Application Form

Application Number
Token / Transaction
1. Exam Details
1.1 Examination Name
1.2 Examination Post
1.3 District Head Quarter for Exam
1.4 General Subjects (PRE)
: 101210105666076 Payment Mode : E-Mitra Application Filled Date : 22/02/2016 4:36 PM
: 1699099914342237 Reference Application : 101210105666076
: INSPECTOR FACTORY AND BOILER 2015
: INSPECTOR FACTORY AND BOILER
: AJMER
: Inspector Factory and Bolers

1.5 Optional Subjects (PRE) :

1.6 General Subjects (MAINS) :
1.7 Optional Subjects (MAINS) :
1.9 Medium Of Exam :
2. Department Preferences
2.1 Department Preference :
3. Applicant's Details
3.1 Applicant's Full Name : ANIL KUMAR DANGI
3.2 Applicant's Father Full Name : SEDU RAM DANGI
3.3 Applicant's Mother Full Name : PHOOLI DEVI
3.4 Date Of Birth (dd/mm/yyyy) : 19/12/1980
3.5 Gender : MALE
3.6 Marital Status : Married
3.7 Category : BC (Non Creamy Layer)
3.7.1 TSP Area (If Any) : TSP-UR
3.8 Home State (Bonafide Resident) : RAJASTHAN
3.9 Home District JAIPUR
Photo & Signature
Of Candidate
4. Other Special Categories
4.1 Category for Disabled Candidates :
4.2 Specific Category for Female :
4.3 Other Category : Govt. service / Panchaytee Raj / Public Sector Employee[RG]

5. Correspondence Details
5.1 Address : PLOT NO 44
ARYA NAGAR
MURLIPURA
,
MURLIPURA ,Tehsil : JAIPUR,City/Village : JAIPUR - 302039
5.2 Email : anil_dangi2005@yahoo.com
5.3 Phone :
5.4 Mobile : 9413841044
6. Qualification
Year Division/Grade
6.1 Secondary : 1996 First
6.2 Sr. Secondary : 1998 Second
6.3 Graduation : 2005 First
6.4 Post Graduation : 2010 First Passed
7. Additional Qualifications/Specifications
7.1 Other Specification/Qualification :
7.2 Examination passed :
7.3 Internship Period : From : To :
7.4 Experience : Days : 11 Months : 5 Year : 5
8. Identification
8.1 Body Mark : a mole on right side of chest below shoulder
9. Disclaimer
I hereby declare that all information made in this application are true, complete and correct to the best of my knowledge and belief. In the event of my information being found false or incorrect or the ineligibility
being detected before or after the Screening Test/Interview, action can be taken against me by the Commission. I have read the provisions of the relevant rules and the Advertisement carefully and I hereby
undertake to abide by them. I further declare that I fulfill all the conditions of eligibility regarding age limits, educational qualification and required experience etc. prescribed for admission to the Screening
Test/Interview. Also I accept SMS facility provided by the Commission.

Rajasthan Public Service Commission

Nodal Officer: Mr. Akhilesh Mittal, System Analyst (Joint Director)
Ghooghara Ghati, Jaipur Road, Ajmer
Help Line : 0145-5151212
Phone : +91+145+ 5151200, 5151240 & 5151090