1/4/2020 BPSSC Online

BIHAR STATE SUB-ORDINATE SERVICES COMMISSION

Recruitment of Enforcement Sub Inspector 2019 (Advt. No. 02/2019)
Under Bihar State Transport Department

ACKNOWLEDGEMENT
REGISTRATION ID : 50259558 DATE & TIME : 04-01-2020 15:31:52

APPLICANT NAME : PUSHPA KUMARI FATHER'S NAME : SURENDRA SINGH

MOTHER'S NAME : SHAKUNTLA DEVI NATIONALITY : INDIAN

MOBILE NUMBER : 7903944023 EMAIL ADDRESS : PRAHULSINGH007@GMAIL.COM

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

GENDER : FEMALE DATE OF BIRTH : 03-02-1996

MARITAL STATUS : MARRIED HUSBAND'S NAME : RAHUL KUMAR SINGH

IDENTITY CARD NO : 246833838657 (AADHAR CARD) IDENTIFICATION MARKS : A CUT MARK ON CHIN

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 070479 19-08-2011
GRADUATION (UG) MAGADH UNIVERSITY BA017571 20-06-2016

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BENEFITS AVAILED BY ME SHALL BE SUMMARILY WITHDRAWN.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

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