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CCC Exam Registration for Government Employees

Dhavalbhai Patel has submitted a registration form for the CCC examination. The form provides his personal details like name, age, address, contact information, as well as organizational details of his employer, the Labour and Employment Department. It also includes documents submitted, payment details, and a declaration signed by Patel confirming the accuracy of the information. The head of Patel's institute has also certified the form and details provided in it.

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503 views3 pages

CCC Exam Registration for Government Employees

Dhavalbhai Patel has submitted a registration form for the CCC examination. The form provides his personal details like name, age, address, contact information, as well as organizational details of his employer, the Labour and Employment Department. It also includes documents submitted, payment details, and a declaration signed by Patel confirming the accuracy of the information. The head of Patel's institute has also certified the form and details provided in it.

Uploaded by

VAV PPP
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

10/5/2020 [Link]/Gujrat/Reports/RegistrationFormReport.

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CCC EXAMINATION FOR GOVERNMENT EMPLOYEE REGISTRATION FORM

Exam Seat No :

Application Form No : GUCCC20042809

Course Name : CCC - EXAMINATION

Personal Details
Full Name : PATEL DHAVALBHAI MAHENDRABHAI

Date of Birth : 20/3/1988

Age : 32Y

Mobile : 8154894496

Gender : Male Female Transgender

Designation : SUPERVISOR INSTRUCTOR

Aadhaar Card No. : 875273516391 GPF/CPF Account No. :

Marital Status : MARRIED Caste : GENERAL

Present Address : 42 SUCITY BUNGLOWS NAGALPUR MEHSANA

Village Name : NAGALPUR

District : MEHSANA Taluka : MEHSANA

State : GUJARAT Pincode : 384002

Whether Physically Handicapped? : Yes No

Are You Blind? : Yes No

Whether Ex-Servicemen? : Yes No

Are you GOVT. employee ? : Yes No

Whether Likely to be promoted higher scales within months? : NO

Date of Joining GOVT. Services : 17/3/2020

Date of Joining in Department : 17/3/2020

Date of Retirement : 31/3/2046

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Application Form No : GUCCC20042809


Organizational Details
Exam Type : THEORY AND PRACTICAL

Name of Secretariat : DIRECTORATE EMPLOYMENT AND TRAINING

Name of Department : LABOUR AND EMPLOYMENT DEPARTMENT

Name of Institute : INDUSTRIAL TRAINING INSTITUTE VAV

Institute/Of ice Address : ITI VAV


OPP MARKET YARD BHABHAR ROAD
AT POST VAV TALUKA VAV
Village Name : BANASKANTHA Taluka : VAV

District: BANASKANTHA State : GUJARAT

Pincode : 385575

Name & Designation of Head of institute/of ice : RASHIK R PRAJAPATI PRINCIPAL ITI VAV

Contact No. of Head : 9687755158

Email Id of Head : prlitivav@[Link]

Payment Details
Date : 05/10/2020 Transaction Number : GUC1234573646
Amount : 200 Payment Type : Online

Documents :
AADHAAR CARD Aadhaar Card No. 875273516391

PAN CARD

VOTER ID

DRIVING LICENSE NO

Declaration
I declare that I have illed the application form after thoroughly understanding rules and the information illed by
me in the application form is correct and true to the best of my knowledge and belief.
I also understand that my application will be rejected if any of the information submitted in this form is found to
be incorrect / false.

TO WHOMSOEVER IT MAY CONCERN


This is to certify that the information given in this registration form for CCC examination is
veri ied and found to be correct as per the of ice records.

Signature of the Of icial Designation:


Name of the Of icial : Please paste your latest photo duly stamped
Email address: by your department head

Note:- ઉમેદવારએ તેમના પર ા સમયે તેમના ડપાટમે ટ હડ ારા સહ કરલ અર ફોમની હાડ કૉિપ સબિમટ
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10/5/2020 [Link]/Gujrat/Reports/[Link]
Note: ઉમદવારએ તમના પર ા સમય તમના ડપાટમ ટ હડ ારા સહ કરલ અર ફોમની હાડ કૉિપ સબિમટ
કરાવવી.

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