1/14/2018 Panchayat & Rural Development, Assam

GOVERNMENT OF ASSAM

COMMISSIONERATE OF PANCHAYAT & RURAL DEVELOPMENT

JURIPAR: PANJABARI: GUWAHATI-37

ACKNOWLEDGEMENT FORM

Application Submitted On: 14/01/2018-07:56:31 PM

PAYMENT DETAILS:

Amount: Rs. 250.00 Transaction Ref No.: LHMP5968560829

Date & Time: 14-01-2018 19:57:55 Payment Status: Paid

CANDIDATE DETAILS:

Application ID: 1131371

Name: SHAHAMIJ ALAM

Fathers Name: OSMAN ALI

Gender: Male

Qualification: Graduate in Commerce

Group-3 = Extension Officer (Panchayat), Jr Assistant HQ, Jr Assistant (Anchalik Panchayat), Tax Collector-cum-
Group Applied For = Eligible Posts:
Road Mohorar, Gram Sevak, Gaon Panchayat Secretary

Category: General Religion: Islam

Date of Birth: 1985-12-14 Age, as on 1st January, 2017: 31 years 0 months 18 days

Differently Abled / Physically

Nationality: Indian No
Disabled:

Whether BPL: No Whether Ex-serviceman ?: No

Currently Working in P&RD: No Experience Certificate (if Yes):

Employment Exchange No. / Employee ID (if

851/18 Currently in Govt. Service ?: No
currently in Govt. Service)):

Mobile No.: 7005758509 Email: rukiya12345678@gmail.com

VILL SACHIBARI PO VILL SACHIBARI PO BAGDOBA PS

Permanent Address: BAGDOBA PS DHUPDHARA, Correspondence Address: DHUPDHARA,
Dist.: Goalpara, Pin: 783123 Dist.: Goalpara, Pin: 783123

POSTWISE PREFERENCE DETAILS:

Extension Officer (Panchayat) Fifth Preference

Junior Assistant HQ Fourth Preference

Gram Sevak /Sevika Third Preference

Junior Assistant (Anchalik Panchayat) Second Preference

Tax Collector cum Road Mohorar First Preference

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