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_____________________________________________________________________________________________________________________
Consolidated Advt. No.
0
Case No.
4
F.4-
-R
SENIOR AUDITOR
. B.S.
Name of Post Applied for:
Sr.
No
ACADEMIC QUALIFICATIONS:
Result Declaration Date
Academic
Qualification
Day
1
Matriculation
Intermediate
Month
Board/ University
Year
CGPA/
Div/Grad
% of
Marks
Obtained
3).
Principal Subjects
NAME
OF
COURSE
INSTITUTION
& LOCATION
GRADE
STARTING DATE
Sr.
No.
Day
Month
ENDING DATE
Year
Day
Month
Year
Nature of
Training
Internee
On
Job
Weeks
4)
1
2
3
4
5
5) RESEARCH/PUBLICATIONS/PAPERS/ARTICLES:
Mark R in the last column of the research report/paper/article/publication, if required in the advertisement.
Sr.
No.
1
2
3
4
5
Title
Journal/Conferences
(In case of
paper/article)
Publisher
Day
Publication Date
Month
Year
6)
EXPERIENCE: (i) Start from first employment in ascending order (ii) Do you possess relevant Post-Qualification experience for the post as mentioned in the advertisement. Experience (each) claimed here must be authenticated by
providing experience certificate/valid proof of that period with exact dates, job description/specification issued by the Competent Authority (specimen at Annex-A).
-2-
10
Attach additional sheet if required on the same pattern.
10
11
12
Day
13
14
Apprentice
Month
Part Time
Year
Honorary
Year
Daily Wages
Month
Adhoc
Day
Contract
Year
Officiating
Month
Temporary
TOTAL PERIOD
Permanent
Day
1
To
(Write to-date if you are still in service)
NATURE OF JOB
Private
From
STATUS
Semi Govt.
PERIOD
ORGANIZATION/
MINISTRY/DIVISION/
DEPARTMENT
Armed Forces
BS
Prov. Govt.
NAME OF THE
POST
Fed. Govt.
Sr.
No
15
16
17
18
19
20
21
22
23
24
25
26
27
MAIN DUTIES
PERFORMED
(Attach additional
sheet if needed)
28
- 3 -
7) Check List:
Have you filled/attached attested copies of all required documents as per following sequence?
Yes / No
1.
2.
3.
4.
5.
6.
7.
8.
8) Declaration (i): I hereby solemnly declare that I am not in possession of any domicile certificate other than District _______________________
claimed / submitted alongwith this application form for the instant case. I further declare that if I am found in possession of any
domicile certificate other than the one mentioned above, I will be liable to dismissal from service any time with costs or any other
penalty.
Declaration (ii): I certify that the statements made by me in the answers to the foregoing questions 1-6 are true, complete and correct to the best of my
knowledge and belief. Submission of fake/forged documents and any misrepresentation or omission discovered even after appointment
may render my appointment liable to termination in addition to the action decided by the Commission. I have also carefully read the
General Instructions to the candidates and I am bound by the terms and conditions contained therein.
Note:- Attested copies of all the documents should be attached in above order and numbered in continuation of page number of Application Form.
Applicants Signature
Date