Odisha Sub-ordinate Staff Selection Commission (OSSSC) Page No.

1
Copy of the Provisional Re-Registration Form submitted online for the Post of
Combined Recruitment Examination(IV)-2023 for the district cadre posts of RI, Supervisor (ICDS),
ARI, Amin and SFS -2023

Re-Registration Number : 00184898

Re-Registration Date and Time : 26/01/2024
14:52:55
Advertisement Details
Advertisement Number : IIE-60/2023-938(C)/OSSSC
Advertisement Date : 29/12/2023
Registered Username & Contact Details
Registered Username : Lachman145
Registered Password : As filled by you during registration
Mobile Number : 9090573967
Email ID : p.lachmandora@gmail.com
Post & Category Registration Details
Applied to : Odisha Sub-ordinate Staff Selection Commission (OSSSC)
Post Applied : COMBINED RECRUITMENT EXAMINATION(IV)-2023 FOR THE DISTRICT
CADRE POSTS OF RI, SUPERVISOR (ICDS), ARI, AMIN AND SFS

RA
Post Preference : 1) REVENUE INSPECTOR
: 2) ASSISTANT REVENUE INSPECTOR
: 3) AMIN

DO
: 4) STATISTICAL FIELD SURVEYOR
District wherein you want to appear in the : BALANGIR
Recruitment Examination. MA 4
Category Applied :
N
SOCIALLY EDUCATIONALLY BACKWARD CLASS (SEBC)
CH RE
Sub-category of the applied Category : TELENGA
Personal Details
LA - C

Name of the Applicant : P LACHMAN DORA

Father's Name : P TRIPATI DORA
Mother's Name : P INDU DORA
- P C)

Gender : MALE
Date of Birth : 14/05/1992
98 SS

Age (as on 01/01/2023) : 30 Years 7 Months 18 Days

Restrictions, if any, imposed by any Recruitment Commissions/Boards
48 (OS

Have you been debarred from appearing the : NO

recruitment examination of any
Commission/Board?
Odia Language Knowledge
What are the activities you can perform in Odia : Speak , Read & Write
language ?
Your Odia language Passing Standard : Passed Matriculation or equivalent Examination with Odia as the medium of
examination in non-language subjects
18

Undertaking
00

I do hereby solemnly declare that I have carefully gone through the Recruitment Advertisement of the Commission for the post mentioned
above and I fulfill all the conditions of eligibility prescribed for admission to the examination. I further declare that the information furnished and the
copies of the documents uploaded by me for registration/reregistration of my name for the recruitment examination for the post mentioned above are
true and relevant. If any such information or document or undertaking provided by me is/are found false or irrelevant during or after selection, my
candidature/selection shall be cancelled and I shall be liable to penal action as per law. Further I declare that whenever required the information
furnished and to be furnished by me during the course of Registration and Application may be used by the Commission or may be shared for bonafide
Government Purpose only.

Signature of Applicant

Note :
1) It may be noted that mere Registration/Re-registration does not mean complete filing of online Application.
Hence you are advised to fill up and submit the online Application as per the guidance of the system after
completing the Registration/Re-registration.Incomplete applications shall be summarily rejected.
2) This is a computer report generated through OSSSC portal (www.osssc.gov.in) and does not require any seal
and signature of the issuing authority.