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SSC Junior Engineer Exam Application 2019

This document contains details of an application that has been provisionally accepted for the Junior Engineer (Civil, Mechanical, Electrical and Quantity Surveying & Contracts) Examination 2019. It provides personal information of the applicant such as name, father's name, date of birth, gender, category, nationality, address, highest qualification, preferred examination centers, and declaration of truthfulness of the application. The applicant is Abhinav Jain seeking the post of JE-Civil Engineering with fee payment details.

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Abhi J
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40 views2 pages

SSC Junior Engineer Exam Application 2019

This document contains details of an application that has been provisionally accepted for the Junior Engineer (Civil, Mechanical, Electrical and Quantity Surveying & Contracts) Examination 2019. It provides personal information of the applicant such as name, father's name, date of birth, gender, category, nationality, address, highest qualification, preferred examination centers, and declaration of truthfulness of the application. The applicant is Abhinav Jain seeking the post of JE-Civil Engineering with fee payment details.

Uploaded by

Abhi J
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
JUNIOR ENGINEER (CIVIL, MECHANICAL,
ELECTRICAL AND QUANTITY SURVEYING &
CONTRACTS) EXAMINATION 2019
REGISTRATION NO: 30000640292

APPLICATION IS PROVISIONALLY ACCEPTED


1. NAME AS PER 2. NEW/CHANGED 3. FATHER'S NAME 4. MOTHER'S NAME
MATRICULATION NAME
CERTIFICATE
ABHINAV JAIN - ASHISH KUMAR JAIN PRERNA JAIN
5. DATE OF BIRTH (DD/MM/YYYY) 6. AGE AS ON 01-01-2020 7. GENDER
21/06/1997 22.6 MALE
10. MARK OF VISIBLE
8. CATEGORY 9. NATIONALITY
IDENTIFICATION
UNRESERVED CITIZEN OF INDIA MOLE ON RIGHT CHEEK
11. MATRICULATION (10th CLASS) EXAMINATION 12. MATRICULATION (10th 13. MATRICULATION (10th
BOARD CLASS) ROLL NO CLASS) YEAR OF PASSING
CENTRAL BOARD OF SECONDARY EDUCATION
5242214 2013
(CBSE)
14. PREFERENCE OF EXAMINATION CENTERS
EXAMINATION CENTER ( FIRST ) EXAMINATION CENTER ( SECOND ) EXAMINATION CENTER ( THIRD )

KANPUR ( 3009 ) MEERUT ( 3011 ) LUCKNOW ( 3010 )


[Link] EX- 15.1. HAVE YOU ALREADY 15.2. LENGTH OF SERVICE IN 15.3. DATE OF DISCHARGE
SERVICEMAN (ESM)? JOINED A CIVIL POST BY ARMED FORCES ( IN YEARS ) FROM ARMED FORCES
AVAILING BENEFIT OF (DD/MM/YYYY)
RESERVATION FOR EX-
SERVICEMAN (ESM) :?
NO - - -
16. WHETHER PERSON WITH DISABILITY 16.1 IF YES, TYPE OF DISABILITY (OH, HH,VH, OTHERS)
(PWD) ?
NO -
17. 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)?
NO
17.1 WHETHER SCRIBE IS REQUIRED 17.2 WILL YOU MAKE YOUR OWN 17.3 IF SCRIBE IS TO BE
ARRANGEMENT OF SCRIBE? ARRANGED BY SSC, INDICATE
MEDIUM
NO - -
18. WHETHER SEEKING AGE RELAXATION? 18.1 IF YES,INDICATE CODE
NO -
19. POST(S) APPLYING FOR
JE- CIVIL ENGINEERING
20. QUALIFICATION DETAILS
HIGHEST TECHNICAL QUALIFICATION RELEVANT TO SUBJECT/ STREAM
THE POST OF INTEREST
B. TECH CIVIL ENGINEERING
21. DO YOU BELONG TO ECONOMICALLY WEAKER SECTIONS (EWS) ?
NO
22. 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
23. POSTAL ADDRESS 24. PERMANENT ADDRESS
53C JAIN NAGAR RAILWAY ROAD 72C JAIN NAGAR RAILWAY ROAD

DISTRICT: MEERUT DISTRICT:MEERUT


STATE: UTTAR PRADESH STATE: UTTAR PRADESH
PIN : 250002 PIN : 250002
MOBILE NO: 8171141163 EMAIL: abhi2197@[Link]
SIGNATURE

FEE PAYMENT AMOUNT TRANSACTION NO TRANSACTION DATE


NOT EXEMPTED 100 CPU4422706 05/09/2019
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: 22/09/2019 1:45:48 PM

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