FEDERAL PUBLIC SERVICE COMMISSION

Aga Khan Road, Sector F-5/1, ISLAMABAD

Website: www.fpsc.gov.pk E-mail: fpsc@fpsc.gov.pk Fax: 051-9213386-9203410

Application Form No.

APPLICATION FORM FOR RECRUITMENT TO BS-16 & ABOVE POSTS

To be filled by the candidate
Application Fee (Original Treasury Receipt) No.. .. date..For Rs. Name of Bank Branch Code... Tehsil/ District (Bank Branch Located).. For Official Use Only

For Official Use only

Receiving Stamp FPSC HQ/Provincial/Regional Office

Paste Photograph for (female candidates also)

Batch No.

Diary No.

_____________________________________________________________________________________________________________________ Consolidated Advt. No. Case No.

F.4-

-R

Category (If applicable) Subject

Name of Post Applied for:. B.S.

Ministry/Division/Department . 1) Name: (Write in capital letters with spelling as per Matriculation Certificate)

2) Fathers Name/Husbands Name (For female married candidates)

3)

d
Date of Birth (exact as per Matric certificate)

Exact age on Closing Date

4) Computerized (NADRA) National Identity Card (CNIC) No. of Applicant 5) Encircle the relevant Code:
6) a) Gender Male Female M F b) Religion Muslim Non-Muslim

M
NM

Self Domicile: (Encircle the relevant Code of your domicile).

Balochistan Khyber Pakhtoonkhwa (KP) Sindh (Rural) Sindh (Urban)

District of Domicile:
Punjab (Including ICT) Azad Kashmir Gilgit Baltistan (GB) FATA

Domicile Code
7)

10

20

30

31

40

60
Multan

61
Peshawar Quetta

90
Sukkur

Encircle the relevant Code separately for Test and Interview Centre. D.I.Khan Gilgit Islamabad Karachi Lahore Test Centre Code Interview Centre Code
8)

I Karachi

K Lahore L

P Peshawar P

S Quetta Q

Islamabad

I K Encircle the relevant Code in case of Age Relaxation:

Not claimed (Within age limit) Govt. Servant including serving in Armed Forces
Armed Forces Released/Retired Commissioned Officer/Personnel Scheduled Caste

Age Relaxation

Buddhist Community

Azad

Kashmir

Gilgit Baltistan (GB)

Recognized Tribes of Tribal Areas

CODE

00

01

02

03

04

05

06

07

9) (a) Present Postal Address: (IN CAPITAL LETTERS): ________________________________________________________

____________________________________________________________________________________ District___________________

(b) Permanent/Alternate Address__________________________________________________________________________

____________________________________________________________________________________District___________________

10) Contact Nos:

Contact Phone Nos. with City Code Please write all Nos.
E-Mail Address Office Residence Cell No. Fax No.

Applicants Signature Date

- 2 11). ACADEMIC QUALIFICATIONS: Do you possess the minimum educational qualification as mentioned in the advertisement as on the closing Date?

Yes

No

Board/ University

CGPA/ Div/Grad e % of Marks Obtained

Sr. No.

Advertised Minimum Qualification and higher

Matriculation Intermediate

Result Declaration Date (Certificate issued only by the Controller of Examination of Board/University will be accepted)

Day

Month

Year

Principal Subjects

1 2 3 4 5 6 7

12)

COURSES/TRAINING (Certificate, Diploma, Post-Graduate Diploma, on job training etc.) STARTING DATE ENDING DATE Nature of Training Intern On ee Job

GRADE

Sr. No.

NAME OF COURSE

INSTITUTION & LOCATION

Day

Month

Year

Day

Month

Year

1 2 3 4 5

13) RESEARCH/PUBLICATIONS/PAPERS/ARTICLES:

Mark R in the last column of the research report/paper/article/publication, if required in the advertisement. Sl. No. 1 2 3 4 5

Title

Journal/Conferences (In case of paper/article)

Publisher

Day

Publication Date Month Year

14) Do you fall in the category of a disabled candidate?

If yes, then encircle the relevant Code:

DISABILITY

Visual impaired (Blind)

Physically Impaired

Hearing/Speech impaired (deaf & dumb)

CODE
Computer Writer If you need any assistance for attempting the question paper in the examination/ test, then Mark the relevant Box

V
Computer Audio Recorder Braille Writer

P
Computer Audio Recorder Writer

H
Audio Recorder AR

Code

AR

AR

Weeks

15)

EXPERIENCE: (i) Start from first employment in ascending order (ii) Do you possess relevant Post-Qualification experience for the post as mentioned in the advertisement. Experience (each) claimed here must be authenticated by providing experience certificate/valid proof of that period with exact dates, job description/specification issued by the Competent Authority.(Specimen at Annex-A)
PERIOD Fed. Govt. From To
(Write to-date if you are still in service)

Armed Forces

Semi Govt.

Daily Wages

Sl No

NAME OF THE POST

BS

Prov. Govt.

Permanent

Temporary

Day
1 2 3 4 5

Month
6

Year
7

Day
8

Month
9

Year
10

Year
11

Month
12

Day
13

14

15

16

17

18

19

20

21

22

23

24

25

26

Apprentice
27

Officiating

Part Time

Honorary

Contract

Private

Adhoc

ORGANIZATION/ MINISTRY/DIVISION/ DEPARTMENT

STATUS TOTAL PERIOD

NATURE OF JOB MAIN DUTIES PERFORMED (Attach additional sheet if needed)

28

-3-

10 Attach additional sheet if required on the same pattern.

Attach additional sheet if required on the same pattern.

- 4 -

16) Check List: Have you filled/attached attested copies of all required documents as per following sequence?
Yes / No 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Correct Case No. / Name of post/Department as per Advertisement. Original Treasury Challan with application form. Latest Three (3) Photographs Mentioning your name on backside. Copy of Computerized National Identity Card (CNIC). Copy of Matric/Secondary School Certificate (Proof of Age). Copy of required Degrees/Diplomas/Certificates. Proof of Post-Qualification experience. Copy of self Domicile Certificate. Departmental Permission Certificate (For Govt. Servants) In Case of Disabled Candidates, certificate of Disability from the Competent Authority.

17) Declaration (i): I hereby solemnly declare that I am not in possession of any domicile certificate other than District _______________________ claimed / submitted alongwith this application form for the instant case. I further declare that if I am found in possession of any domicile certificate other than the one mentioned above, I will be liable to dismissal from service any time with costs or any other penalty. Declaration (ii): I certify that the statements made by me in the answers to the foregoing questions 1-17 are true, complete and correct to the best of my knowledge and belief. Submission of fake/forged documents and any misrepresentation or omission discovered even after appointment may render my appointment liable to termination in addition to the action decided by the Commission. I have also carefully read the General Instructions to the candidates and I am bound by the terms and conditions contained therein.
Note:- Attested copies of all the documents should be attached in above order and numbered in continuation of page number of Application Form.

Applicants Signature Date

- 5 ANNEX-A SPECIMEN OF EXPERIENCE CERTIFICATE (To be typed/printed on Letter Head of Ministry/Division/Department/Organization/Firm) Certified that Mr./Miss/Mrs.................................................................................................................................... has been/is employed in this Ministry/Division /Department / Firm/Organization as.......................................................... from......................................to.................................(dates) whole time/part time/honorary basis/contract basis/daily wages. The work of Mr./Miss/Mrs....................................................while employed in this Ministry/Division/ Department/Firm/Organization was/is satisfactory. The duties/job specifications are/were as follows:(1) (2) (3) (4) (5) ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................. ................................................................................................................................................................ ................................................................................................................................................................

Date of Issue.............................. Signature.. Name of Issuing Authority.................. FOR PRIVATE ORGANIZATION ........................................................... Designation....................................... BPS (or Equivalent)........................... Office Stamp/Seal............................. Phone No...

CNIC No.
(Issuing Authority)

Name:

Address: ----------------------------------------------------------------------------------------------------------------------------------------- Phone No.-----------------------

Note : (i)

Experience certificate must be issued under the signature of an officer at least one step higher than the post applied for. For example in case of a candidate for a post of BS-17, the experience certificate must be issued under the signature of head of the department/an officer of BPS-18 or equivalent as the case may be.

(ii)

In case of a candidate who served/is serving in a private Firm/Organization, experience certificate must be issued under the signature of Chief Executive/Head of Private Firm/Organization with CNIC No. address, Phone Nos.

(iii)

Experience certificate must be issued on the official letter pad with reference/file No. and date of issue and it should be duly stamped with full address. Telephone No. should also be indicated, failing which the experience certificate will not be acceptable.

(iv)

In case of more than one employer each experience certificate must be on the pattern as given above to derive the authentication/period of relevancy/irrelevancy of the job.

- 6 ANNEX-B CERTIFICATE TO BE PRODUCED BY CANDIDATES BELONGING TO THE TRIBAL AREAS This is to certify that Mr./Miss/Mrs........................................................................................................................... Son/Daughter of....................................................................................................................................................... belongs to the recognized tribe of............................................................................................................................ and is a permanent resident of Village/Town........................................................................................................... of District/Trible Area............................................................................................................................................... and his/her family have been living in that area since............................................................................................. belongs to a Gilgit Baltistan,* Federally Administered Tribal Area* Provincially Administered Tribal Area*. Note :Tribal Area as defined vide Article 246 of the Constitution of the Islamic Republic of Pakistan. *Strike out whichever is not applicable.

Dated.............................................

Signature................................... Political Agent Office stamp/seal must be affixed

ANNEX-C CERTIFICATE TO BE PRODUCED BY THE CANDIDATE FROM THE KASHMIR AFFAIRS DIVISION, GOVERNMENT OF PAKISTAN, ISLAMABAD This is to certify that Mr./Miss/Mrs........................................................................................................................... Son/Daughter of...................................................................................................................................................... is a permanent resident of Village/Town..................................................................... of District............................. of Azad Jammu & Kashmir Territory and has been living in the aforesaid areas or any other part of Pakistan.

Dated.............................................

Signature....................................... Designation.............................................. Office stamp/seal must be affixed.

FEDERAL PUBLIC SERVICE COMMISSION

Application Form No. _________ DEPARTMENTAL PERMISSION CERTIFICATE FOR PERSONS IN GOVERNMENT SERVICE (To be detached from the application form and submitted to candidates employing department before the closing date. No column should be left blank). (1) (a) Full name of the advertised post____________________________________________________ (b) Name of Department/Division/Ministry_______________________________________________ (c) Commissions Advertisement No._______________ of 201 _____________________________ (d) Case No.F.4-_____________ /201 - R______________________________________________ (2) (i) Name of candidate______________________________Fathers Name____________________ (ii) CNIC No. -

(iii) Designation________________________________________________BS _________________ (iv) Present department with complete address___________________________________________ _____________________________________________________________________________ (3) I have applied for the above post on the prescribed form separately to the Commission. Departmental permission certificate may kindly be forwarded to the Secretary, Federal Public Service Commission, F-5/1, Aga Khan Road, Islamabad, Closing Date for receipt of application by the Commission is _______________. Date_______________________ Signature of the candidate___________________ __________________________________________________________________________________________ FOR USE BY THE DEPARTMENT (EMPLOYER OF THE CANDIDATE) Attention :
Division/Department concerned must forward this certificate or communicate the refusal to F.P.S.C. within 60 days from the closing date for receipt of applications or before interviews whichever is earlier, failing which the head of the organization will have to account for its non-submission or delay to the Government. On selection, the department will have to relieve the official for joining the post.

No.____________________ Date___________________ (4) Forwarded: Mr./Miss/Mrs___________________________________________________is employed in this department since _________________he/she/holds a temporary/permanent/adhoc/contract/daily wages post under the Federal/Provincial/Semi-Government/Government/Autonomous/Corporation(Strike out not applicable). His/her total continuous government service Federal/Provincial______years_____months_____ days. (5) The candidate has availed extraordinary leave for __________years_________Months_________days and or has availed study leave for__________years__________months__________days. (6) The place of domicile as declared by him/her and accepted at the time of first entry into Government/ SemiGovernment/ Autonomous/Corporation service was___________________Province/Area. In case of Sindh, indicate Sindh (Rural) or Sindh (Urban). (7) There is nothing adverse in his/her performance evaluation report (PER)/annual confidential reports/records, antecedents/character, which may render him/her ineligible/unsuitable for the post applied for. (8) In case it is decided by the department to forward a case where adverse entries do exist in an officers/Officials record, extracts of the adverse entries from the relevant ACRs should be sent alongwith the departmental permission certificate for information of the Commission. Also confirming that the adverse remarks were communicated to the candidate and no appeal petition is pending for decision thereon. Signature_________________________ Secretary, Federal Public Service Commission, F-5/1, Aga Khan Road, Islamabad. Name____________________________ Designation and department with complete address (to be signed by head of the Department/Division/Ministry (Official stamp must be affixed)

Banks Name Banks Code District of Bank Branch.. Bank Details Must be filled by the candidate

T.R-6

Important

(Treasury Rule 29) Chalan No. (BANKS COPY) Treasury/Sub-Treasury Cash paid into the National Bank of Pakistan State Bank of Pakistan

For Bank use only

Received Payment Rs./=

(in words) Rupeesonly)

Date
Name of Candidate . Secretary, Federal Public Service Commission, Islamabad Case No. F. 4 Examination Fee for the post of Rs. (Rupees .only) /20 -R Full particulars of the remittance and of authority (if any) Name (or designation) & address of the person on whose behalf money is paid

To be filled in by the remitter

By whom tendered

CENTRAL QUARDUPLICATE

Signature Treasury Officer/Bank Officer with Stamp

Amount
Head of Account

C 02101 Organs of States - Exam Fee Realized by FPSC

Banks Name Banks Code District of Bank Branch..

T.R-6

Important

Bank Details Must be filled by the candidate

For Bank use only

Received Payment Rs./=

(in words) Rupeesonly)

(Treasury Rule 29) Chalan No. (TREASURYS COPY) Treasury/Sub-Treasury Cash paid into the National Bank of Pakistan

Date
Name of Candidate . Secretary, Federal Public Service Commission, Islamabad Case No. F. 4 /20 -R Examination Fee for the post of Rs. (Rupees .only)

By whom tendered Name (or designation) & address of the person on whose behalf money is paid Full particulars of the remittance and of authority (if any)

State Bank of Pakistan

To be filled in by the remitter

CENTRAL TRIPLICATE

Signature Treasury Officer/Bank Officer with Stamp

For Bank use only

Amount
Head of Account

C 02101 Organs of States - Exam Fee Realized by FPSC

T.R-6

Bank Details Must be filled by the candidate

CENTRAL

Name of Candidate . Secretary, Federal Public Service Commission, Islamabad Case No. F. 4 /20 -R Examination Fee for the post of Rs. (Rupees .only)

By whom tendered

State Bank of Pakistan

Received Payment Rs./=

Name (or designation) & address of the person on whose behalf money is paid Full particulars of the remittance and of authority (if any)

(in words) Rupeesonly)

DUPLICATE

To be filled in by the remitter

(Treasury Rule 29) Chalan No. CANDIDATES COPY) Treasury/Sub-Treasury Cash paid into the National Bank of Pakistan

Signature Treasury Officer/Bank Officer with Stamp Date Signature Treasury Officer/Bank Officer with Stamp

Amount
C 02101 Organs of States - Exam Fee Realized by FPSC

Head of Account

Important

Date
For Bank use only

Banks Name Banks Code. District of Bank Branch..

Banks Name Banks Code District of Bank Branch..

T.R-6

Important
By whom tendered Bank Details Must be filled by the candidate

CENTRAL

Name of Candidate . Secretary, Federal Public Service Commission, Islamabad Case No. F. 4 /20 -R Examination Fee for the post of Rs. (Rupees .only)

Received Payment Rs./=

State Bank of Pakistan

Name (or designation) & address of the person on whose behalf money is paid Full particulars of the remittance and of authority (if any)

(Treasury Rule 29) Chalan No. Treasury/Sub-Treasury Cash paid into the National Bank of Pakistan

To be filled in by the remitter

(in words) Rupeesonly)

ORIGINAL

Amount
C 02101 Organs of States - Exam Fee Realized by FPSC

(FPSCS COPY)

Head of Account