STAFF SELECTION COMMISSION

BLOCK NO. 12, CGO-COMPLEX, LODHI ROAD, NEW DELHI

110003
CONSTABLE(EXECUTIVE) MALE AND FEMALE IN
DELHI POLICE EXAMINATION
2020
REGISTRATION NO: 50001903613

APPLICATION IS INCOMPLETE
1. NAME AS PER 2. NEW/ CHANGED 3. FATHER'S NAME 4. MOTHER'S N
MATRICULATION NAME
CERTIFICATE
RAJA - MUMTAZ MIYA BABY KHAT
5. DATE OF BIRTH
6. AGE AS ON 01/07/2020 7. GENDER 8. CATEGO
(DD/MM/YYYY)
22/03/2001 19.3 MALE OBC FOR DELHI
9. NATIONALITY 10. MARK OF VISIBLE IDENTIFICATION
CITIZEN OF INDIA NON CREAMY LAYER
11. MATRICULATION (10th CLASS) EXAMINATION 12. MATRICULATION (10th 13. MATRICULAT
BOARD CLASS) ROLL NO CLASS) YEAR OF
NATIONAL INSTITUTE OF OPEN SCHOOLING (NIOS) 270433162550 2017
14. DO YOU BELONG TO A CASTES NOT INCLUDED IN CENTRAL LIST OF OBCs BUT NOTIFIED AS OBC BY TH
OF NCT OF DELHI ?
YES
15. WHETHER DEPARTMENTAL CANDIDATE OF DELHI POLICE ?
NO
16. WHETHER SON/ DAUGHTER OF SERVING, RETIRED OR DECEASED PERSONNEL/ MULTI-TASKING STAFF
POLICE
NO
17. HAVE YOU REPRESENTED A STATE AT THE NATIONAL LEVEL OR THE 17.1. IF YES, INDICATE DISCI
COUNTRY AT THE INTERNATIONAL LEVEL IN SPORTS DURING PRECEEDING YOUR SPORT
3 YEARS FROM THE CLOSING DATE OF RECEIPT OF ONLINE APPLICATIONS?
NO -
18. PREFERENCE OF EXAMINATION CENTERS
EXAMINATION CENTER EXAMINATION CENTER EXAMINATION CENT
(FIRST PREFERENCE) (SECOND PREFERENCE) (THIRD PREFERENC
DELHI ( 2201 ) ROORKEE ( 2006 ) JAIPUR ( 2405 )
 19.WHETHER EX- 19.1. DATE OF DISCHARGE 19.2. HAVE YOU ALREADY JOINED A CIVIL P
SERVICEMAN (ESM)? FROM ARMED FORCES AVAILING BENEFIT OF RESERVATION FO
(DD/MM/YYYY) SERVICEMAN (ESM) ?
NO - -
19.4. LENGTH OF SERVICE IN ARMED FORC
19.3. DATE OF JOINING THE CIVIL POST (DD/MM/YYYY) YEARS)

- -
20. WHETHER ELIGIBLE FOR SPECIAL QUOTA AS ESM FOR DELHI POLICE ?

21. WHETHER SEEKING AGE 21.1. IF YES,INDICATE CODE

RELAXATION ?

NO -

22. ARE YOU A NATIONAL CADET CORPS (NCC) CERTIFICATE HOLDER ? 22.1. TYPE OF CERTIFICA

NO -
24. DETAILS OF QUALIFY
23. HIGHEST QUALIFICATION
EDUCATIONAL QUALIFICA
INTERMEDIATE/ HIGHER SECONDARY/ 10+2 (2) 12TH
BOARD/ YEAR OF
ROLL NO SUBJECTS PERCENTAGE
UNIVERSITY PASSING
NATIONAL
INSTITUTE
ENGLISH MATH ENGLISH
OF OPEN 270433173597 2020 59
PSYCHOLOGY CHEMISTERY PHYSICS
SCHOOLING
(NIOS)
ADDRESS DETAILS
25. POSTAL ADDRESS 26. PERMANENT ADDRESS
F209 F209
RESETTLEMENTCOLONY RESETTLEMENTCOLONY
BAWANA BAWANA
DISTRICT: NORTH WEST DELHI DISTRICT:NORTH WEST DELHI
STATE: DELHI STATE: DELHI
PIN : 110039 PIN : 110039
MOBILE NO: 8920922280 EMAIL: rjakhan518@gmail.com
FEE PAYMENT AMOUNT TRANSACTION NO TRANSACTION
NOT EXEMPTED 100 - -
DECLARATION
1. I HAVE READ THE NOTICE OF EXAMINATION AND ACCEPT ALL THE TERMS & CONDITIONS ME
THEREIN.

2. I HEREBY DECLARE THAT ALL STATEMENTS MADE IN THIS APPLICATION ARE TRUE, COMPLET
CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THAT IN THE EVENT O
INFORMATION BEING FOUND SUPPRESSED/FALSE OR INCORRECT OR INELIGIBILITY BEING DETE
BEFORE OR AFTER THE EXAMINATION, MY CANDIDATURE/ APPOINTMENT IS LIABLE TO BE
CANCELLED.I AM WILLING TO SERVE ANYWHERE IN INDIA.
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