You are on page 1of 2

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL


WEST BENGAL POLICE RECRUITMENT BOARD
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
APPLICATION FORM FOR THE POST OF CONSTABLES/ LADY CONSTABLES IN WBP 2020
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
A4C5C800EB00A649CEBADFE4CF82758303A410C23CE8689E9BA16009C0461DA5
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL


30569187MA971007A
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
Application SA971007NL
Sl. No. 30569187

SA971007NL
To SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
The Chairman
SA971007NL
West BengalSA971007NL SA971007NL
Police Recruitment Board SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
POLICE RECORDS BHAVAN, ARAKSHA BHAVAN, BLOCK -DJ , SECTOR -II,
SALTLAKE, KOLKATA-700091
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
Sir,
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
I hereby apply for the post of Constables/Lady Constables in WBP 2020. Necessary particulars are
SA971007NL below:-
furnished SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL
Post appliedSA971007NL
for SA971007NL SA971007NL
: Constables/Lady SA971007NL
Constables in WBP 2020 SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL


Name in FullSA971007NL SA971007NL
SA971007NL : SURAJ MONDAL
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
Gender : Male Category : OBCA Date of Birth : 07/10/1997
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
Father's Name : ALAUDDIN MONDAL Mother's Name : MOHIRAM MONDAL
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
Marital Status : Un-Married Husband Name :
SA971007NL SA971007NL
HG in WBP/NVF / CV in WBP SA971007NL SA971007NL
: Not Applicable ServiceSA971007NL SA971007NL
Experience Details : YearSA971007NL
Month SA971007NL
Days SA971007NL
00 00 00
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
Mobile : 7001163365 Email : surajmondalkpi@gmail.com
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
Complete Mailing Address :
SA971007NL SA971007NL SA971007NL SA971007NLP.S-KALYANI,
VILL+P.O-CHANDAMARI, SA971007NL SA971007NL
DIST-NADIA, SA971007NL SA971007NL SA971007NL
PIN-741245

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL


PO : CHANDAMARI

POLICE STATION
SA971007NL SA971007NL SA971007NL : KALYANI SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
SA971007NL
DISTRICT : NADIA
SA971007NL SA971007NL SA971007NL PIN : 741245
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
STATE : WEST
SA971007NL SA971007NL SA971007NL BENGAL
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
NEAREST RAILWAY STATION : KALYANI SILPANCHAL (KLYS)
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
Permanent Address :
VILL+P.O-CHANDAMARI,
SA971007NL SA971007NL SA971007NL SA971007NLP.S-KALYANI,
SA971007NLDIST-NADIA, PIN-741245
SA971007NL SA971007NL SA971007NL SA971007NL
PO : CHANDAMARI
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
POLICE STATION : KALYANI
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
DISTRICT : NADIA PIN : 741245
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
STATE : WEST BENGAL
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
NEAREST RAILWAY STATION : KALYANI SILPANCHAL (KLYS)
SA971007NL SA971007NL SA971007NL
Educational Qualification
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
: Class X Pass : Yes
SA971007NL
Name ofSA971007NL
Examination SA971007NL SA971007NL
Year of Passing (YYYY) SA971007NL
Name of theSA971007NL
Board / Council SA971007NL
/ University SA971007NL
Marks % /SA971007NL
Grade
Madhyamik (Class X) 2013 WEST BENGAL BOARD OF SECONDARY EDUCATION 54.76 / B+
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
Higher Secondary (10+2) 2015 WEST BENGALCOUNCIL OF HIGHER SECONDARY 70.60 / A
EDUCATION SA971007NL SA971007NL SA971007NL
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
Graduation /
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
Post Graduation /
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL Page


SA971007NL
1 of 2

A4C5C800EB00A649CEBADFE4CF82758303A410C23CE8689E9BA16009C0461DA5
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL
Application Sl. No. 30569187SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
30569187MA971007B
Name : SURAJ MONDAL A4C5C800EB00A649CEBADFE4CF82758303A410C23CE8689E9BA16009C0461DA5
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL


Registration & NCO No. issued by the
Do you belong to exempted category? : NO
labour department, Govt. of W.B. :
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
Able to Speak,
SA971007NL Read & Write SA971007NL : SA971007NL
SA971007NL BENGALI SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
Your Community : Religion : ISLAM
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
Employed in any Government : NO Organization Name :
OrganisationSA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
SA971007NL
Have you ever been subjected to a criminal investigation as an accused involving moral turpitude? : NO
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
Police Station Name in Full FIR No. FIR Date Sections of Law
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL


Application Fees : Rs. 150.00 Bank Charge : Rs. 0.00
SA971007NL SA971007NL SA971007NL
Processing Charge : Rs. 20.00 SA971007NL SA971007NL
Total FeesSA971007NL
paid SA971007NL SA971007NL SA971007NL
: Rs. 170.00
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL


Transaction ID : VSM29720461567 [ Online Payment through Bill Desk ]
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
Transaction Date : 04/02/2021 21:10:02
SA971007NL SA971007NL SA971007NL SA971007NL
(Rupees One SA971007NL SA971007NL
Hundred Seventy only) SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL


Declaration :
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
(i) I possess all the Essential Qualifications for the Post.
SA971007NL SA971007NL
(ii) I solemnly SA971007NL
declare that all SA971007NL
statements made SA971007NL
in this application form are SA971007NL SA971007NL
true, complete and SA971007NL
correct to the SA971007NL
best of my knowledge
and belief. In the event of any information being found suppressed / false or incorrect, or if my ineligibility is detected before,
SA971007NL SA971007NL
during or after the tests SA971007NL SA971007NL
and medical examination, SA971007NL
my candidature SA971007NL
/ appointment SA971007NL
will stand cancelled andSA971007NL SA971007NL
my claim to recruitment
will stand forfeited. I also declare that I have submitted no other application form for this examination.
SA971007NL SA971007NL
(iii) I have never SA971007NL
been debarred SA971007NL
from any examination SA971007NL
conducted SA971007NL
by any Service CommissionSA971007NL SA971007NL
/ Recruitment Board SA971007NL
of the Government
of West Bengal.
SA971007NL SA971007NL
(iv) I have not SA971007NL
been subjected SA971007NL
to a criminal investigation SA971007NL
involving SA971007NL SA971007NL SA971007NL SA971007NL
moral turpitude.
(v) I shall submit
SA971007NL the No Objection
SA971007NL SA971007NLCertificate from the Head
SA971007NL of the Office/
SA971007NL DisciplinarySA971007NL
SA971007NL Authority if shortlisted
SA971007NL for Interview.
SA971007NL
(applicable only for candidates in Government service)
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
Place : KALYANI Yours faithfully,
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL
Date : 04 Feb 2021 21:10:02
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL


Full signature of the candidate (only in Long Hand)
SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL

SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL SA971007NL Page


SA971007NL
2 of 2

A4C5C800EB00A649CEBADFE4CF82758303A410C23CE8689E9BA16009C0461DA5

You might also like