Sample Application Form

For the post of MUNSIFF-MAGISTRATE

Registration Form
Personal Information
Name of the Candidate (As entered in matriculation certificate/changed by notification in
Official Gazette)
Expansion of Initials, if any, in the order in which they are given
Gender MALE,FEMALE
Category (State whether SC/ST/OBC/GENERAL) SC,ST,OBC,GENERAL
Date of birth (dd-mm-yyyy) Date--- Month--- Year
Address for Communication
House Name/No
Street/Lane
Locality
Post Office
State
District
District
PIN Code
Permanent Address"=
House Name/No
Street/Lane
Locality
Post Office
State
District
District
PIN Code
e-Contact Information
Mobile Number
E-mail ID
Land Phone Number with STD Code (Only digits)
Citizenship & Nativity
Are you a citizen of India? (If yes, give details) Yes,No
Marital Status
Marital Status (If Married, give details) Single,Married,Widow,Widower,Divor
ced
Disability Details
Are you a Differently Abled candidate? (If yes, give details) Yes,No
Age Relaxation
Do you claim relaxation of upper age limit available to adult members belonging to any of Yes/No
the Scheduled Castes and their children when such adult members are converted to other
religion? (If yes, give details)
Central/State Govt. Service
Are you in the service of Central or State Govt.? (If yes, give details) Yes/No
Eligibility Criteria
Are you a holder of a degree in Law recognised by the Bar Council of India for the purpose Yes/No
of enrolment as an Advocate? (If yes, give details)
Recruitment by Transfer Details
Category to which you belong Now holding any one of the post
enumerated in feeder categories (i) to
(vii).
Now not holding any one of the post
enumerated in feeder categories (i) to
(vii) but has held any one or more of
such posts and is now holding a post in
a higher scale of pay in any of the
offices from which appoinment is to be
made.
Feeder Category (viii).
Name of the Department to which you belong
Name of Post now held
Scale of Pay
Postal address of the office
Are you an approved Probationer in the post now held? Yes/No
Are you on deputation now? Yes/No
Have you passed any departmental tests ? Yes/No
Is there any adverse remark recorded in your confidential report and communicated to you ? Yes/No
Service Particulars (in the offices from which appointment is to be made)

Name of Post(s) held Department Scale of Pay Period (dd-mm-yyyy) Length of service
From To (Years, Months, Days)
 Part - II
Place of Birth Details
Country of Birth India,Others
Place of Birth with name of Country (Give the name of Village,
Taluk,District and State for those born in India)
Spouse Details (Only if applicable)
Name of Spouse
Address of Spouse
Occupation of Spouse
Details of Parents / Guardian
Details with respect to Parents or Guardian Parents,Guardian
Language Proficiency
What is your mother tongue? Languages To Read To Write To Speak
Malayalam
English
Hindi
Tamil
Kannada
Specify other
language
known, if any
Qualification
Stream Main Subject Year of Passing Class/ % of Name of
Grade Mark University
Graduation
LLB
Post Graduation
Post Graduation in
Law
Additional Qualification
Do you have any additional qualification? (If yes give details) Yes/No
Employment Details
Have you been employed on a regular or temporary basis under Central Yes/No
or State Govt. or any Quasi-Govt. Institution or any Govt. owned
company or Local Self Govt. Institution? (If yes give details)
Other Details
Do you have any Computer Knowledge? (If yes give details) Yes/No
Have you specialized in any particular branch of law? (If yes give Yes/No
details)
Have you undertaken any research work? (If yes give details) Yes/No
Do you have any teaching experience? (If yes give details) Yes/No
Have you published any articles or books? (If yes give details) Yes/No
Have you got any opportunity to render legal aid? (If yes give details) Yes/No
Extra curricular activities
Do you have any extra curricular activities? (If yes give details) Yes/No
Enrollment & Practice Details
Have you got enrolled as an advocate? (If yes give details) Yes/No
Are you a practicing Advocate on the date of application? (If yes give Yes/No
details)
Debarment / Disqualification Details
 Have you been debarred for candidature in any previous selections by Yes/No
any public authority? (If yes give details)
Have you been disqualified for candidature in any previous selections by Yes/No
any public authority? (If yes give details)
Have you been found ineligible for candidature in any previous Yes/No
selections by any public authority?. (If yes give details)
Have you been dismissed from service of Central or State Government Yes/No
or any Quasi-Government Institution or any Government owned
Company or Corporation or any Local Self Govt. Institution? (If yes
give details)
Was any penalty other than dismissal from service imposed on you Yes/No
during your service? (If yes give details)
Is any disciplinary proceedings/vigilance enquiry initiated or Yes/No
contemplated against you? (If yes give details)
Were you subjected to any proceedings for professional misconduct by Yes/No
the Bar Council? (If yes give details)
Criminal / Civil cases in which you are a party
Are/Were you a party in any civil/criminal proceedings? (If yes give Yes/No
details)
Details of persons who can testify about you
Name and address of three respectable persons (not related to you) who
can testify about your character, conduct and reputation
Name and address of the first person
Name and address of the second person
Name and address of the third Person
Additional Information
Were you a candidate for selection of Munsiff-Magistrate earlier? (If yes Yes/No
give details)
Do you desire to furnish any other relevant information? (If yes give Yes/No
details)
Declaration

I hereby declare that the details furnished above are correct and complete to the best of my knowledge and belief, that I possess
sound health and active habits, that I am free from any bodily defect or infirmity which would render me unfit to work as a
MUNSIFF-MAGISTRATE in the Kerala Judicial Service, that I am not aware of any other circumstance which may impair my
fitness for employment under the Government, that my character and antecedents are such that they will not disqualify me from
Government service, that I have read and understood the terms and conditions stipulated in the Notification in response to which
the application has been submitted and that I shall abide by the relevant rules and other conditions of recruitment laid down from
time to time.

❏ I affirm

Place:

Date :

Powered by TCPDF (www.tcpdf.org)