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How to Complete Application Form

The document is an application confirmation for a candidate named Senma Kaushikbhai Shankarbai, who is applying for positions as a Process Server/Ballif and Court Attendant in Gujarat. It includes personal details, educational qualifications, contact information, and payment details for the application fee. The candidate has declared that all information provided is true and acknowledges the eligibility conditions for the program.

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0% found this document useful (0 votes)
4 views3 pages

How to Complete Application Form

The document is an application confirmation for a candidate named Senma Kaushikbhai Shankarbai, who is applying for positions as a Process Server/Ballif and Court Attendant in Gujarat. It includes personal details, educational qualifications, contact information, and payment details for the application fee. The candidate has declared that all information provided is true and acknowledges the eligibility conditions for the program.

Uploaded by

maheshsenma16
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

Application

240610113275
Number

Do Not Send this Page to National Testing Agency (NTA)


Candidate is requested to retain the printout of Confirmation page for future Reference.
Personal Details
Candidate`s Name SENMA KAUSHIKBHAI SHANKARBHAI Father's Name SHANKARBHAI
Mother's Name HANSABEN Date of Birth 15-09-1998
ARE YOU A
RESIDENT OF
Nationality INDIAN YES
GUJARAT STATE
(DOMICILE)
Gender MALE Marital Status SINGLE
Identity Type AADHAAR NUMBER
Name on Aadhaar Card SENMA KAUSHIKBHAI SHANKARBHAI Aadhaar Number XXXX XXXX 5080
Category SC
Category Certificate Cast Certificate Issuing
10 30-12-2014
Number Date
Caste Category
Certificate Applying GUJARAT
State
Are you a Pwd
NO
Candidate
Are You a Ex-Service
NO
Man?
Are You a Government
NO
Employee ?
Mother Tongue GUJARATI
[Link]. Language Read Write Speak
1 GUJARATI YES YES YES
2 ENGLISH YES YES YES
3 HINDI YES YES YES

Contact Details
Correspondence Address

Premises No./Name SENMA VAS Sub-Locality NA


Locality NANA RAMANDA Country INDIA
State GUJARAT District PATAN
Pincode 384265 Email SENMAKAUSHIK6@[Link]
Alternate Mobile
Mobile Number 9173638147 8980402751
Number

Permanent Address

Premises No./Name SENMA VAS Sub-Locality NA


Locality NANA RAMANDA Country INDIA
State GUJARAT District PATAN
Pincode 384265
Qualification Details
10TH OR EQUIVALENT
Qualifying Exam 10TH OR EQUIVALENT
Name of Board GUJARAT SECONDARY & HIGHER SECONDARY EDUCATION BOARD
SHETH C V VIDYALAYA AND SHRI I L
Month and Year of
March / 2016 Name of School PATEL HIGHER SECONDARY SCHOOL
Passing
BALISANA
Roll No. A4301210
Result Status PERCENTAGE
Total Marks 600.0 Marks Obtained 373
Percentage 62.16 %
12TH OR EQUIVALENT
Qualifying Exam 12TH OR EQUIVALENT
Name of Board GUJARAT SECONDARY & HIGHER SECONDARY EDUCATION BOARD
SHETH C V VIDYALAYA AND SHRI I L
Month and Year of
March / 2018 Name of School PATEL HIGHER SECONDARY SCHOOL
Passing
BALISANA
Roll No. G585639
Result Status PERCENTAGE
Total Marks 750.0 Marks Obtained 434
Percentage 57.86 %
GRADUATION
Qualifying Exam GRADUATION Course Name [Link]
Name of University HEMCHANDRACHARYA NORTH GUJARAT UNIVERSITY
Month and Year of
March / 2021 Name of Institute SMT T S R COMMERCE COLLAGE PATAN
Passing
Roll No. 50726
Result Status PERCENTAGE
Total Marks 800.0 Marks Obtained 490
Percentage 61.25 %
POST GRADUATION
Qualifying Exam POST GRADUATION Course Name [Link]
Name of University HEMCHANDRACHARYA NORTH GUJARAT UNIVERSITY
JETHIBA K PATEL ARTS COLLAGE AND B
Month and Year of
March / 2023 Name of Institute A PATEL AND B D VYAS COMMERCE
Passing
COLLAGE CHANASMA
Roll No. 01980
Result Status PERCENTAGE
Total Marks 500.0 Marks Obtained 279
Percentage 55.8 %
Experience Details
Do You Have Any Work Experience NO
Criminal Proceeding
Criminal Proceeding (If Any) :
If any FIR/Criminal Proceeding/Court Case
NO
Pending/Lodged/Convicted/ ?
Details NA
Post Applied
Post Name PROCESS SERVER/BALLIF Post Group DISTRICT COURT
Do You Have
Do You Have
Sufficient knowledge
knowledge of Driving YES YES
of Gujarati and/or
Cycle/ Two Wheeler ?
Hindi Language ?
Do You Have Basic
knowledge of YES Certifying Institute OM INSTITUTE PATAN
Computer ?
Certificate Issuing
07-07-2022 District Preference 1 PATAN
Date
District Preference 2 MAHESANA District Preference 3 AHMEDABAD
Post Name COURT ATTENDANT Post Group HIGH COURT
Document Upload
1 PHOTO

2 SIGNATURE

Payment Details
Invoice Code HCG_240610113275_17183011035061 Exam Fee 1250
Payment Submit Date 13-06-2024 11:21 PM Payment Success Date 13-06-2024 11:23 PM
Gateway Name ICICI Payment Status SUCCESS
Declaration
I declare that information furnished by me in the application form is true in all respect and nothing is concealed. In case any entry or information
is found to be false, this shall entail automatic cancellation of my admission besides rendering me liable to such actions as deemed fit by the
University. I hereby undertake that I have carefully gone through the eligibility conditions prescribed in the prospectus for the programme. I am
applying after satisfying that I meet the eligibility conditions. If at any stage it is found that I do not fullfill the minimum prescribed criteria, my
admission, if granted, shall stand cancelled and I shall have no right to admission whatsoever.
Ip Address [Link] Domain Name [Link]
Date 13-06-2024 23:23:21 PM

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