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JAMMU & KASHMIR SERVICES SELECTION BOARD

GOVERNMENT OF JAMMU & KASHMIR

APPLICANT ID: 138667 APPLICATION DATE: 10/01/2021 12:17:05 PM

APPLIED APPLICATION FORM FOR DIVISION/DISTRICT CADRE POSTS

NAME OF POST - Sub Inspector
ADVERTISEMENT NUMBER - 04 OF 2020
PERSONAL DETAILS

Full Name Father's Name

MR Mohd Fareed Bajan

Mother's Name Gender

Amna Begum Male

Date Of Birth Age as on 01.01.2020

03/05/1995 24

Mobile Number Email Whether Married

7006829761 mohdf9478@gmail.com No

Whether you are Domicile of Jammu and Division District

Kashmir or not?

yes Jammu Rajouri

Has Domicile Certificate been issued

(If No, Domicile Certificate needs to be produced at the time of Document Verification)
yes
Permanent Address

House No./ Room No. Locality/ Mohalla/ Ward Village/ Town/ City
Number
39 Gakhrote
09

Division District Tehsil

Jammu Rajouri Koteranka

Block Panchayat Pincode

budhal Gakhrote A 185132

Correspondence Address

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House No./ Room No. Locality/ Mohalla/ Ward Village/ Town/ City
Number
39 Gakhrote
09

Division District Tehsil

Jammu Rajouri Koteranka

Block Panchayat Pincode

budhal Gakhrote A 185132
Category of Applicant

Category
Scheduled Tribe

Date of Issue of Certificate Date of Validity of the Category Issuing Authority

Certificate

11/24/2012 Tehsildar

Are you Specially Abled Person (PH)?

NO

Are you an employee of J&K Government?

NO

Are you an Ex-Servicemen?

NO

Have you ever been selected for any other Government Job under ESM Category?
NO
Criminal Proceedings

Please enter FIR(s) details

Whether any prosecution is pending in any Court of Law against you?

No

Was any Court Case been filed against you?

No

Whether any disciplinary action has been initiated by Government/Semi-Government Organisations

against you?
No
Qualification Details

Matric Board Matric Percentage Matric Result Date

JK State Board 53 05/25/2012
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Whether 10+2

SSSC(12th) Board
JK State Board

SSSC(12th) Percentage SSSC(12th) Result Date Whether 10+2 with Science

Subject

58.6 05/13/2014

Whether Graduate

Graduation Graduation College Graduation Graduation Result

University Percentage Date
BA
Jammu University 63.70 07/03/2018

PG PG DEGREE PG DEGREE PERCENTAGE

Other Details

Do you possess the prescribed educational qualifications as per the Choice of Examination
advertisement / notification? Center at
YES Jammu Division
Declaration

I hereby declare that I have carefully read the Advertisement Notification for this post and all the
terms and conditions indicated therein and undertake to abide by the terms and conditions of the
advertisement / notification for participating in the selection process. I fulfill all the terms and
conditions mentioned in the advertisement notification and the information provided by me herein is
true and correct to the best of my knowledge. I also undertake that in case of failure to possess the
qualification prescribed in the advertisement notification, the board will be fully competent to debar
me from the selection process. I further stipulate that I have carefully read the Government
notification and assure that I am not barred by the provisions of the said notification. I further
undertake that I shall not claim any benefit of any qualification/category that have not specifically
indicated in this online application form. Further, I am aware that I will be liable for appropriate penal
action, disqualification from the selection process or loss of the job in the event of selection having
been made, if the information provided by me is proved to be incorrect at any stage. The charges for
filling up the form are Rs.350 and are non-refundable. I am aware that I shall not have claim over the
charges, once successfully paid to J&K Services Selection Board, J&K. All the disputes related to
refund of excess payment, if any, are subject matter of the J&K Service Selection Board. Candidates
are advised to apply for refund of excess payment, if any, through official portal www.ssbjk.org only.
No chargeback request shall be entertained. Do you agree(Yes)?

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