Anusuya Sethi: Application Form Applicant Copy (To Be Retained by The Applicant)

Application Form
Applicant Copy (To be retained by the applicant)

Applicantion Sequnece
IPOIS001055
Number/User ID:
User Password: 1023643
Post Applied 1: Industrial Promotion Officer
Post Applied 2:
Preference 1: Industrial Promotion Officer
Preference 2:
Personal Details
Advertisement Number :
4091
Advertisement Date : 21st December 2016
Post Name: Industrial Promotion Officer and Industrial
Supervisor
Nationality : Indian
Applicant Full Name : Mr SOMYARANJAN SETHI
Applicant Father's Name : Mr BIDYADHAR SETHI
Applicant Mother's Name : Mrs ANUSUYA SETHI

Applicant Husband's Name : Mr
Other Personal Details
Gender : Male
Mobile Number : 9437262501
Email Address : bhatticher@gmail.com
Current Address:(All Communication to the candidate from OSSC is to be made in this address)
House No., Street/Lane, b-1420,nalco nagar
Village , Post Office, Police
Stn, etc :
State/U.T. : ODISHA
Tehsil/City : angul
District : Anugul
District Other:
Pin code : 759145
Permanent Address
House No., Street/Lane, BONKA,BELAGUNTHA
Stn, etc :
State/U.T. : ODISHA
Tehsil/City : BHANJANGAR
District : Anugul
District Other:
Pin code : 761119
Exam City
Choice of district/city for appearing in the examination
Bhubaneswar
Other Details
Whether passed minimum
Seventh class exam. in Yes
Odia :
Applicant Age Details
Date of Birth : 27/Sep/1990
Age as on 01.01.2016 : 25 Years 3 Months 5 Days
Category Details
Category Claimed : Scheduled Caste - SC
Date Of Issue SEBC
Certificate:
Special Category
Physically Challenged : No
Type of Physical disability:
Whether Ex-Serviceman : No
Have you ever Availed the
benefits of Ex-Service Man
for re-employment in Govt No
Service :
Served in :
No. of Years , Months & Years Months Days
Days served :
Date / Likely date of
Discharge :
Level PPO No :
Whether holder of Sports
Person Certificate :
No
ID card no. issued by

Director of Sports :
In Service Details
In Service (Odisha Govt.
No
Contractual) :
From Date :
To Date :
Total Years & Months Of Years Months Days
Experience :
Are you employed under :
Name of the Organisation :
Name Of the Post :
10th Standard Details
10th Standard Roll Number
As Mentioned in the 12RB240
Certificate :
10th Standard Passed Exam
Type :
Annual
Board / University : BSE,Odisha

Other Board: BSE,Odisha
CGPA/Percentage : Percentage
Year Of Passing : 2006
Division : Second
Total Marks: 750
Marks Obtained : 444
Percentage Obtained : 59.2
Exam 10 + 2/Equivalent Details
Stream : Science
Other Stream:
Branch:
Other Branch:
Board / University : Others
Other Board / University: SCTEVT
Division : First
Total Marks/CGPA: 4500
Marks/CGPA Obtained : 2794
Graduation Details
Stream : Bachelor In Engineering/Bachelor In Technology
Other Stream:
Branch: Electrical and Electronics Engineering
Other Branch:
Board / University : Biju Patnaik University of Technology,Rourkela
Other Board / University:
CGPA/Percentage : CGPA
Division : First
Marks/CGPA Obtained : 6.72
Treasury Challan Details:
Treasury Challan Number :
Treasury Challan Date :
Name Of Treasury:
Amount: 0
Application Form
OSSC Copy
Applicantion Sequnece
Number/User ID: IPOIS001055
Post Applied 1: Industrial Promotion Officer

Post Applied 2:
Preference 1: Industrial Promotion Officer
Preference 2:
Personal Details
Advertisement Number :
4091
Advertisement Date : 21st December 2016

Post Name: Industrial Promotion Officer and Industrial
Supervisor
Nationality : Indian
Applicant Full Name : Mr SOMYARANJAN SETHI
Applicant Father's Name : Mr BIDYADHAR SETHI
Applicant Mother's Name : Mrs ANUSUYA SETHI
Applicant Husband's Name : Mr
Other Personal Details
Gender : Male
Mobile Number : 9437262501
Email Address : bhatticher@gmail.com
Current Address:(All Communication to the candidate from OSSC is to be made in this address)
House No., Street/Lane, b-1420,nalco nagar
Stn, etc :
State/U.T. : ODISHA
Tehsil/City : angul
District : Anugul
District Other:
Pin code : 759145
Permanent Address
House No., Street/Lane, BONKA,BELAGUNTHA
Stn, etc :
State/U.T. : ODISHA
Tehsil/City : BHANJANGAR
District : Anugul
District Other:
Pin code : 761119
Exam City
Choice of district/city for appearing in the examination
Bhubaneswar
Other Details
Whether passed minimum
Seventh class exam. in Odia : Yes
Applicant Age Details

Date of Birth : 27/Sep/1990
Age as on 01.01.2016 : 25 Years 3 Months 5 Days
Category Details
Category Claimed : Scheduled Caste - SC
Date Of Issue SEBC
Certificate:
Special Category
Physically Challenged : No
Type of Physical disability:
Whether Ex-Serviceman : No
Have you ever Availed the
benefits of Ex-Service Man for
re-employment in Govt No
Service :
Served in :
No. of Years , Months & Days Years Months Days
served :
Date / Likely date of
Discharge :
PPO No :
Whether holder of Sports
Person Certificate :
No
ID card no. issued by Director
of Sports :
In Service Details
In Service (Odisha Govt.
Contractual) : No
From Date :
To Date :
Total Years & Months Of Years Months Days
Experience :
Are you employed under :
Name of the Organisation :
Name Of the Post :
10th Standard Details
10th Standard Roll Number As
12RB240
Mentioned in the Certificate :
10th Standard Passed Exam
Annual
Type :
Board / University : BSE,Odisha
Other Board: BSE,Odisha
Division : Second
Total Marks: 750
Marks Obtained : 444
Exam 10 + 2/Equivalent/Diploma Details
Stream : Science
Other Stream:
Branch:
Other Branch:
Board / University : Others
Other Board / University: SCTEVT
Division : First
Marks/CGPA Obtained : 2794
Graduation Details
Stream : Bachelor In Engineering/Bachelor In Technology
Other Stream:
Branch: Electrical and Electronics Engineering
Other Branch:
Board / University : Biju Patnaik University of Technology,Rourkela
Other Board / University:
CGPA/Percentage : CGPA
Division : First
Marks/CGPA Obtained : 6.72
Treasury Challan Details:
Treasury Challan Number :
Treasury Challan Date :
Name Of Treasury:
Amount: 0
Declaration
I __________________________ Son/ Daughter of Shri _________________________ Age___________
Year__________
resident of ________________ District ________________ hereby declare that the information given above
and in the enclosed
documents is true to the best of my knowledge and belief and nothing has been concealed therein. I am well
aware of the fact that
if the information given by me is proved false/ not true, I will have to face the punishment as per the law. Also,
all the benefits
availed by me shall be summarily withdrawn.
Signature should not exceed the box provided
Date:
Place:
Full Signature of the Applicant (Ink Signed)

Sender By Post
From
Name: Mr SOMYARANJAN SETHI To,
Father’s Name: Mr BIDYADHAR SETHI The Secretary,

Odisha Staff Selection Commission,
Barrack No.1,
Unit No.V,
Bhubaneswar-751054.
House No., : b-1420,nalco nagar
Street/Lane,
Village , Tel: 06742392233
Post Office, Fax: 06742391153
Police Stn
City/Tehsil: angul
District: Anugul
Other District:
Pincode: 759145

Anusuya Sethi: Application Form Applicant Copy (To Be Retained by The Applicant)

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Anusuya Sethi: Application Form Applicant Copy (To Be Retained by The Applicant)

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Drepturi de autor:

Formate disponibile

Application Form

Applicant Copy (To be retained by the applicant)

Applicant Mother's Name : Mrs ANUSUYA SETHI

ID card no. issued by

Board / University : BSE,Odisha

Post Applied 1: Industrial Promotion Officer

Advertisement Date : 21st December 2016

Applicant Age Details

Signature should not exceed the box provided

Full Signature of the Applicant (Ink Signed)

Name: Mr SOMYARANJAN SETHI To,

Father’s Name: Mr BIDYADHAR SETHI The Secretary,

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