GOVERNMENT OF ASSAM

STATE LEVEL POLICE RECRUITMENT BOARD, ASSAM

REHABARI:::GUWAHATI
APPLIED DATE : 30-OCT-2023 ACKNOWLEDGEMENT SLIP DOWNLOADED DATE : 03-APR-2024

RECRUITMENT ID:
APRECN2811404159
ADVERTISEMENT NO.:
SLPRB/REC/SI (UB)/646/2023/58
PERSONAL DETAILS
NAME: DATE OF BIRTH: GENDER:
SRI DHRITIMAN BAISHYA 16-DEC-2001 MALE
FATHER'S NAME: MOTHER'S NAME: CASTE/CATEGORY:
DWIJENDRA NATH BAISHYA GITA DEKA BAISHYA GENERAL
PHONE NO.: EMAIL ADDRESS: EMPLOYMENT EXCHANGE NO.:
9365855625 DHRITIMANBAISHYA123@GMAIL.COM 5912215/06/2023
ADDITIONAL PHONE NO.: AADHAR NUMBER
NA 723796469717
PERMANENT ADDRESS
ADDRESS:
NALBARI KAITHALKUCHI
DISTRICT: POLICE STATION(P/S): PINCODE:
NALBARI BELSOR PS 781370
CORRESPONDENCE ADDRESS
ADDRESS:
NALBARI KAITHALKUCHI
DISTRICT: POLICE STATION(P/S): PINCODE:
NALBARI BELSOR PS 781370
POST PREFERENCE
PREFERENCE POST NAME DEPARTMENT NAME
PREFERENCE 1 SUB INSPECTOR OF POLICE (UB) ASSAM POLICE
ACADEMIC QUALIFICATIONS
EXAMINATION BOARD/INSTITUTE/UNIVERSITY YEAR OF PASSING PERCENTAGE(%)
CLASS 10 SEBA(ROLL NO : B18-667-0005) 2018 87.00 %
CLASS 12 AHSEC (SCIENCE) 2020 71.00 %
NERIM GROUP OF INSTITUIONS ( BA / B.SC /
GRADUATION 2023 76.53 %
B.COM OR EQUIVALENT )
ADDITIONAL
( -- ) -- --
QUALIFICATION
QUESTIONARIES
ARE YOU BELONGS TO TEA
TRIBES OR ADIVASI ------- NOT SUBMITTED
COMMUNITIES ?
DO YOU HAVE NCC
------- NOT SUBMITTED
CERTIFICATE ?
UPLOADS
AGE PROOF CERTIFICATE SUBMITTED
DECLARATION

I, HEARBY, DECLARE THAT THE PARTICULARS GIVEN BY ME IN THIS FORM ARE TRUE TO THE BEST OF MY
KNOWLEDGE AND BELIEF AND ANY MISTAKE/MISINFORMATION, DETECTED AT THE TIME OF ADDMISION OR AT ANY
STAGE IN FUTURE, WILL RESULT IN THE CANCELATION OF ADMISSION/CANDITATURE. I HAVE READ THE INFORMATION
BULLETIN AND UNDERSTOOD ALL THE PROCEDURE. IN CASE I FURNISH ANY FALSE INFORMATION, MY RESULT WILL
NOT BE DECLARED/MY CANDIDATURE WILL AUTOMATICALLY STAND CANCELLED. I SHALL ABIDE BY TERMS AND
CONDITIONS THEREIN.