उत्तर प्रदेश सरकार GOVERNMENT OF UTTAR PRADESH
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Subordinate Services Selection Commission
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Application Photo & Signature Other Details
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Uttar Pradesh Subordinate Services Selection Commission,Lucknow
उत्तर प्रदेश अधीनस्थ सेवा चयन आयोग, लखनऊ
Detailed Application Form ( विस्तृत आवेदन पत्र )
Under: PRELIMINARY ELIGIBILITY TEST (PET) 2023
Notification Details :
Advertisement Number :
02-Exam/2024
Applied For :
Assistant Store Keeper/Assistant Grade-III,
Personal Details
Registration Number.
55700186053
Advertisement / Notification No
02-Exam/2024
Candidate's Name
ROHIT SINGH
Father's / Husband's Name
RAJIV SINGH
Mother's Name
SANGEETA SINGH
Date of Birth
01/02/2000
Domicile of Uttar Pradesh
Yes
Home State
UTTAR PRADESH
Home District
SHAHJAHANPUR
Gender
Male
Category
General
Economically Weaker Sections (EWS)
No
Are you Married ?
No
Mobile Number
91* * * *2229
Email ID
* * *kurrohit715090@[Link]
Other Details
Are you a Dependent of UP Freedom Fighter?
No
Are you a U.P. Ex. Army?
No
Are you an ECO/SSCO/CO Of Army ?
No
Are you Handicapped of Uttar Pradesh?
No
Are you Blind Or Have Vision problem?
No
Are you Deaf or Have hearing problem?
No
Have you any physical Problem?
No
Have you psychological/ neurological problem? :
No
Have you Multiple Disabilities? :
No
Are you a Skilled Player of Uttar Pradesh?
No
Level of Player
N/A
Employment Details
Never Employment in Uttar Pradesh
Additional age relaxation other than above reasons(Caste category,Sub category,Service duration
etc.)
Are you claiming any additional age relaxation ?
No
Academic Details
Examination Board Name Year of Roll Is Obtained Total Percentage
Passed Passing Number Grade Marks Marks
System
High School CENTRAL BOARD OF 2015 5057624 Yes N/A N/A 70.3
SECONDARY
EDUCATION
Intermediate UTTAR PRADESH 2022 2225671444 No 338 500 67.6
BOARD OF HIGH
SCHOOL AND
INTERMEDIATE
EDUCATION
Bank Transaction Details
Bank Name - Payment Mode :
State Bank Of India - INB
Fees, Transaction ID - Date:
Rs. 25.00 , CPADNUAAD5 -20/02/2024
Details of essential qualifications for the post (Assistant Store Keeper/Assistant Grade-III, ) ↓
Sr Qualification Acquired Name of Board/ Year Of Certificate/Roll Marks
No. Institute/University Passing Number Detail
Issue Date
1 Must have Yes 2022 2225671444 Is Grade:
passed UP BOARD No
Intermediate 18/06/2022 Obt Marks:
Examination 338.00
of the Board Tot Marks:
of High School 500.00
and Per: 67.60
Intermediate
Education U.P.
or an
Examination
recognized by
recognized by
the
Government
as equivalent
thereto.
2 Must possess Yes N/A N/A N/A Is Grade:
a minimum N/A
speed of 25 N/A Obt Marks:
words per N/A
minute in Tot Marks:
Hindi N/A
Typewriting Per: N/A
and 30 words
per minute in
English
Typewriting.
Preferential Qualification Details
S No. Qualification Acquired
1 Served in the Territorial Army for a minimum period of two years or No
2 Has obtained National Cadet Corps B certificate No
↓ Address Details ↓
Name , C/O:
House no./Village :
Street No./PO :
Locality/Kasba/City :
State / District Name :
Pin :
Permanent Address
rohit singh
viilage thingri
post thingri
jalalabad
UTTAR PRADESH / SHAHJAHANPUR
242221
Correspondence/Mailing Address
rohit singh
viilage thingri
post thingri
j l l b d
jalalabad
UTTAR PRADESH / SHAHJAHANPUR
242221
Declaration
✔ मैं एतद्द्वारा घोषणा करता/करती हूं कि मैंने विज्ञापन भलीभांति पढ़ लिया है और मैं इसके सभी
नियम और शर्तों को स्वीकार करता/करती हूं ।
I hereby declare that I have read the advertisement and I accept all the terms &
conditions of the same.
✔ मैं एतद्द्वारा घोषणा करता/करती हूं कि इस आवेदन में की गई सभी प्रविष्टियां/विवरण मेरी जानकारी
और विश्वास के अनुसार सत्य, पूर्ण और सही हैं।
I hereby declare that all the entries/statements made in this application are true,
complete and correct to the best of my knowledge and belief.
✔ मैं एतद्द्वारा घोषणा करता/करती हूं कि आवेदन की अंतिम तिथि तक मुख्य परीक्षा के लिए निर्धारित
सभी शैक्षणिक/अन्य पात्रता मानदंडों को पूरा करता/करती हूं । मै अवगत हूं कि मेरे द्वारा प्रस्तुत की गई
कोई भी जानकारी गलत/असत्य पाये जाने की दशा में मेरा अभ्यर्थन आयोग द्वारा निरस्त कर दिया
जाएगा ।
I hereby declare that I fulfil all the educational/ other eligibility criteria prescribed for
the Main Examination in respect of the post being applied for, as on the last date of
application. I am aware that in case any of the information submitted by me is found to
be incorrect or false, then my candidature shall be liable to be cancelled by the
Commission.
Please login with your PET registration number to avail the Dashboard facility for all
activities of recruitment process.
Current status of application
Your application is under processing.
App. form submission date : DATE :20/02/2024 ,TIME :19:17:27
App. form printing Date & Time : [ 20/02/2024 ,7:18:55 PM ]
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