իᱫ֒ᮧֈ֧֘֔֫շ֧֚֗֞ը֑֫չᮧ֑֞չ֒֞վ

(UTTAR PRADESH PUBLIC SERVICE COMMISSION, PRAYAGRAJ)

᭄֟֗֞֌֊֚ե᭎֑֞A-4/E-1/2021)
᭭ց֞֍֊֚ᭅ֚֟᭭ց֒ᮕ֧փ֌֡ᱨ֙֐֛֟֔֞֌֒֠ᭃ֞

bᮧ֐֞օ֠շ֒օᮧ֌ᮢ(ATTESTATION FORM)

Registration No: 72000128172 Roll Number 052284

ռ֧ֆ֞֗֊֠ದ
1bթ֚ᮧ֌ᮢ֐ᱶշ֫ժտ֢ւ֢֚֠ռ֊֞ֈ֧֊֑֞֞ᳰշ֚֠ֆ᭝֑֌֢օᭅ֢֚ռ֊֞շ֫֟ս֌֞֊֞է֊֛ᭅֆ֞(Disqualification ) ֚֐տ֠վ֑֧֞չ֠ն֒թ֧֚֚
ի᭥֐֠ֈ֚֗֞֒֘֞շᳱ֑֧֚֗֞շ֧֟֔ձէ֊֡֌֑֡Ღէ֊֛ᭅ֚֐տ֞վ֚֞շֆ֛֞֨_
֑ᳰֈի᭥֐֠ֈ֗֞֒թ֚ᮧ֌ᮢշ֫֏֒֊֧ֆև֞ᮧ᭭ֆ֡ֆշ֒֊֧շ֧֎֞ֈ֟֊ᱨ᭐ֈ(Detained) , ֈ֚֫֙֟᭟ֈ(Convicted) , ᮧ֟ֆ֗֞ᳯ֒ֆDebarred)
ըᳰֈᳰշ֑֞վ֑֞ֆ֫ի֚շ֧᳞֧֫֒իᱫ֒ᮧֈ֧֘֔֫շ֧֚֗֞ը֑֫չᮧ֑֞չ֒֞վշ֢֚֫֟ռֆᳰշ֑֧վ֞֊֧ռ֛֞֟ձ_ղ֚֞֊շ֒֊֧֌֑֛֚֒֐տ֞վ֞ձչ֞
ᳰշֆ᭝֑֌֢օᭅ֢֚ռ֊֞֟ս֌֞ժչ֑֛֠֨_

է᭤֑ևᱮշ֞֌֢֒֞֊֞֐ի֌֊֞֐ᲂշ֧֚֞և֑ᳰֈշ֫ժ֛֫ SHUBHAM VERMA

֟֌ֆ֞շ֞֌֢֒֞֊֞֐ի֌֊֞֐ᲂշ֧֚֞և֑ᳰֈշ֫ժ֛֫ SARVESH KUMAR
ֆև֞᭪֑֑֚֗֞շ֞֊֞֐֑ᳰֈշ֫ժ֛֫
֐֞ֆ֞շ֞֌֢֒֞֊֞֐ի֌֊֞֐ᲂշ֧֚֞ևb֑ᳰֈշ֫ժ֛֫ REKHA VERMA

֟֊᳜֟֔֟ոֆշᳱ᳦֑֒֞֠ֆ֞
֟֌ֆ֞Citizen of India ֐֞ֆ֞Citizen of India
֌֟ֆ֌᭜֊֠bb
֟֊᭥֊֟֔֟ոֆշ֞վ᭠֐᭭և֞֊
֌֟ֆb֌᭜֊֠
᭭և֑֞֠֟֊֚֗֞շ֞֌֢֒֞֌ֆ֞էև֞ᭅֆչ֩֗և֞֊֞ֆև֞֟վ֚֔֞փշ֐֞չᭅ֑֞չ֔֠֐շ֞֊֊֛֚֟ֆ
SARVESH KUMAR,544 1112 EKTA NAGAR,BALAGANJ,LUCKNOW,UTTAR PRADESH,226003
֑ᳰֈ֐֢֔ֆզ֌֞ᳰշ᭭ֆ֞֊շ֞֟֊֛֚֗֞֠֫ֆ֫ի֚ֈ֧֘֐ᱶ֌ֆ֞ֆև֞֏֞֒ֆ֐ᱶᮧᮯվ֊(Migration) շ֒֊֧շᳱֆ֞֒֠ո

֗ֆᭅ֐֞֊շ֞֌֢֒֞֌ֆ֞
SARVESH KUMAR,544 1112 EKTA NAGAR,BALAGANJ,LUCKNOW,UTTAR PRADESH,226003
֟֌ս֧֔֌֞եռ֗֙ᲃbշ֧֌ֆᱶ
NA
ը֑֡ֆև֞վ᭠֐շᳱֆ֞֒֠ո֑ᳰֈի᭥֐֠ֈ֗֞֒֐֨ᳯᮝ᭍֑֢֧֔֘֊֛֫ֆ֫ի֚շᳱ֐֨ᳯᮝ᭍֑֢֧֔֘֊շ֧֚֐֑շᳱը֑֡
25-07-1996

֘֨֟ᭃշէ֛ᭅֆ֑֞ᱶ֟վ֚֐ᱶի᭥֐֠ֈ֗֞֒շ֫15֗֙ᭅշᳱը֑֧֚֡֟֘ᭃ֞ᮧ֞᭡ֆշ֒֊֧շ֧᭭և֞֊ն֚֒֞և֐ᱶ᭭շ֢֔ᲂֆև֞
շ֧֞֔վᲂ֐ᱶ᭪֑ֆ֠ֆᳰշ֑֧չ֑֧֗֙ᭅᳰֈ֑֧վ֑֧֞
᭭շ֢֔շ֧֞֔վշ֞֊֞֐֌֢֧֒֌ֆ֧շ֧֚֞և ᮧ֧֗֘շ֞֗֙ᭅ սַ֫֊֧շ֞֗֙ᭅ ֌֒֠ᭃ֞վ֫֌֚֞շᳱ֛֫

LUCKNOW PUBLIC COLLEGE, 2010 2011 ֛֞ժ᭭շ֢֛֑֧֚֔֞֒շ֧᭛ᮟ֠

RAJAJIPURAM, LUCKNOW
LUCKNOW PUBLIC COLLEGE, 2012 2013 թ᭛ց֒֐֠֟փձց
RAJAJIPURAM, LUCKNOW
CAREER COLLEGE OF NURSING, 2014 2018 ᳩ֞ֆշ֟փ᭡֔֫֐֞
HARDOI ROAD, SITAPUR BY PASS
ROAD, LUCKNOW

\ߙȸ€ȯ¡èȡ¢š

Reg No: 72000128172 Roll Number: 052284 Print Date:-14/11/2021 09:27 AM Page No :- 1
 թ֔֞շ֧շ֧ղ֧֚ֈ֫֟վ᭥֐֧ֈ֞֒᭪֑֟Ღ֑ᲂշ֧֊֞֐֑֞ղ֧֚᭪֑֟Ღ֑ᲂշ֛֞֗֞֔֞վ֫ի᭥֐֠ֈ֗֞֒շ֫վ֞֊ֆ֧֛ᲂ

1) ARPIT PATEL 2) AYUSH SINGH

544 1120 EKTA NAGAR BALAGANJ LUCKNOW 544 1792 EKTA NAGAR, BALAGANJ, LUCKNOW
9793067671 7007351726
parpit08071997@gmail.com singhayush999@gmail.com

(I) ᭍֑֞ը֌շ֏֠ᳰշ֚֠᭠֑֑֑֞֞֔᳇֞֒֞ᳰշ֚֠է֌֒֞։շ֧֑֧֟֔֟չ֒᭢ֆ֞֒է֟֏֑֫֟վֆ(Prosecuted ), ֟֊ᱨ᭐ֈ(Detained) , էև֗֞

ը֎᳍bBound ) , էևᭅֈե֟փֆ(Fined ), ֈ֫֙ದ֚֟᳍ᳰշ֑֧չ֑֧"֊֛ᱭ
NA
(II)ᳰշ֚֠֔֫շ֧֚֗֞ը֑֫չ᳇֞֒֞֌֒֠ᭃ֞ռ֑֊ᲂ֐ᱶ֚֟᭥֐֟֔ֆ֛֫֊֧շ֧֑֧֟֔ᮧ֟ֆ֗֞ᳯ֒ֆէ֊֛ᭅᳰշ֑֧չ֑֧֑֞ᳰշ֚֠է᭠֑֟֘ᭃ֞ᮧ֞֟։շ֚֞֒֠ե᭭և֞
᳇֞֒֞շ֫ժ֌֒֠ᭃ֞ֈ֧֊֧շ֧֟֔ձᮧ֟ֆ֗֞ᳯ֒ֆ֑֞֎֛᭬֟շ֣ֆ(Rusticate) ᳰշ֑֧չ֑֧"֊֛ᱭ
(III) ᭍֑֞թ֚ᮧ֐֞օ֠շ֒օᮧ֌ᮢշ֫֏֒ֆ֧֚֐֑ը֌շ֧֟ո֔֞֍᭠֑֑֑֑֑֞֞֔֟֗᭫֗֟֗᳒֞֔֞ᳰշ֚֠է᭠֑֟֘ᭃ֞bᮧ֞֟։շ֚֞֒֠ե᭭և֞շ֧
֚֐ᭃշ֫ժ֗֞ֈ֟֗ռ֞֒։֠֊֛֨"֊֛ᱭ
NA

֑ᳰֈ(I) ֑֞(II) ֑֞(III) շ֞վ֗֞֎֛֞դ֛֨ֆ֫֗֞ֈ֟չ֒᭢ֆ֞֒֠֟֊֒֫։էևᭅֈ᭛փֈ֫֙ದ֚֟᳍ֈ᭛փ֞ֈ֧֘ըᳰֈշ֞֌֢֒֞֟֗֗֒օֆև֞թ֚ᮧ֌ᮢ

շ֫֏֒ֆ֧֚֐֑᭠֑֑֑֑֞֞֔֟֗᭫֗֟֗᳒֞֔֟֘ᭃ֞bᮧ֞֟։շ֞֒֠ըᳰֈշ֧֚֐ᭃ֟֗ռ֞֒֞։֠֊֗֞ֈշ֞ᮧշ֞֒ᳰֈ֑֞վ֑֞
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է᭤֑ևᱮ᳇֞֒֞պ֫֙օ֞զ

֐ᱹթ֚֎֞ֆշᳱպ֫֙օ֞շ֒ֆ֞շ֒ֆ֛֥֢֠ᳰշթ֚ը֧֗ֈ֊֌ᮢ֐ᱶվ֫֗օᭅ֊֛֛֨֗֐֧֧֚֒ե᭄֞֊ձ֗ե֚֟֗᭫֗֞շ֧է֊֚֚֡֞֒᭜֑֗֌֢օᭅ
֛֨ն֑֒ᳰֈի֚֐ᱶէ֚᭜֑֟֗֗֒օ֌֑֞֞վ֑֞ֆ֫֐ᱹէ֌֞ᮢւ֛֒֞ᳰֈ֑֞ֈ֠վ֞լ֥ն֑֒ᳰֈռ֑֟֊ֆ֛֫չ֑֛֞֫չժ֛֥֢ֆ֧֧֚֚֫֗֞
֛ց֞ᳰֈ֑֞ֈ֠վ֞լ֥_

ᳰֈ֊֞եշ _____________________
᭭և֞֊ է᭤֑ևᱮշ֛֞᭭ֆ֞ᭃ֒
֌֢֒֞֊֞֐ SHUBHAM VERMA
֌֢֒֞֌ֆ֞ SARVESH KUMAR,544 1112 EKTA
NAGAR,BALAGANJ,LUCKNOW,UTT
AR PRADESH,226003

Reg No: 72000128172 Roll Number: 052284 Print Date:-14/11/2021 09:27 AM Page No :- 2