5/19/2014

Public Service Commission U.P., Allahabad

0 0,
I Declare that I have Read the detailed User Manul & Notification.

Notification Details ( Examination )

1. Advertisement Number :
2. Applied For :

A-1/E-1/2014

3. Examination Name :

COMBINED STATE/UPPER SUBORDINATE SERVICES PRELIM.

EXAMINATION-2014

P.C.S. - PRELIM. EXAMINATION - 2014,

Candidate Personnel Details

4. Application ID :
5. Candidate Registration No. :
6. Candidate Name :
7. Father's/Husband's Name :
8. Gender - Date of Birth :
9. Domicile of UP / Category :
10. Are you Married?
11. Contact No./ Email-ID :

200071102008444
10222200879
AZAT SHATRU
B K SINGH
Male - 05/09/1990
Yes / General
No
9910643182 / azat.3277@gmail.com
Bank Transaction Details

12. Bank Name - Payment Mode :

13. Fees, Transaction ID - Date:

State Bank Of India - EC

Rs. 115.00 , 11886860 - 16/05/2014
Other Details of Candidate

14. Are you Dependent of UP Freedom Fighter?

No

15.a. Are you UP Ex. Army?

No
15.a.1 Service Duration (Day-Month-Year) : 0

- 0

- 0

15.a.2 Retirement Date(Date/Month/Year) : _ _ _

15.b. Are you ECO/SSCO/CO of Army ?

No
15.b.1 Have you complete 5 year service ? No

15.b.2 Have your services been extended for

rehabilitation and no disciplinary action is pending No
against you ?

15.c. Have you ever been Debarred from U.P. Public Service Commission? :

No

15.c.1 Completion Date of Debarment (DD/MM/YYYY) : ../../....

16. Are You Handicap of UP?

No
16.1 Are you Blind Or Have Vision problem? : No
16.2 Are you Deaf or Have hearing problem? : No
16.3 Have you any physical Problem? : No

17. Are You Skilled Player Of UP? :

No

18. Are You Govt./Ex-Govt. State Employee of Uttar Pradesh ? :

No

High School & Intermediate Board,Year of passing & Roll Number Details
Sr.No Exam ination
Passed
1.
High School
2.

Interm ediate

Board Nam e

Year of Passing

Roll Num ber

CENTRAL BOARD OF SECONDARY

EDUCATION
ANDHRA PRADESH BOARD OF
INTERMEDIATE EDUCATION

2006

4151594

2008

0827222505

Essential Qualification Details

Sr No. Qualification

Acquired

Yes

Bachelors degree from any recognized University or equivalent qualification up to the last date for receipt of Application.

19.1. Are You Graduate? :

Yes
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5/19/2014

19.1. Are You Graduate? :

You have selected these Subjects in Under Graduation

Sr No.

Under Graduation Subject Name

Acquired

1.

Electrical Engineering

Yes

19.2. Are You Post Graduate? :

No

20. Specific Post Details With Other Essential Qualification :

No

21. Do You Know Hindi in Devnagari Lipi? :

Yes

Candidate's Address, Photo Signature Details

22. Address :

s k singh

23.1. House no./Village :

sh-5/60-5k

23.2. Street No./PO :

laxmanpur p o shivpur

23.3. City Name :

varanasi

23.4. State / District Name :

Uttar Pradesh / VARANASI

23.5. PIN :

221003

24. Photo&Signature

I accept the following declaration : Yes

1. I hereby declare that I have read all terms & conditions accroding to the advertisement and I accept it.
2. I hereby declare that all the entires/statements made in this application are true, complete and correct to the best of my knowledge and belief.
3. I under take that if any information furnished or documents submitted by me are found to be false or have been concealed, then my
application/candidature is liable to be rejected/cancelled by UPPSC.

Current status of application

Your application is under processing.
Application Form Submission Date :

19/05/2014 , Time : 9:18:14 PM

Application Form printing Date & Time : [ 19/05/2014 ,9:27:22 PM ]

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