snitt22, 631 PM Applicant Print Atomic Minerals Directorate for Exploration & Rese Department of Atomic Energy i Application Registration No. Post Category Post code/Post Applied For First Name Middte Name sur Name Father's / Husband's Name Mother's Name Marital Status Date of Birth (oo-m-rr) Gender category Religion Nationality State of Domici [Are you from PWD category? Are you an Ex-Servicemen/Ex-Police? released as a consequence thereof? Are you presently employed? ‘communication Datails Address For Correspondence Are you defence Personnel disabled in operation during hostilities with any foreign country or ina disturbed area and 33093322 GROUP/C (Non-Gazetted) 03 / SECURITY GUARD [AKASH GOVIND CHITPILLE AKASH Govinp cHrTprie. Govinp ANJANA SINGLE 29-01-1997 MALE (OBC(NON-CREAMY LAYER) Name of Cast Certificate No. Date of issue of certificate : (Bank Account Details) Applicant Name: (ome tn Banc zou) Account Now IFSC code: Bank Name: Branch Name: CITIZEN OF INDIA MAHARASHTRA No No No No ASDAWAN ‘AT POST VISHNUPURE KUMBHAR 27-02-2013 AKASH GOVINDRAO CHITPILLE 62298300035 sB1Noo20425, STATE BANK OF INDIA DHANEGAON MDC cIDCO TOWNSHIP MARKET NANDED tps sopisterintrinorog22irmapplicantPrint aspx?regno=kdmBepBAMKOdSuQvqoECBGGWhMsIL1%2bxWaGaPWHjJMI.3dtne-back-butlon‘111122, 631 PM ity / vit State Pincode Permanent Ad city/vitloge State Pincode Mobile No e-Mail x0 Alternate E-Mail ID Applicant Print :ASDAWAN MAHARASHTRA + 431606 : ASDAWAN 2 AT POST VISHNUPURE ASDAWAN MAHARASHTRA + 431606 1 sigsaes21s +: akashchitpilleoo2@gmail.com : sameerkhan14444@gmail.com Aadhaar No 1 617308087678 Do you have Minium quslistiom and expasiensn as Speiiedaguinet the postin the Advertsoment wherever YES apileabiet Educational Deals uatieation Discptine/Degree Name of scoot/catege/Board | percentage | Month & Year of ssc/ioth = taTaR seas | ee-a0is Ba. vewoun oe 06-2022 CONSTRUCTION SUPERVISOR ume eas | o7aoe Centr For Examiatio Examination Centre Choice 1 MUMBAI Examination Centre Cholee 2. NAGPUR Examination Centre Choice 3. HYDERABAD Payment Dea Payment Wode Transaction Fa Amount Transaction Date ONLINE PAYMENT pay KehaiBEDWVaRGS 27 riein-2022 117.220.146.129 11-11-2022 3:350m Declaration: Thereby decare at al statements made inthis agplieation are ru, complete an carect tothe best of my knowlege and bei. urdestan that in he eve of ay Iefomaian being Yond fae at sy age ont seg he shay étera searing to be raquements the post. hy cnskature? appear bie be ‘ncaeg temic (Signature ofthe candidate) [Name of the candicate: AKASH GOVIND CHITPILLE ‘Application Registration Number: 33093322 hips register inctrinerog22srmapplicanPrin aspx?rogn’ ImcpSAMKOdSUQvaoECHGGWnisIL’%.20XWad9PWHwuM%eScno-back-buton