Registration ID

HARYANA PUBLIC SERVICE COMMISSION 711387074959457

Post Name Haryana Civil Services (Executive Branch) & Other Allied Services - 2023

Basic Detail

Applicant Name: DEEPAK Mobile No: 7876552001

Gender: Male

Email: DEEPAKKAUSHIK2222@GMAIL.COM Date of Birth: 23-11-1994

Category: EWS Nationality: CITIZEN OF INDIA

Father's Name: SHRI BHAGWAN Mother's Name: SHEELA DEVI

Have you ever been debarred by UPSC/HPSC/other State PSCs or any other
No
Government Department?:

Have you ever been convicted by Criminal Court: No

Are you an employee of Govt. of Haryana: No

Sub Category Detail

Applicable Sub Category: None

Permanent Address

Address: Vill mundhal kalan

State: Haryana District: Bhiwani Tehsil: Bhiwani

Town/Village: Mundhal Kalan Pin Code: 127041

Correspondence Address

Address: Vill mundhal kalan

State: Haryana District: Bhiwani Tehsil: Bhiwani

Town/Village: Mundhal Kalan Pin Code: 127041

Date :
Place :
Candidate signature

Date of Printing : 13/12/2023

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 Registration ID
HARYANA PUBLIC SERVICE COMMISSION 711387074959457

Bank Account Details

Name of the Account Holder Deepak

Bank Account No 3198492823

Name of the Bank Central Bank Ofindia

IFSC Code CBIN0280408

Are you domicile of Haryana State? Yes

Payment Detail

Bank Refrence Number: 85251286010

Order ID: 44380071138042

Payment amount: ₹ 250.00

Payment date: 13-12-2023

Qualifying Examination

Name of the
Passing Marks Total
Qualification Board/University/ Roll Number Percentage
Year Obtained Marks
Institution
Matric Haryana Board of School Education 2009 2208447216 395 500 79.00
Central Board of Secondary
10+2 2012 2606894 326 500 65.20
Education
Arts
University of Delhi, Delhi 2016 7225707 612 1200 51.00
(BA programme)

Have you worked or are you presently working on adhoc / contract / work-charged / daily wages basis in any
No
Department/Board/Corporation of Haryana Government to claim age relaxation?

Employees of Haryana Government or HighCourt or any Court Subordinate thereto,having at least 4 years
No
service in a substantive or officiating (excluding ad-hoc)capacity on or before 01.01.2023.

Optional Subject Details

Optional Subject For The Main Exam: Law (15)

Date :
Place :
Candidate signature

Date of Printing : 13/12/2023

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 Registration ID
HARYANA PUBLIC SERVICE COMMISSION 711387074959457

Post Prefrence Details

Post Prefrence Details

Prefrence 1 Haryana Civil Services (Executive Branch)

Prefrence 2 Deputy Superintendent of Police

Prefrence 3 Excise & Taxation Officer

Prefrence 4 District Food & Supplies Controller

Prefrence 5 'A' Class Naib Tehsildar

Prefrence 6 Block Development & Panchayat Officer

Prefrence 7 Assistant Excise & Taxation Officer

Prefrence 8 Assistant Registrar Cooperative Societies

Prefrence 9 District Food & Supplies Officer

Prefrence 10 Traffic Manager

Prefrence 11 Assistant Employment Officer

Physical Details

Height: 176

Chest (expanded): 95

Chest (unexpanded): 86

Date :
Place :
Candidate signature

Date of Printing : 13/12/2023

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 Registration ID
HARYANA PUBLIC SERVICE COMMISSION 711387074959457

Uploaded Documents

S.N. Document Name

1. Document for Matric

2. Document for 10+2

3. Document for Qualifying Examination

4. Document for Category Certificate

Declaration

I have filled up my particulars and I verify that I have read the same and found the same to be correct as per the original documents and have not
concealed anything, and thereafter submitted the same. If at any stage, any particular in the application form is found incorrect/false as per available
data, then my candidature shall be liable to be rejected/cancelled without giving me any opportunity of hearing, at any stage i.e., prior to/after my
recruitment/appointment.

Date :
Place :
Candidate signature

Date of Printing : 13/12/2023

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