Page No.

1/16

UNION PUBLIC SERVICE COMMISSION

DETAILED APPLICATION FORM
CIVIL SERVICES (MAIN) EXAMINATION, 2018

RID. : 11815620385
Roll No. : 0800482
Name : AMIT KUMAWAT
Email : amitkumawat93@gmail.com
Mobile : 9818088621

1. (a) Date of Birth | 04-11-93

(b) Age Relaxation claimed | NO
(c) Nature of Age relaxation claimed |
(If yes, upload a scanned documentary proof/ documentary evidence in support of your claim)

2. (a) Address for correspondence to which | NEAR JAT BOARDING, MODI ROAD
Communication is to be sent |
Post Office: | JHUNJHUNU
City: | JHUNJHUNU
District: | JHUNJHUNU
State : | RAJASTHAN
Pin Code : | 333001
(b) Telephone No. (with STD Code) | -
(c) Mobile No. | 9818088621
(d) Fax No. |
(e) E-mail address | AMITKUMAWAT93@GMAIL.COM
(f) Permanent Postal Address | NEAR JAT BOARDING, MODI ROAD
|
Post Office: | JHUNJHUNU
City: | JHUNJHUNU
District: | JHUNJHUNU
State : | RAJASTHAN
Pin Code : | 333001

3. Gender : | MALE

4. Marital Status : | UNMARRIED

(If Married, Nationality of spouse) |
5. (a) Citizenship : | A CITIZEN OF INDIA.(1)
(b) Nationality : | INDIAN

6. Mother tongue : | HINDI

7. Place of Birth :
Post Office | JHUNJHUNU

Roll No. :- 0800482 |

 Page No. 2/16
City/Town/Village | JHUNJHUNU
District | JHUNJHUNU
State | RAJASTHAN
Pincode | 333001

8. (a) Community | OBC (3)

Note 1: Candidate belonging to OBCs but coming in the 'Creamy Layer' and thus not being entitled to OBC
reservation should indicate their community as 'General Category(others)(Code No.4)'.
Note 2: Candidates belonging to neither SC,ST nor OBC Communities should write 'General'
Category(Others) Code No.4' against the column of community and not leave it blank.'.
Note 3: No change in the community status already indicated by candidate in his / her application form for this
examination will ordinarily be allowed by the Commission.
Note 4: In case you are a 'SC, ST or OBC'(Non Creamy Layer) candidate, upload a scanned copy of certificate in
support of your claim. It should be issued prior to the date of closure of online application form for Civil
Services (Preliminary) Examination, 2018 (i.e. prior 06.03.2018).
Note 5: Candidates belonging to OBC non creamy layer category will have to fill OBC proforma online.
(b) Date of issue of caste certificate | 22-08-2017
(c) Name of the Caste as mentioned in the | KUMAWAT
Community Certificate and Name of | RAJASTHAN(30)
the issuing State

(d) State your religion if you belong to

Scheduled Caste / If OBC, state
Creamy or Non Creamy Layer | Non Creamy Layer
(e) If you belong to any of the minority
Communities notified by the Government
(Muslim/Christians/Sikhs/Budhists/
Zoroastrians[Parsi]/Jains) | NO
(f) If yes, Name of the Minority
community |

9. Whether you are a candidate with | NO

1.(a)(i) Benchmark Disability (upload a
scanned Certificate of disability)
(ii) If yes, disability certificate form |
(iii) If yes, disability certificate date |
(b) Category |
(c) Percentage of disability as indicated in |
certificate
(d) Are you Ortho with locomotor |
disability and cerebral palsy having
impairment of dominant(writing
extremity) ?
(e) Would you require scribe in the |
Examination
(i) If yes, "Commission's Scribe" or "Own |
Scribe"
(f) Would you require any assistive |
device(s)
(g) Would you require questin paper in |
larger font

Roll No. :- 0800482 |

 Page No. 3/16

9. 2. (a) Have you ever been recommended as a | NO

PH/PwBD candidate in the
examinations conducted by the UPSC
in the past?

(b). If yes, mention name and year of the examination(s) with Roll No.
Name of Examination Year of Examination Roll No.

(c) Whether such recommendation was on | NO

the basis of the Disability Certificate
NOW UPLOADED by you for the
CS(M) Exam, 2018?
(d) After any such recommendation by the | NO
UPSC were you ever found UNFIT/
NOT RECOMMENDED by the Central
Standing Medical Board or any other
Medical Board constituted by the
Government with regard to your
physical disability?
(e) If yes, provide details thereof |

10. Choice of Centre for Examination | JAIPUR

11.(a)(i)Are you a candidate with Benchmark

Disability with Hard of Hearing or
hail from Arunachal Pradesh/
Manipur/Meghalaya/Mizoram/Nagaland/
Sikkim and are claiming exemption
from appearing in INDIAN LANGUAGE
FOR PAPER A? | NO

Note : Such exemption from appearing at INDIAN LANGAUGE FOR PAPER A is permissible to those Hard
of Hearing candidates with Benchmark Disability who have been granted such exemption from 2nd or
3rd language courses by the concerned education Board/University. The candidate needs to upload
an undertaking/self-declaration in this regard to claim such exemption to the Commission.

(ii)Indian Language for Paper A | HINDI

(b) Optional Subject for paper VI & VII | MATHEMATICS

12. (a)Language Medium for Examination

for Paper I to Paper V
(Essay and General Studies) | ENGLISH

(b) Language Medium for Examination

for Paper VI to Paper VII (Optional
Subject as at (b) of Col. 11 above) | ENGLISH

(c) In case of Sindhi and Santhali

type of script should be indicated
by the candidate |

Roll No. :- 0800482 |

 Page No. 4/16
Note : In case of candidates opting for literature in any of the Indian Language as optional subject for papers
VI & VII , they would have to write these two papers (VI & VII) in the script specified for that
particular language as given in Annexure IV of Instructions to candidate.

(d)Language Medium for Interview

Test(i.e. para 27 of the Instructions)
to Candidates) | ENGLISH

13. (a) Name of Father | SUBHASH KUMAWAT

(b) Name of Mother | RAJESHWARI DEVI
(c) Nationality of Father | INDIAN
(d) Nationality of Mother | INDIAN
(e) Father's Profession: | TAILORING
(f) Mother's Profession: | HOUSEWIFE
(g) If your Father is in service,the post held
by him (if retired, indicate the post held
by him at the time of his retirement) | NA
(h) If your Mother is in service,the post held
by her (if retired, indicate the post held
by her at the time of her retirement) | NA
(i) Annual income of your Father | RS.196950
(j) Annual income of your Mother | RS.0
(k) State to which your Father originally | RAJASTHAN
belongs
(l) District to which your Father originally | JHUNJHUNU
belongs
(m) State to which your Mother originally | RAJASTHAN
belongs
(n) District to which your Mother originally| JHUNJHUNU
belongs
(o) Father's present postal Address | NEAR JAT BOARDING
(If deceased give last address) | MODI ROAD
Post Office: | JHUNJHUNU
City: | JHUNJHUNU
District: | JHUNJHUNU
State : | RAJASTHAN
Pin Code : | 333001
(p) Mother's present postal Address | NEAR JAT BOARDING
(If deceased give last address) | MODI ROAD
Post Office: | JHUNJHUNU
City: | JHUNJHUNU
District: | JHUNJHUNU
State : | RAJASTHAN
Pin Code : | 333001

14.1(a) Do you possess the prescribed Educational

Qualification (Vide rule-7 of the rules of the Examination)?
Please upload a scanned copy of the Certificate
if answer is "YES" | YES

Note : If you do not possess the prescribed educational qualification as mentioned in rule-7 of the

Roll No. :- 0800482 |

 Page No. 5/16
examination your candidature is liable to be cancelled.

(b) Do you have any basic Educational

Qualification or higher qualification
obtained from a foreign institution? | NO

14.2 Educational Qualifications : Commencing with Matriculation or equivalent examination till Graduation:-
(Please upload scanned copy of all Certificates/Degree)
Examination Class/ Percentage CGPA Year of Subject(s) Name of Name of
Passed Division of Score Out of School/College Board/University
/Grade Marks(%) Passing /Institution
10th or Equivalent FIRST 93 2008 HINDI, ENGLISH, RAJASTHANI BOARD OF
SCIENCE, SOCIAL SHISHU MANDIR SECONDARY
SCIENCE , EDUCATION
MATHEMATICS RAJASTHAN
AND SANSKRIT
12th or Equivalent FIRST 85.38 2010 HINDI, ENGLISH, NEW JHUNJHUNU BOARD OF
PHYSICS , ACADEMY SECONDARY
CHEMISTRY and EDUCATION
MATHEMATICS RAJASTHAN
Stream at Graduation Level :-- ENGINEERING
B. TECH. FIRST 6.22 10 2016 BIOCHEMICAL INDIAN INSTITUTE INDIAN
ENGINEERING OF TECHNOLOGY INSTITUTE OF
AND DELHI TECHNOLOGY
BIOTECHNOLOGY DELHI, NEW
DELHI

14.3 Higher Educational Qualifications : Commencing with Post Graduation or equivalent examination :-
(Please upload scanned copy of all Degree etc.)
Examination Class/ Year of Date of Likely date CGPA Percentag Subject(s) College/Institution Board/
Passed Division Passing Joining of Score Out of e University
/Grade Completion of
Marks(%)
M.TECH. FIRST 2016 2011 NA 6.91 10 BIOCHEMICAL INDIAN INSTITUTE INDIAN
ENGINEERING OF TECHNOLOGY INSTITUTE OF
AND DELHI TECHNOLOGY
BIOTECHNOLOGY DELHI, NEW
DELHI

Were you ever employed? :

15.(i) | NO

16. Please give Particulars at the University/State/National Level in respect of:-

(a) Prizes, Medals, Scholarships etc.
(b) Sports/N.C.C. etc.
| 1. POST GRADUATE RESEARCH FELLOWSHIP BY IIT
DELHI 2. FIRST RANK IN THE SIGMAA TALENT SEARCH
EXAMINATION AT HIGHER SECONDARY LEVEL 3.
PANDIT NAROTTAM LAL JOSHI AWARD FOR
OUTSTANDING PERFORMANCE IN SECONDARY
EXAMINATION
| 1. PLAYED SHOT PUT AT INTER HOSTEL LEVEL IN IIT
DELHI

Roll No. :- 0800482 |


(c) Position(s) of distinction Leadership
held in College
(d) Other extra curricular activities and
interests (Such as hobbies etc.)
Page No. 6/16
| ACTIVITY HEAD OF SECURITY MANAGEMENT IN
RENDEZVOUS 2013 AT IIT DELHI
| 1. TEACHING AND MENTORING 2. READING BOOKS 3.
VIPASSANA MEDITATION 4. JOGGING

17. Having regard to answers given against

columns 6,7,13,14.2 & 14.3 which is the State
/Union Territory that you would claim
as your home State/U.T. ? | RAJASTHAN

18.All the candidates, who qualify for Personality Test/Interview on the basis of Result of Civil Services (Main)
Examination, 2018, will be required to submit their Order of Preferences for Zone(s)/State(s) Cadre (for IAS/IPS)
through an Addendum to the Detailed Application Form. This addendum to DAF will be made available to the
qualified candidates of the Written Examination [Civil Services (Main) Examination, 2018].

19.All the candidates who qualify for Personality Test/Interview on the basis of Result of Civil Services (Main)
Examination, 2018 will be required to submit their Order of Preferences for Participating Services through an
Addendum to the Detailed Application Form. This addendum to DAF will be made available to the qualified
candidates of the Written Examination [Civil Services (Main) Examination, 2018].

20. Have you ever been debarred by

the UPSC from any of its
Examinations/Selections? | NO

21. Whether you have ever applied for

U.P.S.C. Examination /Recruitment:- | YES
Details of other application for Examination/Recruitment held/to be held by UPSC :-
Name of Examination/Post Month and Roll. No. Whether you Whether you Whether you Whether continuing till
year of appeared at appeared at were recomm date or resigned(with date)
Examination the the Interview ended for
/Advt./Item Examination appointment
No. for
Recruitment
INDIAN FOREST SERVICE (PRE.) 2016 0654651 YES NO NO NA
INDIAN FOREST SERVICE (PRE.) 2017 0 YES NO NO NA

22. How many times have you appeared

at the Civil Services(P)
Examination so far, including the current
Examination held in June, 2018 |3

23. Details of Examination in which you have appeared including CS(P), 2018
Year 2016 2017 2018
Roll No. 0654651 0 0800482

24. Have you ever accepted allocation

to a Service/Post on the basis
of Civil Services Examination
held in earlier years? | NO
(a). Year of the Civil Services
Examination on the basis of which

Roll No. :- 0800482 |

 Page No. 7/16
you had been last allocated to
service/post |
(b). Name of service/post to which
allocated |
(c). Your Roll No. for the examination |
(d). Whether you were appointed/joined
Service? | NO

(e). Whether you are continuing in that

Service/Post? |

(f). If you have resigned from such post/service

Mention date of acceptance of the resignation
by the Competent authority |

25. Fee Payment Details (Subject to Verification) :-

Application No. | 18990800482
Transaction-Id | IK00RZZQB7
Fee Paid (in Rs.) | 200
Agency Name | State Bank of India
Mode of Payment | By Internet Banking

Details of Fee paid: Fee to be paid is Rs.200/- (Two hundred only) (Female/SC/ST/Physically
challenged candidates are not required to pay any fee) Through online mode only.'

Candidates applying (excepting Female/SC/ST/PwBD candidates who are exempted from payment
of fee) for Civil Services (Main) Examination are required to pay a fee of Rs.200/- (Rupees Two
Hundred only) either by depositing the money in any Branch of SBI by cash, or by using Net Banking
facility of SBI/State Bank of Bikaner & Jaipur/State Bank of Hyderabad/State Bank of Mysore/State
Bank of Patiala/ State Bank of Travancore or by using Visa/Master Credit/RuPay Card/Debit card.

26. Photo Identity Card | AADHAR CARD (2220 5937 0779)

27. List of Scanned documents to be uploaded by the candidate:-

--> Scanned Copy of proof of date of birth as prescribed in Para below Note IV under Rule 6 of the rules
for the exam. [Col. 1(a) of DAF]
--> Scanned Copy of Certificate in support of claim to belong to SC / ST / OBC (where applicable),
(Annexure VI[Undertaking for OBC candidates] & VII[OBC annexure] may be filled online by OBC
candidates)[Col. 8(a) of DAF]
--> Scanned Copy of the certificate of educational qualifications (including a copy of recognition letter /
equivalence certificate from AIC/UGC, if applicable)[Col. 14 of DAF]
--> Scanned copy of documentary proof in support of service/status/land holding/income from different
sources/property held by parents of OBC (non- creamy layer) candidates. [Annexures VI[Undertaking for
OBC candidates] & VII[OBC annexure] of DAF]
--> Scanned copy of the selected Photo Identity Card (viz. Aadhaar Card, Voter Card, PAN Card, Passport,
Driving Licence or any other Photo Identity Card issued by the Central/State Government.)

Roll No. :- 0800482 |

 Page No. 8/16

OBC ANNEXURE

1. Name of the Candidate | AMIT KUMAWAT

2. Roll No | 0800482

3. (a) Name of Father | SUBHASH KUMAWAT

(b) Date of birth of Father | 11-10-1966
(c) Whether your Father is having Permanent Account | YES
Number(PAN)
(c) PAN No. of Father | AOMpc07051

4. (a) Name of Mother | RAJESHWARI DEVI

(b) Date of birth of Mother | 06-06-1971
(c) Whether your Mother is having Permanent Account | NO
Number(PAN)
(c) PAN No. of Mother |

5.(a)(i) Profession of father | TAILORING

(ii) Whether your Father is/was in service. | NO

(b)(i) If in service whether he is/was working under |

Central Government/State
Government/Central Public Sector
Undertaking/ State Government Public Sector
Undertaking/ Autonomous Body/ Bank/
Insurance Organisation/ Universities/ Private
Organisation/ Others

(ii) Please write full name and address of the |

concerned organization. In case of
PSU/Autonomous Body/Bank/Universities/
Insurance organizations and please provide
name and address of the Controlling
Department / Ministry/Government also.

(iii) Name of the post to which he was appointed |

by direct recruitment

(iv) Group of the post (viz. group A, B, C or D) to |

which he was appointed by direct recruitment
and the year of recruitment

Roll No. :- 0800482 |

 Page No. 9/16
(v) If post of the organization is not classified as | NO ()
Group A, B, C or D, whether the post to which
the father was appointed by direct recruitment
is comparable or equivalent to any Group A,
B, C or D post in Government as per DOPT
OM No. 36012/22/93-Estt.(SCT), dated
8.9.1993. If yes, to which it is comparable and
please upload the relevant Government
order/notification establishing such
equivalence / comparability of post if available

(vi) Complete employment details of all the posts

held by Father (From first employment till
present employment) :-

Name of the post and group of the post & Pay Scale of the post Date of Appoint Age at the Method of Recruitment
equivalence of post ment/promotion time of appoin /appointment
to the post tment/promoti
on
NA NA NA NA NA

(vii) If the father has retired/resigned or terminated |

from service, the details of present status from
the time of retirement/resignation/termination.
If reemployed, mode of re-employment.

(viii) Whether the father has/had been in | NO ()

employment in any International Organisation
like U.N., IMF, World Bank etc. If yes,
duration of such employment

(ix) If father is dead, date of his demise |

(x) If father suffers from permanent incapacitation | NO

while in service.

(xi) If father suffers from permanent |

imcapacitation while in service, date from
which he so suffers

6. (a) Whether father of the candidate holds or has ever held | NO

a Constitutional post
(b) If yes, name of the post (s) and duration of holding |
post(s)

7. (a) If father is/was in the rank of Colonel and above | NO

in the army and to the equivalent posts in the
Navy and the Air Force and the Para Military
Forces.
If yes, upload the relevant appointment order.

8.(a)(i) Profession of mother | HOUSEWIFE

Roll No. :- 0800482 |

 Page No. 10/16

(ii) Whether your Mother is/was in service. | NO

(b)(i) If in service whether she is/was working under |

Central Government/State
Government/Central Public Sector
Undertaking/ State Government Public Sector
Undertaking/ Autonomous
Body/Bank/Insurance
Organisation/Universities/ Private
Organisation/Others

(ii) Please write full name and address of the |

concerned organization. In case of
PSU/Autonomous Body/Bank/Universities/
Insurance organizations and please provide
name and address of the Controlling
Department / Ministry/Government also.

(iii) Name of the post to which she was appointed |

by direct recruitment

(iv) Group of the post (viz. group A, B, C or D) to |

which she was appointed by direct recruitment
and the year of recruitment

(v) If post of the organization is not classified as | NO ()

Group A, B, C or D, whether the post to which
the Mother was appointed by direct
recruitment is comparable or equivalent to any
Group A, B, C or D post in Government as per
DOPT OM No. 36012/22/93-Estt.(SCT), dated
8.9.1993. If yes, to which it is comparable and
please upload the relevant Government
order/notification establishing such
equivalence/comparability of post if available

(vi) Complete employment details of all the posts

held by Mother (From first employment till
present employment) :-

Name of the post and group of the post & Pay Scale of the post Date of Appoint Age at the Method of Recruitment
equivalence of post ment/promotion time of appoin /appointment
to the post tment/promoti
on
NA NA NA NA NA

(vii) If the Mother has retired/resigned or |

terminated from service, the details of present
status from the time of
retirement/resignation/termination. If
reemployed, mode of reemployment.

Roll No. :- 0800482 |

 Page No. 11/16

(viii) Whether the mother has/had been in | NO ()

employment in any International Organisation
like U.N., IMF, World Bank. If yes, duration
of such employment

(ix) If mother is dead, date of her demise |

(x) If Mother suffers from permanent | NO

incapacitation while in service.

(xi) If mother suffers from permanent |

imcapacitation while in service, date from
which he so suffers

9. (a) Whether mother of the candidate holds or has ever | NO

held a Constitutional post
(b) If yes, name of the post (s) and duration of holding the |
post(s)

10.(a) If Mother is/was in the rank of Colonel and above | NO()

in the army and to the equivalent posts in the
Navy and the Air Force and the Para Military
Forces.
If yes, upload the relevant appointment order.

11. (A) Whether the parents of the candidate own | NO

agricultural land

(B) If yes,
(a) Area of the irrigated land owned by father, mother |
and children put together

(b) Area of the unirrigated land owned by father, |

mother and children put together

(c) Statutory ceiling limit of irrigated land holding at |

the place where land owned is located

(d) Statutory ceiling limit of unirrigated land holding |

at the place where land owned is located

(e) If the land is both irrigated and unirrigated, |

indicate whether condition given in clause (b) (i) of
Schedule V to the DOP&T O.M.
No.36012/22/93-Estt.(CST), dated 8-9-1993
applies. Give details

12. Annual income of father(in Rs.) for last three consecutive financial years (year-wise) :-

Roll No. :- 0800482 |

 Page No. 12/16
Financial Year 2017-18 Financial Year 2016-17 Financial Year 2015-16
[Assessment Year [Assessment Year [Assessment Year
2018-2019] 2017-2018] 2016-2017]
(a) Income from salary 196950 243365 204435
(b) Income from agriculture 0 0 0
(c) Income from other sources 0 0 0
(d) Whether your father has filed the ITR? YES YES YES
If yes, then upload ITR.
(e) Whether your Father has filed the ITRs for YES YES YES
the last 3 years in respect of your father are
available with you for uploading?
(f) Undertaking ,I will submit the complete ITRs NO NO NO
to the Commission before/at the date of
interview

13. Annual income of mother(in Rs.) for last three consecutive financial years (year-wise) :-

Financial Year 2017-18 Financial Year 2016-17 Financial Year 2015-16

[Assessment Year [Assessment Year [Assessment Year
2018-2019] 2017-2018] 2016-2017]
(a) Income from salary 0 0 0
(b) Income from agriculture 0 0 0
(c) Income from other sources 0 0 0
(d) Whether your mother has filed the ITR? NO NO NO
If yes, then upload ITR.
(e) Whether your mother has filed the ITRs for NO NO NO
the last 3 years in respect of your mother are
available with you for uploading?
(f) Undertaking ,I will submit the complete ITRs NO NO NO
to the Commission before/at the date of
interview

14. (a) Details of wealth held by parents
(b) Whether the wealth held is above in exemption limit
as prescribed in Wealth Tax Act ?
| TWO PLOTS OF 202.66 SQUARE YARDS AND 400
SQUARE YARDS AT KHASRA JHUNJHUNU AND
KHIDARSAR JHUNJHUNU RESPECTIVELY
| NO

15. Whether you have documentary proof in support of | YES

service/status/land holding/income from different
sources/property held by parents have been attached?
If yes, upload documentary proof.

Roll No. :- 0800482 |

 Page No. 13/16

UNDERTAKING ANNEXURE-VI

I AMIT KUMAWAT son/daughter of Shri SUBHASH KUMAWAT Resident of village/town/city

JHUNJHUNU district JHUNJHUNU state RAJASTHAN hereby declare that I belong to the
KUMAWAT community which is recognized as a backward class by the Government of India for the
purpose of reservation in services as per orders contained in Department of Personnel and Training Office
Memorandum No. 36012/22/93-Estt.(SCT), dated 8.9.1993. It is also declared that I have read and
understood the instructions mentioned in the said DOPT Office Memorandum dated 08.09.1993, and OM
No.36033/1/2013-Estt.(Res.) dated 13.09.2017 and I have reason to declare that i do not fall under
OBC(Creamy Layer) category.

DECLARATION OF OBC ANNEXURE

Information furnished above is true to the best of my knowledge and I have not concealed any relevant information. I swear ,
that if it is found at any stage that information furnished by me is false or that I have concealed some relevant information,
I will forfeit the claim to appointment to any service on the basis of Civil Services Examination, 2018 and also be
liable for any other civil or criminal proceedings.

Place: (Signature of the Candidate)

Date: Name of Candiate: AMIT KUMAWAT

Roll No. : 0800482

Roll No. :- 0800482 |

 Page No. 14/16
DECLARATION TO BE SIGNED BY THE CANDIDATE

I, hereby declare that all statements and entries made in all the columns of this application are true,
complete and correct to the best of my knowledge and belief.

I have read Rule 14 of the Rules of the Civil Services Examination, 2018 published in Part I – , 2018
Section 1 of the Gazette of India Extraordinary dated 7th February, 2018 and understand that in the
event of any information being found false or incorrect or ineligibility being detected before or
after the examination, or flouting of any instructions given by the Commission alongwith e-Admit
card/ Question – cum – Answer Booklets/ e-Summon letter etc.action can be taken against me by
the Commission.

I further declare that I fulfil all the eligibility conditions regarding age limits, educational
qualifications etc. prescribed for admission to the Examination. I have not exhausted the number of
attempts admissible to me under the Rule 4 of the Rules of the Examination.

I have not withheld any information required as per this Detailed Application Form.

I have thoroughly scrutinised the list of scanned documents as enumerated in Column 26 and 27
of the DAF and uploaded scanned copies of all the documents relevant for me.

I have read the Rules of Examination and the instructions carefully and I hereby undertake to abide
by them.

I have informed my Head of the Office/Department in writing that I have applied for this
examination as required in Col. 15 (i) of the DAF.

Signature of the Candidate

Place:
Date:

Roll No. :- 0800482 |

 Page No. 15/16
UNION PUBLIC SERVICE COMMISSION
SUMMARY SHEET
(FOR OFFICE USE ONLY)
DATE:-
SESSION:-
ROLL NUMBER :- | 0800482
NAME OF EXAMINATION :- | CIVIL SERVICES (MAIN) EXAMINATION, 2018
NAME :- | AMIT KUMAWAT
DATE OF BIRTH :- | 04-11-93
OPTIONAL SUBJECT:- | MATHEMATICS
PLACE OF BIRTH :-
TOWN/VILLAGE | JHUNJHUNU
DISTRICT | JHUNJHUNU
STATE | RAJASTHAN

Please give Particulars at the University/State/National Level in respect of:-

(a)Prizes, Medals, Scholarships etc. | 1. POST GRADUATE RESEARCH FELLOWSHIP

BY IIT DELHI 2. FIRST RANK IN THE SIGMAA
TALENT SEARCH EXAMINATION AT HIGHER
SECONDARY LEVEL 3. PANDIT NAROTTAM
LAL JOSHI AWARD FOR OUTSTANDING
PERFORMANCE IN SECONDARY
EXAMINATION
(b) Sports/N.C.C. etc. | 1. PLAYED SHOT PUT AT INTER HOSTEL
LEVEL IN IIT DELHI
(c) Position(s) of distinction Leadership held in | ACTIVITY HEAD OF SECURITY MANAGEMENT
College NDMA guideline for crowd management IN RENDEZVOUS 2013 AT IIT DELHI
(d) Other extra curricular activities and interests (Such | 1. TEACHING AND MENTORING 2. READING
as hobbies etc.) BOOKS 3. VIPASSANA MEDITATION 4.
JOGGING

Educational Qualifications : Commencing with Matriculation or equivalent examination till Graduation:-

Examination Class/ Percentage CGPA Year of Subject(s) Name of Name of
Passed Division of Score Out of School/College Board/University
/Grade Marks(%) Passing /Institution
10th or Equivalent FIRST 93 2008 HINDI, ENGLISH, RAJASTHANI BOARD OF
SCIENCE, SOCIAL SHISHU MANDIR SECONDARY
SCIENCE , EDUCATION
MATHEMATICS RAJASTHAN
AND SANSKRIT
12th or Equivalent FIRST 85.38 2010 HINDI, ENGLISH, NEW JHUNJHUNU BOARD OF
PHYSICS , ACADEMY SECONDARY
CHEMISTRY and EDUCATION
MATHEMATICS RAJASTHAN
Stream at Graduation Level :-- ENGINEERING
B. TECH. FIRST 6.22 10 2016 BIOCHEMICAL INDIAN INSTITUTE INDIAN
ENGINEERING OF TECHNOLOGY INSTITUTE OF
AND DELHI TECHNOLOGY
BIOTECHNOLOGY DELHI, NEW
DELHI

Higher Educational Qualifications : Commencing with Post Graduation or equivalent examination :-

(Please upload scanned copy of all Degree etc.)
 Page No. 16/16
Examination Class/ Year of Date of Likely date CGPA Percentag Subject(s) College/Institution Board/
Passed Division Passing Joining of Score Out of e University
/Grade Completion of
Marks(%)
M.TECH. FIRST 2016 2011 NA 6.91 10 BIOCHEMICAL INDIAN INSTITUTE INDIAN
ENGINEERING OF TECHNOLOGY INSTITUTE OF
AND DELHI TECHNOLOGY
BIOTECHNOLOGY DELHI, NEW
DELHI

Do you have any basic educational

qualification or higher qualification
obtained from a foreign institution? | NO

Powered by TCPDF (www.tcpdf.org)