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APPLICATION IS INCOMPLETE
1. NAME AS PER 2. NEW/ CHANGED 3. FATHER'S NAME 4. MOTHER'S NAME
MATRICULATION CERTIFICATE NAME
SHAHZAD KHAN SANAULLAH SANAULLAH KHAN ARBIYA KHATOON
-
KHAN SALAMULLAH KHAN SANAULLAH KHAN
6. AGE AS ON
5. DATE OF BIRTH (DD/MM/YYYY) 7. GENDER 8. CATEGORY
01/01/2020
19/04/1995 24.8 MALE UNRESERVED
9. WHETHER PERSON WITH DISABILITY (PWD) ? 9.1 IF YES, TYPE OF DISABILITY (OH, HH,VH, OTHERS)
NO -
BA (5) NO
ADDRESS DETAIL
26. CORRESPONDENCE ADDRESS 27. PERMANENT ADDRESS
AT POST BANDUK PURA NEAR MASJID MAIN ROAD AT POST BANDUK PURA NEAR MASJID MAIN ROAD
HIWARKHED TQ TELHARA DIST AKOLA HIWARKHED TQ TELHARA DIST AKOLA
DISTRICT: AKOLA DISTRICT:AKOLA
STATE: MAHARASHTRA STATE: MAHARASHTRA
PIN : 444103 PIN : 444103
MOBILE NO: 7387329472 EMAIL: sk4493207@gmail.com
FEE PAYMENT AMOUNT TRANSACTION NO TRANSACTION DATE
NOT EXEMPTED 100 - -
DECLARATION
1. I HAVE READ THE NOTICE OF EXAMINATION AND ACCEPT ALL THE TERMS & CONDITIONS
MENTIONED THEREIN.
2. I HEREBY DECLARE THAT ALL STATEMENTS MADE IN THIS APPLICATION ARE TRUE, COMPLETE
AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THAT IN THE EVENT OF
ANY INFORMATION BEING FOUND SUPPRESSED/FALSE OR INCORRECT OR INELIGIBILITY BEING
DETECTED BEFORE OR AFTER THE EXAMINATION, MY CANDIDATURE/ APPOINTMENT IS LIABLE TO BE
CANCELLED.I AM WILLING TO SERVE ANYWHERE IN INDIA.
PRINT TAKEN ON: 24/10/2019 5:58:02 PM