BIHAR POLICE SUB-ORDINATE SERVICES COMMISSION

RECRUITMENT FOR BIHAR POLICE SUB INSPECTOR/POLICE SERGEANT/ASSISTANT

SUPERINTENDENT JAIL, 2019 (Advt. No. 01/2019)

ACKNOWLEDGEMENT
REGISTRATION ID : 41470489 DATE & TIME : 24-09-2019 16:59:30

POST PREFERENCES: 1. POLICE SUB INSPECTOR 2. ASSISTANT SUPERINTENDENT JAIL(DIRECT RECRUITMENT) 3. POLICE SERGEANT

APPLICANT NAME : SURBHI KUMARI FATHER'S NAME : OM PRAKASH SINGH

MOTHER'S NAME : MEERA DEVI NATIONALITY : INDIAN

MOBILE NUMBER : 8521046908 EMAIL ADDRESS : BITMPATNA11@GMAIL.COM

ARE YOU A DOMICILE OF BIHAR STATE : YES CATEGORY : GENERAL

GENDER : FEMALE DATE OF BIRTH : 04-09-1987

MARITAL STATUS : UNMARRIED

IDENTITY CARD NO : 953442590673 (AADHAR CARD) IDENTIFICATION MARKS : A MOLE MARK ON LEFT HAND

ARE YOU AN EX-SERVICEMAN? NO ARE YOU A WARDS OF FREEDOM FIGHTER? NO

EDUCATION QUALIFICATION DETAILS

EXAM PASSED SCHOOL/ UNIVERSITY/ BOARD/ INSTITUTE PASSING CERTIFICATE NO CERTIFICATE ISSUED DATE
MATRICULATION BSEB 0281118 16-09-2002
GRADUATION (UG) MAGADH UNIVERSITY 900 27-09-2008

ADDRESS DETAILS
PERMANENT ADDRESS CORRESPONDENCE ADDRESS
HOUSE NO N/A HOUSE NO 28

STREET/MOHALLA N/A STREET/MOHALLA KAVI RAMAN PATH

VILLAGE/TOWN HAIBATPUR VILLAGE/TOWN NAGESHWAR COLONY

POST OFFICE RAMPUR CHAURAM POST OFFICE GPO

DISTRICT ARWAL DISTRICT PATNA

STATE BIHAR STATE BIHAR

PIN CODE 804402 PIN CODE 800001

DECLARATION OF CRIMINAL CASES

HAVE YOU EVER BEEN DEBARRED BY UPSC, SSC OR SPSC OR ANY RECRUITMENT BOARD FROM APPEARING IN ANY EXAM? NO

CRIMINAL PROCEEDING DETAILS, IF ANY

A) WHETHER ANY FIR OR CRIMINAL CASE(S) HAS EVER BEEN REGISTERED AGAINST YOU? NO

B) WHETHER ANY CRIMINAL COMPLAINT CASE OR FIR OR CRIMINAL CASE(S) IS PENDING AGAINST YOU IN COURT OF LAW,
NO
OR WITH POLICE AT THE TIME OF SUBMITTING THE APPLICATION FORM?

C) HAVE YOU EVER BEEN ARRESTED/DETAINED IN ANY CRIMINAL CASE(S)? NO

D) HAVE YOU EVER BEEN TRIED & CONVICTED OR ACQUITTED BY A COURT OF LAW IN ANY CRIMINAL CASE(S)? NO

E) HAVE YOU EVER BEEN TRIED & CONVICTED BY THE COURT BY FILLING ANY BOND FOR GOOD BEHAVIOUR ETC.? NO

DECLARATION BY THE CANDIDATE

I HEREBY DECLARE THAT THE INFORMATION GIVEN ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF AND NOTHING HAS BEEN CONCEALED THEREIN. I AM
WELL AWARE OF THE FACT THAT IF THE INFORMATION GIVEN BY ME IS PROVED NOT TRUE, I WILL HAVE TO FACE THE CONSEQUENCES AS PER THE LAW. ALSO, ALL THE
BENEFITS AVAILED BY ME SHALL BE SUMMARILY WITHDRAWN.

English Signature Hindi Signature