CENTRAL INDUSTRIAL SECURITY FORCE

APPLICATION FORM FOR RECRUITMENT OF CONSTABLE-TRADESMAN-2022

1.Registration ID CISF2203599864

2.Name of the Trade applied for COOK

(Candidates can apply for only one trade)

3.NAME OF THE CANDIDATE AMAN KUMAR

4.FATHER'S NAME PANCHRAM

5.MOTHER'S NAME SUMAN

6.CATEGORY SC

7.Name of the State/UT Belongs to(Domicile/Origin) CHHATTISGARH

8.Have you migrated from the State/UT of your origin to another State/UT NO

9.GENDER MALE

10.NATIONALITY INDIAN

11.Educational Qualification CIVIL

Civil education details 10TH

12.RELIGION HINDU

13.Whether falling under the category of children and dependents of victim KILLED in 1984 riots/communal riots NO
of 2002 in Gujarat?

14.Do you belong to Hill area? NO

15.Whether you are an Ex-Serviceman NO

16.Whether you are a wards of CISF personnel NO

17.Whether you are an employee of Govt.Dept/Public Sector Undertaking/Autonomous Bodies NO

18.Date of Birth 05-12-2003

19.Visible Identification Marks MOLE IN RIGHT HAND

1)

2) MOLE IN RIGHT HAND

20. Permanent address WARD NO 7 JARWE RAASTA BIRGAHNI

Village/Ward

Post BIRGAHNI

State CHHATTISGARH

District JANJGIR-CHAMPA

PINcode 495671

21. Correspondence address WARD NO 7 JARWE RAASTA BIRGAHNI

Village/Ward

Post BIRGAHNI

State CHHATTISGARH

District JANJGIR-CHAMPA

PINcode 495671

22.a)Mobile 9770825637

b)Phone number,if any with STD code

23.Email AMANMAHILANGE728@GMAIL.COM

24.Type of Id Card AADHAR CARD

24.1.Id card No/Details 417803205822

25.Whether the date printed on the photograph Taken NO

26.Have you ever been convicted by any court of law or any other judicial Institution? NO

27. Have you ever been dismissed from any service under the Central or State Govt? NO

28. Have your services ever been terminated while on probation? NO

(Signature of the applicant)

 DECLARATION
TO BE SIGNED BY ALL THE CANDIDATES COMPULSORILY
1. I hereby certify that all the statements made in the application are true, complete and correct to the best of my knowledge and belief. In the event of the information or part thereof being found false or
detected incorrect during the process of recruitment or at any stage thereafter and that I am not satisfying the eligibilty criteria prescribed in this notice, my candidature/appointment is liable to be
cancelled/terminated automatically without any notice to me and action can be taken against me by the CISF.
2. I have read the provisions in the Notice of the examination carefully and I hereby undertake to abide by them.
3. I further declare that, I fulfill all the conditions of eligibility regarding age limits,educational qualifications,Domicile etc prescribed for admission to the examination. I have enclosed photocopies of certificates in
support of claim of Age,Educational Qualifications and Domicile.
4.I also declare that, I do not stand debarred from Government Service as on the date and have never been convicted by any court of law.
5.I have not submitted any other application for this examination. I am aware that if I contravene this rule, my application will be rejected summarily.

(Signature of the applicant)

(Application not signed by the candidate will not be entertained)
Date: 06-12-2022