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MTS Examination 2019 Application Details

1) The document is an application form for the Multi Tasking Staff (MTS) Examination 2019 by the Staff Selection Commission for Sachin Kumar. 2) It provides personal details of Sachin Kumar such as name, father's name, date of birth, category, identification marks, educational qualifications, address details, and preference of examination centers. 3) By submitting the form, Sachin Kumar declares that all information provided is true and correct and understands that suppression of any facts could lead to cancellation of candidature.

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Crystal Garcia
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57 views2 pages

MTS Examination 2019 Application Details

1) The document is an application form for the Multi Tasking Staff (MTS) Examination 2019 by the Staff Selection Commission for Sachin Kumar. 2) It provides personal details of Sachin Kumar such as name, father's name, date of birth, category, identification marks, educational qualifications, address details, and preference of examination centers. 3) By submitting the form, Sachin Kumar declares that all information provided is true and correct and understands that suppression of any facts could lead to cancellation of candidature.

Uploaded by

Crystal Garcia
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

STAFF SELECTION COMMISSION

BLOCK NO. 12, CGO COMPLEX, LODHI ROAD, NEW DELHI


110003

MULTI TASKING STAFF (MTS) EXAMINATION 2019

REGISTRATION NO: 30000182278

APPLICATION IS PROVISIONALLY ACCEPTED


1. NAME AS PER 2. NEW/CHANGED
MATRICULATION 3. FATHER'S NAME 4. MOTHER'S NAME
NAME
CERTIFICATE
SACHIN KUMAR - SURAJ KUMAR SEEMA DEVI
5. DATE OF BIRTH (DD/MM/YYYY) 6. AGE AS ON 01/08/2019 7. GENDER
20/09/1997 21.1 MALE
8. CATEGORY 9. ID NUMBER 10. NATIONALITY
SC 94XXXXXXXX08 CITIZEN OF INDIA
11. MARK OF VISIBLE IDENTIFICATION : MOLE ON RIGHT HAND
12. MATRICULATION (10th CLASS) EXAMINATION 13. MATRICULATION (10th 14. MATRICULATION (10th
BOARD CLASS) ROLL NO CLASS) YEAR OF PASSING
CENTRAL BOARD OF SECONDARY EDUCATION
5230783 2012
(CBSE)
15. PREFERENCE OF EXAMINATION CENTERS
EXAMINATION CENTER ( FIRST ) EXAMINATION CENTER ( SECOND ) EXAMINATION CENTER ( THIRD )

3015 - MURADABAD 3009 - KANPUR 3005 - BAREILLY


16.1. HAVE YOU ALREADY
JOINED A CIVIL POST BY 16.3. DATE OF DISCHARGE
[Link] EX- 16.2. LENGTH OF SERVICE IN
AVAILING BENEFIT OF FROM ARMED FORCES
SERVICEMAN (ESM)? ARMED FORCES ( IN YEARS )
RESERVATION FOR EX- (DD/MM/YYYY)
SERVICEMAN (ESM) :?
NO - - -
17. WHETHER PERSON WITH DISABILITY 17.1 IF YES, TYPE OF DISABILITY (OH, HH,VH, OTHERS)
(PWD) ?
NO -
18.1 WHETHER SUFFERING FROM CEREBRAL PALSY
-
18.2 DO YOU HAVE A PHYSICAL LIMITATION TO WRITE AND SCRIBE IS REQUIRED TO WRITE ON YOUR BEHALF
(CERTIFICATE TO THIS EFFECT FROM THE CHIEF MEDICAL OFFICER/ CIVIL SURGEON & MEDICAL
SUPERINTENDENT OF A GOVERNMENT HEALTH CARE INSTITUTION AS PER NOTICE OF THE EXAMINATION
WOULD BE REQUIRED AT THE TIME OF EXAMINATION)?
-
18.3 WHETHER SCRIBE IS REQUIRED 18.4 WILL YOU MAKE YOUR OWN 18.5 IF SCRIBE IS TO BE
ARRANGEMENT OF SCRIBE? ARRANGED BY SSC, INDICATE
MEDIUM
- - -
19. WHETHER SEEKING AGE RELAXATION? 19.1 IF YES,INDICATE CODE
NO -
20. STATE(S) / U.T. PREFRENCE CODE
J,F,1,H,A,2,B,C,D,E,G,I,K,L,M,N,O,P,Q,R,S,T,W,V,Y,Z,3,4,5,6,7,8,U
21. EDUCATIONAL QUALIFICATION
MATRICULATION/ 10TH CLASS PASS
22. DO YOU BELONG TO ECONOMICALLY WEAKER SECTIONS (EWS) ?
-
23. DO YOU WANT TO MAKE AVAILABLE YOUR PERSONAL INFORMATION FOR ACCESSING JOB OPPORTUNITY IN
TERMS OF DoP&T'S O.M NO.39020/1/2016-ESTT.(B) DATED 21.06.2016 ?
NO
ADDRESS DETAIL
24. POSTAL ADDRESS 25. PERMANENT ADDRESS
RAJKIYA ADARSH COLONY NEAR 23 PAC KANTH ROAD RAJKIYA ADARSH COLONY NEAR 23 PAC KANTH ROAD
MORADABAD MORADABAD
DISTRICT: MORADABAD DISTRICT: MORADABAD
STATE: UTTAR PRADESH STATE: UTTAR PRADESH
PIN: 244001 PIN: 244001
MOBILE NO. : 9897614876 EMAIL ID: sahinsuraj788@[Link]
SIGNATURE

FEE PAYMENT AMOUNT TRANSACTION NO TRANSACTION DATE


EXEMPTED - - -
DECLARATION
1. I HAVE READ THE NOTICE OF THE EXAMINATION AND ACCEPT ALL THE TERMS & CONDITIONS OF
THE NOTICE OF THE EXAMINATION.

2. I HEREBY DECLARE THAT ALL STATEMENTS MADE IN THIS APPLICATION ARE TRUE, COMPLETE
AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THAT IN THE EVENT OF
ANY INFORMATION BEING FOUND SUPPRESSED/FALSE OR INCORRECT OR INELIGIBILITY BEING
DETECTED BEFORE OR AFTER THE EXAMINATION, MY CANDIDATURE/ APPOINTMENT IS LIABLE TO BE
CANCELLED.I AM WILLING TO SERVE ANYWHERE IN INDIA.
PRINT TAKEN ON: 08/05/2019 4:46:32 PM

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