Indian Coast Guard Application for Enrolled Personnel CGEPT-01/2024

  Application Status
NAME Abhishek Varma

REGISTRATION NO 2309NGC0173118

DATE OF BIRTH 04-Sep-2002

APPLIED BRANCH Navik(GD)

CATEGORY Scheduled Caste (SC)

PAYMENT STATUS Exempted

DATE OF APPLICATION FORM 22-Sep-2023

SUBMITTED

  Personal Information
Note/Instructions:
1. Please do not use any prefix such as Mr or Ms.
2. Name as recorded in the matriculation/secondary examination marksheet.
3. Name (Candidate’s/Father’s/Mother’s Name) given in the application and all the uploaded documents i.e. ID Card, educational
certificates, category certificate (SC/ST/OBC/EWS) or any other uploaded document should be same or else the candidature will
be cancelled.
4. E-mail ID and mobile number once entered can’t be changed during the entire recruitment process.
5. Candidate is to bring same ID card (provided here) in original at all stages of recruitment.
6. Two different identification marks such as birthmark, mole and burn/injury mark are to be entered as text.
7. Candidate to upload class 10th marksheet with date of birth mentioned on certificate as date of birth proof or else Birth certificate
to be uploaded.
8. Candidate is to scan the original documents (neither photocopy nor self-attested photocopy) to upload in the online application.
9. Scanned document should be saved in .jpeg / .jpg format and size should be between 50KB to 150KB.
10. All the uploaded documents uploaded must be in Hindi or English. If, the document is in any language other than English or Hindi
then candidate is to upload both original and English translation of document as one file/document (after merging both
documents) in the online application.
11. Click here for specimen of document.
12. SC candidate availing their respective quota, must ensure that valid category certificate should have been issued (date of issue) on
or before the closing date of application.

NAME Abhishek Varma FATHER'S NAME Bishanpal Singh MOTHER'S NAME Rajbala

EMAIL ID XXXXXXXXXXXXXXX MOBILE XXXXXXXXXX ALTERNATE XXXXXXXXXX

MOBILE

NATIONALITY Indian MARITAL Unmarried GENDER Male

STATUS

AADHAR NUMBER XXXXXXXX4139 ID CARD Aadhaar Card ID CARD NO. XXXXXXXX4139

IDENTIFICATION A Mole Of Face IDENTIFICATION A Cut Mark Of Forehead CATEGORY Scheduled Caste
MARK 1 MARK 2 (SC)
DATE OF ISSUE OF 22-Mar-2017 DATE OF BIRTH 04-Sep-2002 DATE OF BIRTH 10th Class
CATEGORY PROOF TYPE Marksheet/Certific
CERTIFICATE
ate
SECONDARY EMAIL XXXXXXXXXXXXX AGE RELAXATION No FEE WAVIER Yes
ID XX CLAIMED

EMPLOYMENT Unemployed COMMUNITY Always valid (no GOT INFORMATION Youtube

TYPE CERTIFICATE validity date ABOUT INDIAN
VALIDITY COAST GUARD
mentioned on RECRUITMENT
certificate)

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   Class 10th Details
Note/Instructions:
1. 10th marksheet and certificate need to be uploaded at Stage-II.
2. In case of CGPA or Grade, conversion formula document need to be uploaded at Stage-II.
3. If you have additional certificate, the document of the same need to be uploaded at Stage-II.

EDUCATION U.P. Board of High GRADING SYSTEM Percentage DO YOU HAVE No

BOARD School & INDICATED IN ADDITIONAL
MARKSHEET MARKSHEET
Intermediate
Education
10TH CERTIFICATE 12324366 YEAR OF PASSING 2019 NO. OF SUBJECTS 6
NUMBER IN CLASS 10TH

Subject Hindi English Mathematics Science Social Sciences commerce

Marks Obtained 82 81 75 74 76 77

Total Marks 100 100 100 100 100 100

  Class 12th Details

Note/Instructions:
1. 12th marksheet and certificate need to be uploaded at Stage-II.
2. In case of CGPA or Grade, conversion formula document need to be uploaded at Stage-II.
3. If you have additional certificate, the document of the same need to be uploaded at Stage-II.

EDUCATION U.P. Board of High GRADING SYSTEM Percentage DO YOU HAVE No

BOARD School & INDICATED IN ADDITIONAL
MARKSHEET MARKSHEET
Intermediate
Education
12TH CERTIFICATE 098415 YEAR OF PASSING 2021 NO. OF SUBJECTS 5
NUMBER IN CLASS 12TH

Subject Physics Mathematics General Hindi English Chemistry

Marks Obtained 71 65 76 70 73

Total Marks 100 100 100 100 100

  Additional Details
1) Have you been Discharged from the Indian Army / Indian Navy / Indian Air Force or any No
government organization ?
2) Has any warrant or summons for your appearance as witness been issued and pending No
before a court of law for the time being in force ?
3) Are any proceedings in respect of an offence alleged to have been committed by you No
pending before a criminal court in India ?
4)Has any warrant or summons for your offence been issued and pending before a court of No
law for the time being in force ?
5) Has a warrant for your arrest been issued by a court under any law for the time being in No
force ?
6) Have you, at any time preceding the date of this application, been convicted by a court No
of India for any offence and sentenced in respect thereof to imprisonment ?
7) Have you applied in higher court for acquittal against the conviction of lower court ? No

8) Have you ever been debarred by ICG / Army / Navy / Air Force / UPSC / Central or No
State govt. during any recruitment process ?

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   Communication Details

Note/Instructions:
1. In case of reserved category applicants, either current or permanent address of online application should be same as the address
mentioned in caste/category certificate (SC, ST, OBC(Non-Creamy Layer) & EWS).

Permanent Address
HOUSE/STREET 77, Dr. Ambedkar colony LANDMARK RAJADARWAJA, POST OFFICE PARIKSHITGARH
PARIKSHITGARH
COUNTRY India STATE/ UT UTTAR PRADESH DISTRICT Meerut

SUB DISTRICT Mawana PIN CODE 250406 PHONE NO WITH 6398722789

AREA CODE

Present/Current Address
HOUSE/STREET 77, Dr. Ambedkar colony LANDMARK RAJADARWAJA, POST OFFICE PARIKSHITGARH
PARIKSHITGARH
COUNTRY India STATE/ UT UTTAR PRADESH DISTRICT Meerut

SUB DISTRICT Mawana PIN CODE 250406 PHONE NO WITH 6398722789

AREA CODE

Domicile Details
DOMICILE STATE Uttar Pradesh

  Photo And Signature

Note/Instructions:
1. Click here for specimen of photograph.
2. While uploading Photo / Signature / Thumb image, file nomenclature should be as follows:
Passport photograph: Passport_Photograph
Scanned signature image: Signature
Left hand thumb impression image: Thumb_Impression
3. Any discrepancy or anomaly in clarity of images of uploaded documents in the online application will lead to cancellation of
candidature.

PHOTO LEFT HAND THUMB IMPRESSION SIGNATURE

  Stage - I - Exam City Preferences

Note/Instructions:
1. Candidates are to fill first choice within 30 kms from the present residence. In case if no centre is available within 30 kms then the
other choices should be nearest to the present address.
2. Your next 4 preferences nearest to present address in increasing order of distance.
3. Non-compliance to these instructions may lead to cancellation of your candidature during document verification.

1. MEERUT 2. GHAZIABAD 3. DELHI AND NCR 4. BAREILLY 5. GORAKHPUR

  Stage - II - Exam City Preferences

1. NOIDA 2. GOA 3. KOLKATA 4. BHUBANESHWAR 5. CHENNAI

  List Of Uploaded Documents

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 Note/Instructions:
1. Uploading of documents/additional documents is restricted upto prior downloading of E-admit card for Stage-II. No documents
can be uploaded by the candidate after downloading Stage-II E-admit card. Failure of uploading of documents within the time
promulgated by ICG will lead to the cancellation of candidature. Any request for uploading new document after downloading of E-
admit card for Stage-II will not be entertained.
2. Affidavits duly signed by the candidate accepting their mistake of false information in online application will not be considered at
various stages of examination and their candidature will be cancelled.
3. Documents in Digilocker will not be accepted at any stage of the examination as electronic devices are not permitted in
examination premises. Candidates to bring their original documents at all stages of CGEPT examination.
4. All candidates will be compulsorily subjected to identity check prior commencement of the examination of Stage- I, II, III of CGEPT.
The identity check will include verification/matching of Photograph, biometric, signature and identification marks as mentioned in
this application.

Stage-I
1. ID Proof (Aadhaar Card)
2. Date of Birth Proof (10th Class Marksheet/Certificate)

Checking for Print Preview

Note/Instructions:
You are directed to completely check the print preview of the application and certify that your application is correct in all aspects as
per the advertisement. You are directed to go through the common reasons for rejection as published on the website and certify that
your application is correct and does not fall for rejection in document verification as per the rules prescribed in the advertisement for
Stage-I, II & III as published on the website. You may edit the application and the uploaded documents if there is any mistake or error
before submitting the application. Once the application is submitted, no changes are allowed.
a. HAVE YOU SEEN THE PRINT PREVIEW BEFORE SUBMITTING THE APPLICATION ? YES

b. DO YOU WANT TO EDIT THE APPLICATION OR THE UPLOADED DOCUMENTS IF THE DETAILS IN YOUR APPLICATION ARE INCORRECT OR THE YES
DOCUMENTS ARE INCORRECTLY UPLOADED ?

c. DID YOU UTILIZE THE "EDIT" OPTION AFTER SEEING THE PRINT PREVIEW PRIOR FINAL SUBMISSION ? YES

d. DO YOU WANT TO SUBMIT THE APPLICATION FINALLY ? YES

IF YOU CHECK YES, YOUR APPLICATION WILL BE SUBMITTED AND NO CHANGES WILL BE ALLOWED FURTHER.

  Declaration
a. I hereby declare that all the above information provided by me is correct.
b. I owe allegiance to the sovereignty, unity and integrity of India. I have not lost, surrendered or been deprived of the citizenship of
India.
c. I am eligible to apply for the said rank category as per the Indian Coast Guard (ICG) advertisement for present batch and have also
read the FAQs and common reasons for rejection during various stages of recruitment given on website.
d. I declare that I have applied for only one post viz. either Navik (DB) or Navik (GD) or Yantrik (Mechanical) or Yantrik (Electrical) or
Yantrik (Electronics) in present cycle. I understand that if, multiple applications are filled by me, then ,only the latest filled
application will be accepted and all the other applications will be rejected and the exam fee paid against these applications will not
be refunded.
e. I declare to remember my mobile number and E-mail ID used during filling of online application, as, the primary mode of
communication of ICG with me will be either through ICG website or E-mail.
f. I understand that Coast Guard will be uploading E-admit card, result of various stages of recruitment in my login dashboard and will
also be publishing various updates/announcements regarding recruitment on Coast Guard recruitment website. Hence, I declare to
visit ICG website and my login dashboard on regular/daily basis. ICG will not be responsible if I fail to visit ICG website on a daily
basis and comply with the instructions therein given from time to time and will not claim re-examination.
g. I understand that capturing and verification of biometric impression is mandatory for appearing at all stages of recruitment.
h. I understand that Indian Coast Guard reserves the right to conduct assessment/adaptability of candidates at any stage of the
recruitment process, prior issue of appointment letter to avoid impersonation. I understand that my candidature can be cancelled
on account of impersonation and the decision of Indian Coast Guard will be final and binding on me in this regard.

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 i. I understand that my candidature will be cancelled and I will be debarred from future Coast Guard Recruitment examinations in
case I am found to be involved in malpractice during any stage of current recruitment process.
j. I affirm that the information and particulars given by me in this application are true/correct and I am not suppressing any material
information in this regard. I further affirm that the certificates (ID Proof/DOB proof/NOC/Domicile certificate) uploaded in support
of my application for recruitment of the said post are authentic and solely pertain to me and I am fully responsible for the accuracy
of the same.
k. I declare that my SC/ST/OBC (non-creamy layer)/EWS certificate comply with the instructions given in the advertisement
regarding the format of certificate for appointment to the post under Government of India. If my candidature is cancelled on
account of incorrect category document then I shall not be considered against unreserved vacancy as I have submitted false
information.
l. I certify that I am in possession of originals of all the documents uploaded in the online application. Failure to present the original
document as uploaded in online application on account of loss of documents will lead to cancellation of candidature. I understand
that no request in this regard will be entertained by ICG even if I produce an F.I.R. w.r.t. theft of my documents and my candidature
will stand cancelled.
m. I declare that the form is filled by myself and not any other person, and for any mismatch/wrong information/incorrect
photo/signature/thumb image uploads, I will be responsible. I am aware that, my candidature can be cancelled, in case of any
mismatch/wrong information.
n. I have completely checked the print preview of the application and I certify that my application is correct in all aspects as per the
advertisement.
o. NO CLAIM / RISK UNDERTAKING:- I am a candidate for recruitment in Indian Coast Guard. I give my full and free consent at my own
risk that I shall not be entitled to claim any compensation or other relief from the government in respect of any injury or disability
which I may sustain in the course of or as the result of any of the tests (both physical fitness test and medical test) administrated to
me or attended by me during the recruitment procedure, whether due to my own negligence or any other person or otherwise.

Candidate Signatue Verified by (ICG Candidate Signatue Verified by (ICG

Candidate Upload Signature
for Stage II Officer) at Stage II for Stage III Officer) at Stage III

STAMP STAMP

Name: Name:

Rank: Rank:

Note:- Candidate will have to bring the same application form which is verified at Stage II by ICG while reporting at INS Chilka Stage
III or else the candidature will be cancelled.

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 STAGE-I UPLOADED DOCUMENT : ID PROOF (AADHAAR CARD)

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 STAGE-I UPLOADED DOCUMENT : DATE OF BIRTH PROOF (10TH CLASS
MARKSHEET/CERTIFICATE)

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 COMMON REASONS FOR REJECTION DURING DOCUMENT VERIFICATION

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 COMMON REASONS FOR REJECTION DURING DOCUMENT VERIFICATION

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 COMMON REASONS FOR REJECTION DURING DOCUMENT VERIFICATION

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