Application Form

Department of Science & Technology, Government of Bihar

Application for Direct Recruitment of Karyalay Parichari
(Advertisement no. 02/2022 )
Application Details
Application ID :  
OAD/00159901 Application Date :
28-Oct-2022 Post Applied For :
Karyalay Parichari

Personal Details
Applicant Name ASHUTOSH KUMAR
Father's Name ASHOK KUMAR SINGH
Mother's Name SINDHU DEVI
Marital Status Un-Married
Spouse Name
Ex Serviceman No
Date of Birth 05-Dec-1995
Age as on (01.08.2022) 26 Years 7 Months
Gender Male
State of Domicile Bihar
Home District VAISHALI
Category EWS

Nationality Indian
Physically Handicapped No
Category of Physically Handicapped
Percentage of Physically Handicapped
WARD of Freedom Fighter No
Email ID babuashutosh0512@gmail.com
Mobile No. 9708033150
Phone With STD Code
Identification Marks A MOLE MARK ON NECK

Address for Correspondence

Address VILL-SHAMBHUPUR KOARI,PO-ASOI,PS-SARAI,VAISHALI,844114
Pin Code 844114

Permanent Address
Address VILL-SHAMBHUPUR KOARI,PO-ASOI,PS-SARAI,VAISHALI,844114
Pin Code 844114

Educational Qualification
Qualification Board/University Institute/ School/ College Name Certificate No Passing Year Full Marks Marks Obtained % of Marks
I.Matric BSEB PATNA H S SHAMBHUPUR KOARI 0426121 2012 500 313 62.6

Certificate Details
Sl. No. Certificate Name Issuing Authority Certificate No. Issue Date
1 Domicile Certificate CO/RO BRCCO/2022/11689295 17-Oct-2022
2 Caste Certificate CO/RO BCCCO/2022/8581223 17-Oct-2022
3 Disability Certificate
4 Ward of Freedom Fighter Certificate
5 Experience Certificate

Experience Details
Whether worked as a class IV Employee under the world bank polytechnic education
strengthening project in
No
Department of Science & Technology, Government of Bihar,
Patna
Year Experience Claimed 0
 Point Details
Educational Point 62.6
Experience Point 0
Total Point 62.6

I hereby declare that I am a citizen of India. The entries in this application form
are complete, true and correct to the best of my knowledge and
belief. I have read
carefully all the rules and provisions related to this advertisement and I promise
to follow these and also promise that I will not
use any unfair means during the
selection process. I fulfill all the eligibility criteria i.e. Age limit, educational
qualification as prescribed in the
advertisement. I have all eligibility certificates,
whenever the Department of Science and Technology, Bihar, Patna will ask for it,
i will produce the
same failing which my candidature can be cancelled by the Department
of Science and Technology, Bihar, Patna at any time. In case of any
information
provided by me is found to be false or incorrect before or after the selection,
the Department of Science and Technology, Bihar, Patna
will have the right to cancel
my candidature and take appropriate legal action against me. I declare that I have
filled only one application for this
advertisement.

Date:-
28-Oct-2022
Signature of Applicant (In English) Signature of Applicant (In Hindi)