for fraudulent entry and falsification of Government of Indian documents. I also
accept that no TA/ DA will be admissible to me in such cases.