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BSSC

The document is a registration form for Vimal Kumar for the Bihar Staff Selection Commission's 4th Graduate Level Combined Competitive Exam. It includes personal details, educational qualifications, and payment information, confirming his eligibility and compliance with the application process. Vimal Kumar is a 24-year-old male from the Yadav caste, with a domicile in Bihar and has provided all necessary identification and declaration of information accuracy.

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Vimal Kumar
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0% found this document useful (0 votes)
3 views2 pages

BSSC

The document is a registration form for Vimal Kumar for the Bihar Staff Selection Commission's 4th Graduate Level Combined Competitive Exam. It includes personal details, educational qualifications, and payment information, confirming his eligibility and compliance with the application process. Vimal Kumar is a 24-year-old male from the Yadav caste, with a domicile in Bihar and has provided all necessary identification and declaration of information accuracy.

Uploaded by

Vimal Kumar
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

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BIHAR STAFF SELECTION COMMISSION


P.O.-VETERINARY COLLEGE, PATNA - 800014
ADV NO.-05/25, 4th GRADUATE LEVEL COMBINED COMPETITIVE EXAM
चतुर्थ स्नातक स्तरीय संयुक्त प्रतियोगिता परीक्षा
PERSONAL DETAILS
REGISTRATION NO.: 5251128123
FORM NO. : 6251128123
NAME OF APPLICANT : VIMAL KUMAR
FATHER'S NAME : SHAILENDRA PRASAD
MOTHER'S NAME : DAULATIYA DEVI
GENDER : MALE
MOBILE NO. : 8434993793
EMAIL ID : VIMALKUMAR801103@[Link]
DATE OF BIRTH : 03-01-2001 LIVE PHOTO

AGE AS ON 01-08-2025 : 24 YEARS, 6 MONTHS, 29 DAYS


NATIONALITY : INDIAN
CATEGORY : BC
DO YOU BELONG TO NON-CREAMY LAYER ? : YES
CASTE : YADAV / यादव
(EBC/BC-NCLC CERTIFICATE NUMBER) / (SC/ST-CASTE CERTIFICATE
NCLCO/2023/1814315
NUMBER) / (EWS-CERTIFICATE NUMBER) :
ISSUE DATE OF CERTIFICATE : 24-11-2023
CERTIFICATE ISSUING AUTHORITY : RO
PHOTO
DOMICILE OF BIHAR STATE : YES
ISSUE DATE OF DOMICILE CERTIFICATE: 13-09-2025
ISSUE NUMBER OF DOMICILE CERTIFICATE : BRCCO/2025/24918320
DOMICILE CERTIFICATE ISSUING COMPETENT AUTHORITY : RO
SIGNATURE IN ENGLISH
ARE YOU PERSON WITH DISABILITY? : NO

SIGNATURE IN HINDI

DO YOU HAVE AADHAR CARD? : YES (AADHAR CARD NUMBER: 899656558897)


ID PROOF : AADHAAR CARD ID PROOF NO : 899656558897
BIHAR GOVERNMENT EMPLOYEE WHO HAS RENDERED NOT LESS THAN 3 YEARS REGULAR AND
NO
CONTINUOUS SERVICE? :
NUMBER OF ATTEMPTS AFTER BIHAR GOVERNMENT EMPLOYEE?
00
(AFTER DATE: 12-12-2022) :
IDENTIFICATION MARK OF THE CANDIDATE : A CUT MARK ON LEFT EYEBROW
ARE YOU AN EX-SERVICEMAN? : NO
WARD OF FREEDOM FIGHTER? : NO
HAVE YOU EVER BEEN DEBARRED FROM ANY COMPETITIVE EXAMINATION (UPSC/BOARD/STATE
NO
COMMISSION/ANY OTHER)? :
HAVE YOU WORKED UNDER BIHAR GOVERNMENT AFTER BEING RELEASED FROM NCC AFTER
NO
JANUARY 1, 1963?:
ADDRESS DETAILS

CORRESPONDENCE ADDRESS PERMANENT ADDRESS

VILLAGE-AMNABAD POST-KATESAR P.S- VILLAGE-AMNABAD POST-KATESAR P.S-


ADDRESS: ADDRESS:
BIHTA PATNA BIHTA PATNA
VILLAGE/MOHALLA: AMNABAD VILLAGE/MOHALLA: AMNABAD
POST OFFICE: KATESAR POST OFFICE: KATESAR

POLICE STATION: BIHTA POLICE STATION: BIHTA


DISTRICT: PATNA DISTRICT: PATNA
STATE: BIHAR STATE: BIHAR

PIN CODE: 801103 PIN CODE: 801103


EDUCATIONAL QUALIFICATIONS
EDUCATION SUBJECT BOARD / TOTAL MARKS MARKS OBTAINED PERCENTAGE PASSINGDATE CERTIFICATE
UNIVERSITY NUMBER
10TH / MATH SCIENCE ICSE 500 396 79.20 06-05-2016 TD60083397
EQUIVALENT SOCIAL SCIENCE
ENGLISH HINDI
PHYSICAL
EDUCATION
R B NON HINDI
12TH/10TH
ALTERNATIVE
+2/ BSEB 500 329 65.80 06-06-2018 180218369
ENGLISH PHYSICS
EQUIVALENT
CHEMISTRY MATH
MATH PHYSICS
GRADUATION/ PATLIPUTRA
CHEMISTRY HINDI 800 480 60.00 05-08-2022 10092021
EQUIVALENT UNIVERSITY
ENGLISH
PAYMENT DETAILS:
PAYMENT BANK : SBI
TRANSACTION ID : 2893672875729
TRANSACTION DATE : 2025-09-23 20:35:03
REGISTRATION FEE (RS.) : 100
DECLARATION DETAILS:

I HEREBY DECLARE THAT THE INFORMATIONS FILLED UP ABOVE BY ME ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I ALSO DECLARE
THAT I HAVE FILLED UP ONLY ONE APPLICATION FORM. I ALSO UNDERTAKE THAT IF ANY INFORMATION IS FOUND OTHERWISE, I SHALL BE LIABLE
FOR ANY LEGAL ACTION AND CANCELLATION OF MY CANDIDATURE.
DATE : 23-09-2025 21:18:52
DECLARATION ACCEPTED : YES

NOTE: PLEASE KEEP YOUR REGISTRATION NO.,PASSWORD,MOBILE NO AND EMAIL-ID CAREFULLY FOR FURTHER REFERENCE.

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