GOVERNMENT OF MAHARASHTRA

MAHAPARIKSHA MUMBAI , MAHARASHTRA

Maharashtra Information Technology Corporation Ltd. (MAHA IT), 514, 5th Floor, Mantralaya,
Hutatma Rajguru Chowk, Madam Cama Road, Mumbai - 400032
E-mail:enquiry@mahapariksha.gov.in

Personal Details
Posts/Services Applied for Health worker (Male)_Pune-Non PESA
Application Id RDD_HWA_PUN_0453834
First Name Pradip
Middle Name Suresh
Last Name darwade
Mother's Name Aruna
Father's Name Suresh
Nationality INDIAN
No of Children 1
Whether liable to be disqualified for the Government Services according to the prov
No
isions of Maharashtra Civil Services (Declaration of small family) Rules, 2005?
Gender MALE
Date of Birth May 5, 1985
Candidate's Name Pradip darwade
Mobile Number 9850642676
Marital Status MARRIED
Name Change Status NOT CHANGED
Changed First Name NOT APPLICABLE
Changed Middle Name NOT APPLICABLE
Changed Last Name NOT APPLICABLE
Category of the Candidate OBC

Note:Candidate opting for reservation category have to provide original caste category certificate during document verification else your reservation benefits will be rejected.

Caste Certificate APPLICABLE

Caste Validity Certificate NOT APPLICABLE
Caste Certificate Number 86
Place of Issue PUNE
Date Of Issue Aug 29, 2003
Are you ST-PESA Candidate ? NOT APPLICABLE

Note: ST PESA vacancy is applicable for local Scheduled Tribe Candidates only, if original documents are not provided by candidate during document verification, then ST PESA reservation benefits will be rejected for the
selected ST PESA district.

Is there sufficient revenue proof that the candidate himself or his mother / father or g
randfather / grandfather is staying in the Scheduled Areas of the district (ST PESA Di NOT APPLICABLE
strict which the candidate wants to apply for) continuously since January 26, 1950?
Do you want to apply to ST-PESA vacancies? NOT APPLICABLE
Candidate is resident of which scheduled area (District)? NOT APPLICABLE
Physical Disability NOT APPLICABLE

Note:Medical certificate of disability issued by competent authority prior to SADM and the other certificates or SADM will be accepted once verified at the time of document verification by the concerned ZillaParishad
appointing authority.

Do you have disability certificate (minimum 40%)? (SADM, Software for Assessme
NOT APPLICABLE
nt of Disability)
One Arm affected(OA) NOT APPLICABLE
One Leg affected(OL) NOT APPLICABLE
Both Leg affected(BL) NOT APPLICABLE
Both Arm affected(BA) NOT APPLICABLE
One Arm and Leg affected NOT APPLICABLE
Low vision NOT APPLICABLE
Hearing Handicapped NOT APPLICABLE
Blind NOT APPLICABLE
Scribe/Assistant Needed NO
Aadhaar Card Number 848978576126
Aadhaar Enrollment Number NOT APPLICABLE
Are you Orphan as per Women and Child Development Department's Government R
NOT APPLICABLE
esolution No. अमुजा- २०११/ . . २१२/ का- ३, द. २ ए ल २०१८ ?

Project Affected or Dependent on Project Affected? NOT APPLICABLE

Earthquake Affected (Whether death of any family member or the house collapsed
NOT APPLICABLE
in the earthquake has been rebuilt by the government ?)
Are you Anshakalin (Part-time) Employee? (As per reference GR शासन नणय . प अं
NOT APPLICABLE
क -१००९/ . . २०० /२००९/१६-अ , द . २७. १०. २००९)

Name of Office(for Anshkalin Employee): NOT APPLICABLE

Appointing Authority (for Anshkalin Employee): NOT APPLICABLE
Part Time Experience in Years NOT APPLICABLE
Part Time Experience in Months NOT APPLICABLE
Part Time Experience in Days NOT APPLICABLE
Do you have MSCIT certification or equivalent certification ? APPLICABLE
Marathi Language Proficiency(READ) APPLICABLE
Marathi Language Proficiency(WRITE) APPLICABLE
Marathi Language Proficiency(SPEAK) APPLICABLE
Are you son/daughter of a farmer who committed suicide? NOT APPLICABLE
Non-Creamy layer certificate APPLICABLE
Are you an Ex-Serviceman? NOT APPLICABLE
Retired Ex-Service man NOT APPLICABLE
Years of service (Ex-Servicemen) NOT APPLICABLE
Differently abled Ex-Serviceman NOT APPLICABLE
Are you a Government /Semi-Government /Local bodies employee/Regular employ
NOT APPLICABLE
ee of Zilla Parishad?
Name of the Office/Department: NOT APPLICABLE
Joining date: NOT APPLICABLE
Sports Quota NOT APPLICABLE
Meritorious sportspersons Reservation: NOT APPLICABLE
Have you sent all sports certificate from director/deputy director, sport for
NO
verification?
Domicile of Maharashtra YES
Are you an Election employee as per the GR dated 6th Oct, 2010? NO
Are you a census Employee of 1991? NO
Are you a pupil or ward Nominated by freedom fighter? NO
Are you a dependent of Ex-servicemen as per GR mentioned in advertisement? NO
Do you want to avail the benefit of female Reservation? NOT APPLICABLE
I have read the advertisement and agree with the instruction, terms, conditions and eligibility criteria mentioned in the advertisement required for th
YES
e service/post which I am applying. I agree that I fulfill all the eligibility criteria required for this Service/post.
Address Details of the Candidate
Address Type Address
Both Permanent and Current Addr
Pimpri road Darwade mala Talegaon dhamdhere,Shirur, , MAHARASHTRA, 412208
ess
Educational Qualification Details
Name of the Bo
Educational Name of the Qualified Marks Marks
ard/University Passed on Percentage Percentile CGPA GRADE
Qualification course from Obtained Maximum
Name
POST-GRADUATI Political scien MAHARASHT Savitribai Phule NOT APPLIC NOT APPLIC NOT APPLIC
Jul 6, 2012 1050 1600 65.63
ON ce RA Pune University ABLE ABLE ABLE
MAHARASHT Savitribai Phule Jun 29, 2007 NOT APPLIC NOT APPLIC NOT APPLIC
GRADUATE B.A 682 1200 56.83
RA Pune University ABLE ABLE ABLE
Maharashtra St
ate Board of Se
NOT APPLIC NOT APPLIC NOT APPLIC
HSC condary and Hi Jun 2, 2004 363 600 60.5
ABLE ABLE ABLE
gher Secondary
Education
Maharashtra St
ate Board of Se
NOT APPLIC NOT APPLIC NOT APPLIC
SSC condary and Hi Jun 10, 2002 405 750 54
ABLE ABLE ABLE
gher Secondary
Education
Exam Center Details
Preferred Exam Center Location1 Preferred Exam Center Location2 Preferred Exam Center Location3
PUNE KOLHAPUR AHMEDNAGAR
Payment Details
Transaction Type Transaction Id Transaction Status Transaction Date Total Fees
ONLINE MAHAIT_RDD_000000432444 PAYMENT_ATTEMPTED 12/04/2019 10:47 PM 750
ONLINE MAHAIT_RDD_000000432571 SUCCESS 12/04/2019 10:53 PM 750
Before logging on to the registration portal
Sr.No Undertakings
1. I have read and understood the instruction booklet carefully before filling in the form.
2. I have scanned my photograph and signature ready on my desktop confirming to the specified standards mentioned in the information Brochure.
3. I have downloaded the Online information brochure and read it carefully before filling the form.
4. I have the details for payment (Credit Card / Debit Card / Internet Banking) available with me for making Online payment.
5. I agree that my application form will be treated as complete only if I finally submit the application along with the payment of necessary fees.
6. I agree to bear the payment gateway additional charges
7. I accept to receive messages from MAHA-IT even if my mobile number falls under Opt-in and / or DND (Do Not Distrub)/ DNC(Do Not Call) category.
Before submitting the form
Sr.No Undertakings
1. I fulfill the conditions as specified in the eligibility criteria and registration guidelines.
2. All the particulars provided by me in this application are true, correct and complete to the best of my knowledge and belief.
I shall produce all the original documents along with the attested copies as and when required, failing to which I will be considered as blacklisted
3.
and debarred.
In case any particulars given by me in this application are found to be false, incorrect and /or misleading, I shall be liable for being blacklisted or
4.
debarred from all further examinations and selection processes of the Rural Development Department.
Printed On:12/04/2019 10:55:16 PM