APPLICATION FOR MAIN EXAMINATION TO THE POST OF CIVIL JUDGE

(ENTRY LEVEL) 2011 IN CHHATTISGARH LOWER JUDICIAL SERVICE

Date of Examination

11.09.2011

HIGH COURT OF CHHATTISGARH

Last date of receipt of application form 26.08.2011

Roll No. ( for office use only)

(Fill in the form using English BLOCK LETTERS only leaving one box empty between two parts) 1. Name of applicant
Affix photo of size 3.5 x 4.5 c.m. Similar to that affixed on application form of preliminary exam.

2. Name of Father

dont staple or pin

[Link] of Husband

Put Signature in this box

6. Sex 4. Roll No. (Preliminary Examination) 5. Address of applicant Name :... Correspondence Address............................... .. .. Village/City ... District ... State ... Pin Code ..... Contact No... Permanent Address .. .. .. Village/City ..... District ... State .Pin Code..
(Put a tick mark in the relevant box)

Male Female 7. Domicile of Chhattisgarh

(Put a tick mark in the relevant box)

Yes No
(Only bonafied residents of Chhattisgarh state shall be eligible for getting relaxation under reserved category)

8. Category
(Opt. Only One by putting a tick mark in the relevant box)

UR SC ST OBC OH

9. Date of Birth

10. Age as on 01.01.2012

11. Govt. Servant of [Link].

(Put a tick mark in the relevant box)

Date

Month

Year

Year

Month

Day

Yes No

12. Occupation .... Institution.....

13. Whether candidate was ever convicted by a Criminal Court ? (If Yes) (i) By Which Court .......................................... (ii) Convicted u/s. (iii) Description of punishment ....(iv) Date of judgment. 14. Whether the candidate is indebted ? ... If so, to whom and to what extent ?.........................................................................................

123-

Amount of Challan

15. Particulars of Examination fees :. :.

Transaction ID & date of deposit

Name & Address and code of Bank :.

16 . Details of Educational Qualification:-

[Link].
1. 2. 3. 4. 5. 6.

Name of Exam
High School Higher Secondary Graduation Post Graduation LL.B. Any Other Qualification

Board / University

Year of Passing

1-

17. Declaration I, hereby, declare that the entries made in the application from [Link]. 01 to [Link]. 16 are true, complete and correct as per my knowledge and belief. If any information is found false or incorrect or I am found ineligible after or before examination, then High Court can proceed against me under para 12 (twelve), mentioned in advertisement for Judicial Services Examination. I have carefully read the instructions as well as the terms & conditions of Registry and conditions published in the advertisement and I, hereby, promise to abide by the same. I declare that I fulfill all the eligibility conditions for the said examination like prescribed age limit, educational qualification etc.

2-

Place .

Signature of Applicant

HIGH COURT OF CHHATTISGARH, BILASPUR

IDENTITY-SHEET

Civil Judge (Entry Level) Main Examination 2011

------------------------------------------------------------------------------------------------------------------------------------Examination Centre:
(for office use only)

Roll No
(for office use only)

Date & Time of Examination 11/09/2011

11.00 A.M. to 02.00 P.M.

(To be filled by candidate)

Candidate's Name

: .
Affix photo of size 3.5 x 4.5 c.m. Similar to that affixed on application form of preliminary exam.

Father's / Husband's Name:..... Date of Birth :// Domicile of C.G.:.. Correspondence Address Sex :...

Category :...

dont staple or pin

: ... ...... ..

Candidate's Signature

------------------------------------------------------------------------------------------------------------------------------Candidate's Signature in Examination Hall Candidate's Thumb Impression in Examination Hall

Left thumb for Male candidate / Right thumb for Female candidate

ANSWER SHEET NUMBER

Signature of the Invigilator Signature of Centre Superintendent (With Seal)

--------------------------------------------------------------------------------------------------------------------------------------------------------------------Note :- Before sending the application form along with Identity Sheet the candidate must ensure that the information filled in the Identity Sheet is correct. Also put his / her Signature in the appropriate space.

HIGH COURT OF CHHATTISGARH, BILASPUR

Civil Judge (Entry Level) Main Examination-2011 Instructions to qualified candidates for Civil Judge (Entry Level) Main Examination-2011 1. Candidates declared qualified for Civil Judge (Entry level) Main Examination 2011 on the basis of Civil Judge (Entry level) preliminary examination conducted on 26.6.2011 are required to submit the application form in prescribed proforma attached with the intimation letter. Candidates are required to fill-up the application form properly by making appropriate entries to each item. Testimonials duly attested by gazetted officer or Notary in support of educational qualification, Date of Birth, Domicile of Chhattisgarh State, Caste Certificate, Certificate of Physically handicapped having orthopedic disability valid in all respect, which ever is applicable shall be compulsorily attached with the application form. Candidates are required to send three copies of photo of size 3.5 x 4.5 c.m. Similar to that affixed on application form of preliminary exam duly attested by the gazetted officer or Notary, one of which should be affixed on the place specified in the application form & another on Identity Sheet. The candidate qualified for main examination shall have to pay examination fee as under. (i) Rs. 300/- for the candidates who are bonafied resident of Chhattisgarh and belongs to Scheduled Caste, Scheduled Tribe or other Backward Classes notified for State of Chhattisgarh. (ii) Rs. 500/- for all the candidates belonging to Unreserved and OH category. through Network Banking all over India. Therefore, original copy of Challan must be attached along with application form. Challan form is available along with application form on our website i.e [Link]. Dully filled in application form must reach the Registrar General, High Court of Chhattisgarh, Bilaspur on or before 26.08.2011 till 5.00 PM. The High Court shall not be responsible for any delay or non-receipt of the application form. At the top of envelope containing application form the candidate should write in Block letter
APPLICATION FORM FOR C.G. CIVIL JUDGE (ENTRY LEVEL) MAIN EXAMINATION 2011.

2. 3.

4.

5.

6.

7.

Terms and conditions, Instruction included in the advertisement No. 01/S&A Cell/2011 dated 07th March 2011 shall be applicable to the candidates. 9. Result of qualified candidates for Civil Judge (Entry Level) Main Examination 2011, is available on the website [Link] Qualified candidates who are not in receipt of intimation letter with application form may down load the application form from the website [Link]. 10. Violation of any instruction will lead to rejection of the application form as well as candidature. 11. Enclosures:a. Proof of Date of Birth : High School / Higher Secondary - Certificate / Mark-Sheet. b. LL.B. (Final Year)- Degree/Mark Sheet. c. Caste Certificate issued by Competent Authority and valid in all respects. d. Domicile Certificate issued by Competent Authority and valid in all respects. e. NOC of employer (if employed). f. Orthopedicaly Handicapped Certificate issued by Competent Authority and valid in all respects (if opted Orthopedicaly Handicapped category). g. Relevant portion of Challan h. One self addressed envelopes (11 x 5) stamped with postal stamps of Rs. 25/12. Do not fold the application form as well as documents, certificates etc. Use 14 X 10 Inch size
envelope for sending the application form.

8.

(To be accepted by all the Branches of State Bank of India through Core Banking Network) CHALLAN FORM SHOULD BE FILLED BY THE CANDIDATE IN THEIR OWN HANDWRITING First copy for Bank
(This part to be retained by the Bank for its record)

Second copy for candidate

(This part should be kept by candidate)

Third copy for High Court of Chhattisgarh

(This part must be attached along with the application form)

STATE BANK OF INDIA

Name of work : Challan for payment of Examination fee for Civil Judge (Entry Level) Main Exam 2011. Name & Complete Address of the applicant as per application form (IN BLOCK LETTERS) Branch Name & Code : . Transaction ID : . Date of Deposit : Category : . SC/ST/OBC (Only for CG domicile) Rs. 300/UNRESERVED/OH Rs. 500/-

STATE BANK OF INDIA

Name of work : Challan for payment of Examination fee for Civil Judge (Entry Level) Main Exam 2011. Name & Complete Address of the applicant as per application form (IN BLOCK LETTERS) Branch Name & Code : . Transaction ID : . Date of Deposit : Category : . SC/ST/OBC (Only for CG domicile) Rs. 300/UNRESERVED/OH Rs. 500/-

STATE BANK OF INDIA

Name of work : Challan for payment of Examination fee for Civil Judge (Entry Level) Main Exam 2011. Name & Complete Address of the applicant as per application form (IN BLOCK LETTERS) Branch Name & Code : . Transaction ID : . Date of Deposit : Category : . SC/ST/OBC (Only for CG domicile) Rs. 300/UNRESERVED/OH Rs. 500/-

(Bank charge of Rs. 50/- is to be recovered from the candidate separately).

Amount paid Rs. ../- (Rupees ....) Amount paid by Cash deposited in

(Bank charge of Rs. 50/- is to be recovered from the candidate separately).

Amount paid Rs. ../- (Rupees ...) Amount paid by Cash deposited in

(Bank charge of Rs. 50/- is to be recovered from the candidate separately).

Amount paid Rs. ../- (Rupees ..) Amount paid by Cash deposited in

Power Jyoti A/c No. 31656296412 of Registrar Power Jyoti A/c No. 31656296412 of Registrar Power Jyoti A/c No. 31656296412 of Registrar
General, High Court of Chhattisgarh, Bilaspur(CG)
..
BANK STAMP & SIGNATURE [Link] Candidate BANK STAMP & SIGNATURE
Note : (1) Each candidate is to be given separate Transaction ID. (2) Fee receiving branch is requested to write the Name of Candidate, Transaction ID & Branch Code above invariably.

General, High Court of Chhattisgarh, Bilaspur(CG)

..
[Link] Candidate

General, High Court of Chhattisgarh, Bilaspur(CG)

..
BANK STAMP & SIGNATURE [Link] Candidate
Note : (1) Each candidate is to be given separate Transaction ID. (2) Fee receiving branch is requested to write the Name of Candidate, Transaction ID & Branch Code above invariably.

Note : (1) Each candidate is to be given separate Transaction ID. (2) Fee receiving branch is requested to write the Name of Candidate, Transaction ID & Branch Code above invariably.