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Self Attested Passport Size Photo Guide

This document contains an application form for the post of [blank] in Kandhamal, Odisha. The 15-item form requests information such as the applicant's name, father/husband's name, gender, marital status, addresses, date of birth, educational qualifications, category, disability status if any, religion, nationality, employment exchange registration, character certificates, and treasury challan details. The applicant must declare they understand the relevant rules and the information provided is true to the best of their knowledge. The form is addressed to the Registrar of Civil Courts in Kandhamal district and must be filled out for the advertised job position.

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Alok Nayak
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408 views2 pages

Self Attested Passport Size Photo Guide

This document contains an application form for the post of [blank] in Kandhamal, Odisha. The 15-item form requests information such as the applicant's name, father/husband's name, gender, marital status, addresses, date of birth, educational qualifications, category, disability status if any, religion, nationality, employment exchange registration, character certificates, and treasury challan details. The applicant must declare they understand the relevant rules and the information provided is true to the best of their knowledge. The form is addressed to the Registrar of Civil Courts in Kandhamal district and must be filled out for the advertised job position.

Uploaded by

Alok Nayak
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

(FORM-A)

FORMAT OF APPLICATION
[See Para 2A of Appendix 'A']
APPLICATION FOR THE POST
OF Self
attested
Name of the Candidate: passport
2. Father' s (Husband's Name: size
3. Sex (Male/Female) photograph
4. Marital Status (Married/ Un-married):
5. Permanent Address
6. Present Address
Date of Birth (Age as on 11.06.2021):
8. Educational Qualification (Attach attested Copies of Certificates):
Name of the examination Name of the Year Aggregate Grade/ % of
passed Board/ of marks Division Marks
University passing secured secured
H.S.C.

+2 Arts/ Com./ Sc.


Diploma in Comp. Science

Revenue Inspector Training


(for Salaried Amin)
9. Category: (SC/ST/SEBC/GEN/Sports Person/Ex-Service Man)
(Strike out which is not applicable and attach the supporting documents issued by the
competent authority)
I O. Whether Physically/ Orthopedically Handicapped:
(If yes, attach supporting medical certificate issued by the Competent Medical Authority/
Board)
Il. Religion:
12. Nationality:
13. Employment Exchange Registration No:
14. Attach two Character Certificates issued by two Gazetted Officers/ Medical
Practitioners/Sarpanch etc. (mention name, designation of the officers):
15. Details of Treasury Challan with No. and Date:
DECLARATION
I do hereby solemnly affirm and state that I am aware about the provisions of Orissa
District and Subordinate Courts' Non-Judicial Staff Services (Method of Recruitment and
Conditions of Services) Rules, 2008 (Amendment Rules, 2010) and Odisha Group-C &
Group-D Posts (Contractual Appointment) Rules, 2013 and the statements made above are
true and correct to the best of my knowledge and belief and based on record. Any information,
if found incorrect, shall entail summary rejection of my candidature.

Place:
Date: (Signature of the Candidate)

BY ORDER OF THE DISTRICT JUDGE,


Sd/-
Registrar, Civil Courts,
Kandhamal, Phulbani.
APPLICATION FOR THE POST OF "
From To
The Registrar, Civil Courts,

Kandhamal, Phulbani,

Po/PS-Phulbani

District-Kandhamal

PIN-762001

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