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UNION PUBLIC SERVICE COMMISSION

DETAILED APPLICATION FORM [DAF]-I
CIVIL SERVICES (MAIN) EXAMINATION, 2020

RID. : 12016958472
Roll No. : 6409713
Name : MD MANZAR HUSSAIN ANJUM
Email : [Link]@[Link]
Mobile : 9670743467

1. (a) Date of Birth | 15-09-91

(b) Age Relaxation claimed | NO

2. (a) Address for correspondence to which | ROOM NO 27, HAMDARD STUDY CIRCLE
Communication is to be sent | GALI NO 16
Post Office: | SANGAM VIHAR
City: | NEW DELHI
District: | SOUTH DELHI
State : | DELHI
Pin Code : | 110062
(b) Telephone No. (with STD Code) | -
(c) Mobile No. | 9670743467
(d) Fax No. |
(e) E-mail address | [Link]@[Link]
(f) Permanent Postal Address | C15, VILLAGE CHHOWSIA
|
Post Office: | ISLAMPUR
City: | ISLAMPUR
District: | UTTAR DINAJPUR (NORTH DINAJPUR)
State : | WEST BENGAL
Pin Code : | 733202

3. Gender : | MALE

4. Marital Status : | UNMARRIED

(If Married, Nationality of spouse) |
5. (a) Citizenship : | A CITIZEN OF INDIA.(1)
(b) Nationality : | INDIAN

6. Mother tongue : | HINDI

7. Place of Birth :
If born in India: | YES
Post Office | ISLAMPUR
City/Town/Village | ISLAMPUR

Roll No. :- 6409713 |

 Page No. 2/9
District | UTTAR DINAJPUR (NORTH DINAJPUR)
State | WEST BENGAL
Pincode | 733202

8. (a) Community | OBC (3)

Note 1: Candidate belonging to OBC but coming in the 'Creamy Layer' and thus not being entitled to OBC
reservation should indicate their community as 'Unreserved (others) Code No. 4'.
Note 2: Candidates belonging to neither SC,ST,OBC communities nor EWS should opt 'Unreserved (others)
Code No. 4' against the column of community and not leave it blank.
Note 3: No change in the community status already indicated by candidate in his / her application form for
this examination will be allowed by the Commission except in the circumstances mentioned in the
Rule 23 of CSE Rules, 2020.
Note 4: In case you are a 'SC, ST, OBC(Non Creamy Layer) or EWS' candidate, upload a scanned copy of
certificate in support of your claim. For, SC/ST/OBC(Non Creamy Layer)/EWS candidates, it should be
issued prior to the date of closure of online application form for Civil Services (Preliminary)
Examination,2020 (i.e. prior to 03.03.2020).
Note 5: 'Income and Asset Certificate' of Financial Year 2018-19 (i.e. for the period from 1st April, 2018
to 31st March, 2019) must only be submitted as per the prescribed format by the candidates
seeking reservation under EWS Category. Certificate of any other Financial Year shall not be
treated as valid.
(b) Certificate No. | WB0401OBC201705337
(c) Date of issue | 07-08-2017
(d) Designation of issuing authority | SUB-DIVISIONAL OFFICER
(e) Full address of issuing authority | SDO, ISLAMPUR, UTTAR DINAJPUR, WEST
BENGAL 733202

(f) Name of the Caste as mentioned in | NASHYA SEKH (55)

the Community Certificate and | WEST BENGAL
Name of the issuing State
[For SC/ST/OBC Candidates] /
Financial Year of Income for EWS
Candidates.
(g) State Creamy or Non Creamy Layer | Non Creamy Layer
(h) If you belong to any of the minority
Communities notified by the Government
(Muslim/Christians/Sikhs/Budhists/
Zoroastrians[Parsi]/Jains) | YES
(i) If yes, Name of the Minority
community | MUSLIM

9.1.(a) Whether you are a candidate with | NO

Benchmark Disability (upload a
scanned Certificate of disability)
If yes, disability certificate form |
(b) Category |

(c) Percentage of disability as indicated in |

the Certificate of Disability
(d) Certificate No. |
(e) Date of Issue |
(f) Designation of issuing authority |

Roll No. :- 6409713 |

 Page No. 3/9
(g) Full address of issuing authority |
(h) Would you require scribe in the |
Examination
Note 1: The Persons with Benchmark Disabilities in the categories of blindness, locomotor disability (both arm
affected – BA) and cerebral palsy will be provided the facility of scribe, if desired by the person. In case
of other category of Persons with Benchmark Disabilities as defined under section 2(r) of the RPWD
Act, 2016, the facility of scribe will be allowed to such candidates on production of a certificate to the
effect that the person concerned has physical limitation to write, and scribe is essential to write examination
on his/her behalf, from the Chief Medical Officer/ Civil Surgeon/Medical Superintendent of a Government
Health Care institution as per proforma at Appendix – IV of the Notice of CSE, 2020 dated 12th
February, 2020.
Note 2: The candidates have discretion of opting for his/her own scribe or request the Commission for the same.
Note 3: The qualification of the Commission’s scribe as well as own scribe will not be more than the minimum
qualification criteria of the examination. However, the qualification of the scribe should always be
matriculate or above.
Note 4: The Persons with Benchmark Disabilities in the category of blindness, locomotor disability (both arm
affected – BA) and cerebral palsy will be allowed Compensatory Time of twenty minutes per hour
of the examination. In case of other categories of Persons with Benchmark Disabilities, this facility will
be provided on production of a certificate to the effect that the person concerned has physical limitation
to write from the Chief Medical Officer/ Civil Surgeon/ Medical Superintendent of a Government
Health Care institution as per proforma at Appendix – IV of the Notice of CSE, 2020 dated 12th
February, 2020.
(h)(a) If yes, "Commission's Scribe" or "Own |
Scribe"
(i) Would you require any assistive |
device(s)
(j) Would you require question paper in |
larger font size?

Note: Larger font is only for PwBD Candidates suffering from Blindness/ Low Vision.
9. 2. (a) Have you ever been recommended as a | NO
PwBD candidate in the examinations
conducted by the UPSC in the past?

(b). If yes, mention name and year of the examination(s) with Roll No.
Name of the Examination Year of the Roll No.
Examination

(c) Whether such recommendation was on | NO

the basis of the Certificate of Disability
NOW UPLOADED by you for the
CS(M) Exam, 2020?
(d) After any such recommendation by the | NO
UPSC were you ever found UNFIT/
NOT RECOMMENDED by the Central
Standing Medical Board or any other
Medical Board constituted by the
Government with regard to your
physical disability?
(e) If yes, provide details thereof |

10. Choice of Centre for Examination | DELHI

Roll No. :- 6409713 |

 Page No. 4/9
11. (a) Do you hail from Arunachal Pradesh/
Manipur/Meghalaya/Mizoram/Nagaland/
Sikkim and are claiming exemption
from appearing in INDIAN LANGUAGE
FOR PAPER A? | NO
(ii)Indian Language for Paper A | HINDI
(b) Optional Subject for paper VI & VII | GEOGRAPHY

12. (a)Language Medium for Examination

for Paper I to Paper V
(Essay and General Studies) | ENGLISH

(b) Language Medium for Examination

for Paper VI to Paper VII (Optional
Subject as at (b) of Col. 11 above) | ENGLISH

(c) In case of Sindhi and Santhali

type of script should be indicated
by the candidate |

(d)Language Medium for Interview

Test(i.e. para 27 of the Instructions)
to the Candidates) | ENGLISH

13. (a) Name of Father | LATE. MD MASLEHUDDIN

(b) Name of Mother | NIGAR SULTANA
(c) Nationality of Father | INDIAN
(d) Nationality of Mother | INDIAN
(e) Father's Profession: | DECEASED
(f) Mother's Profession: | HOUSEWIFE
(g) If your father is in service, the post held by him
(g)(i) if retired, indicate the post held
by him at the time of his retirement | NA
(h) If your Mother is in service,the post held by her
(h)(i) if retired, indicate the post held
by her at the time of her retirement | NA
(i) Annual income of your Father | RS.0
(j) Annual income of your Mother | RS.180000
(k) State to which your Father originally | WEST BENGAL
belongs
(l) District to which your Father originally | UTTAR DINAJPUR (NORTH DINAJPUR)
belongs
(m) State to which your Mother originally | BIHAR
belongs
(n) District to which your Mother originally| KISHANGANJ
belongs
(o) Father's present postal Address | C15, VILLAGE CHHOWSIA
(If deceased give last address) |
Post Office: | ISLAMPUR
City: | ISLAMPUR
District: | UTTAR DINAJPUR (NORTH DINAJPUR)

Roll No. :- 6409713 |

 Page No. 5/9
State : | WEST BENGAL
Pin Code : | 733202
(p) Mother's present postal Address | C15, VILLAGE CHHOWSIA
(If deceased give last address) |
Post Office: | ISLAMPUR
City: | ISLAMPUR
District: | UTTAR DINAJPUR (NORTH DINAJPUR)
State : | WEST BENGAL
Pin Code : | 733202

(q) Whether your family owns or possesses

any of the following assets.
i. 5 acres of agricultural land and above;
ii. Residential flat of 1000 sq ft. and above;
iii. Residential plot of 100 sq. yards and
above in notified municipalities;
iv. Residential, plot of 200 sq. yards and
above in areas other than the notified
municipalities. | YES

14.1(a) Do you possess the prescribed Educational

Qualification (Vide rule-7 of the rules of the Examination)?
Please upload a scanned copy of the Certificate
if the answer is "YES" | YES
(b) Certificate No. | BM-16099
(c) Date of issue | 26-06-2016
(d) Designation of issuing authority | REGISTRAR IIT KANPUR
(e) Full address of issuing authority | REGISTRAR, IIT KANPUR,
KANPUR, UP- 208016

Note : If you do not possess the prescribed educational qualification as mentioned in rule-7 of the
examination your candidature is liable to be cancelled. The proof of passing the requisite examination
should be dated earlier than the due date (closing date) of Detailed Application Form-I of the Civil
Services (Main) Examination.

(f)(i) Do you have any basic Educational

Qualification or higher qualification
obtained from a foreign institution? | NO

14.2 Educational Qualifications : Commencing with Matriculation or equivalent examination till Graduation:-
(Please upload scanned copy of all Certificates/Degree)
Examination Class/ Percentage CGPA Year of Subject(s) Name of Name of
Passed Division of Score Out of School/College Board/University
/Grade Marks(%) Passing /Institution
10th or Equivalent I 93 2008 English, social The Scholar COUNCIL FOR
studies, science, THE INDIAN
hindi, environment SCHOOL
education, CERTIFICATE
mathematics, EXAMINATIONS
computer application

Roll No. :- 6409713 |

 Page No. 6/9
12th or Equivalent I 92 2010 English, Physics, Saiyyed Hamid Senior ALIGARH
Chemistry, Secondary School MUSLIM
Mathematics Boys AMU UNIVERSITY
Stream at Graduation Level :-- ENGINEERING
B. TECH. NA 6.5 10 2016 CIVIL INDIAN INSTITUTE INDIAN
ENGINEERING OF TECHNOLOGY INSTITUTE OF
KANPUR TECHNOLOGY
KANPUR, U.P.

15.(i) Have you ever been employed? : | YES

If yes, Are you in

Government/Public Enterprise | NO

If yes, Date of intimation in writing

to your Head of Office/Department
regardingappearing in Civil Services
Examination 2020 |

Note: The candidates employed in Government/Public Sector Enterprise/Government Autonomous Bodies

must ensure that they have intimated their parent Department before applying for this Examination with
proof of receipt by the Department. If it found, that the candidates have not done the same, their
candidature is liable to be rejected forthwith without any further notice.

Details of your employments (in chronological order till date)

Designation/Posi Monthly Whether Perman Period Name of Place of Employment
tion remuneration ent/Temporary/ From To employer/ (Address)
(Total) in Rs. Ad hoc etc. Organisation/
Firm/Individual
PROGRAMMER 62500 TEMPORARY 25-07-2016 30-10-2016 QUANTUM POWAI, MUMBAI, 400076
ANALYST PHINANCE
CONSULTING
PRIVATE
LIMITED

15.(ii) Have you been self-employed?: | NO

16. Have you ever been debarred by

the UPSC from any of its
Examinations/Selections? | NO

17. Whether you have ever applied for

U.P.S.C. Examination /Recruitment:- | YES
Details of other application for Examination/Recruitment held/to be held by UPSC :-
Name of Examination/Post Month and Roll. No. Whether you Whether you Whether you Whether continuing till
year of appeared at appeared at were recomm date or resigned(with date)
Examination the the Interview ended for
/Advt./Item Examination appointment

Roll No. :- 6409713 |

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No. for
Recruitment
INDIAN FOREST SERVICE (MAIN) DECEMBE 0857467 YES YES NO NA
R 2019
CIVIL SERVICES (PRE) 2018 0 YES NO NO NA
INDIAN FOREST SERVICE (PRE.) JUNE 2019 0857467 YES YES NO NA
CIVIL SERVICES (PRE) JUNE 2019 0857467 YES YES NO NA
CIVIL SERVICES (MAIN) SEPTEMBE 0857467 YES YES NO NA
R 2019
INDIAN FOREST SERVICE (PRE.) 2018 0 YES NO NO NA
CIVIL SERVICES (PRE) 2017 0 YES NO NO NA

18(a). How many times have you appeared

at the Civil Services(Pre) Examination
so far, including the current
Examination held in October, 2020 | 4

18(b). Details of Examination in which you have appeared including CS(P), 2020
Year 2017 2018 2019 2020
Roll No. 0 0 0857467 6409713

19. Have you ever accepted allocation

to a Service/Post on the basis
of Civil Services Examination
held in earlier years? | NO
(a). Year of the Civil Services
Examination on the basis of which
you had been last allocated to
service/post |
(b). Name of service/post to which
allocated |
(c). Your Roll No. for the examination |
(d). Whether you were appointed/joined
Service? |

(e). Whether you are continuing in that

Service/Post? |

(f). If you have resigned from such post/service

Mention date of acceptance of the resignation
by the Competent authority |

20. Fee Payment Details (Subject to Verification) :-

Application No. | 12096409713
Transaction-Id | IK0AUJKAU9
Paid (in Rs.) | 200
Agency Name | State Bank of India
Mode of Payment | By Internet Banking

Details of Fee paid:Candidates applying (excepting Female/SC/ST/PwBD candidates who are exempted from payment
of fee) for Civil Services (Main) Examination are required to pay a fee of Rs.200/- (Rupees Two

Roll No. :- 6409713 |

 Page No. 8/9
Hundred only) either by depositing the money in any Branch of SBI by cash, or by using Net Banking
facility of SBI or by using Visa/Master/Rupay Credit/Debit card.

21. Photo-ID Proof | AADHAR CARD (XXXXXXXX1735)

22. List of Scanned documents uploaded by the candidate:-

--> Scanned Copy of proof of date of birth as prescribed in Para below Note IV under Rule 6 of the rules
for the exam. [Col. 1(a) of this form]
--> Scanned Copy of Certificate in support of claim to belong to SC / ST / OBC (Non Creamy Layer)/EWS
, (UNDERTAKING FOR OBC CANDIDATES) AND UNDERTAKING FOR EWS CANDIDATES[Col.
8(a) of this form]
--> Scanned Copy of the certificate of graduation or equivalence educational qualifications (including a
copy of recognition letter / equivalence certificate from AIC/UGC, if applicable)[Col. 14 of this form]
--> Copy of the selected Photo ID Proof (viz. Aadhaar Card, Voter Card, PAN Card, Passport, Driving
Licence or any other Photo ID Proof issued by the Central/State Government.)

Roll No. :- 6409713 |

 Page No. 9/9
DECLARATION BY THE CANDIDATE

I, hereby declare that all statements and entries made in all the columns of this application are true,
complete and correct to the best of my knowledge and belief.

2. That I have read Rule 14 of the Rules of the Civil Services Examination, 2020 published in Part I –
Section 1 of the Gazette of India Extraordinary dated 12th February, 2020 and understand that in the
event of any information being found false or incorrect or ineligibility being detected before or
after the examination, or flouting of any instructions given by the Commission alongwith e-Admit
card/ Question – cum – Answer Booklets/ e-Summon letter [Link] can be taken against me by
the Commission.

3. That I further declare that I fulfil all the eligibility conditions regarding age limits, educational
qualifications etc. prescribed for admission to the Examination. I have not exhausted the number of
attempts admissible to me under the Rule 4 of the Rules of the Examination, 2020.

4. That I have not withheld any information required as per this Detailed Application Form- I.

5. I have thoroughly scrutinised the list of scanned documents as enumerated in Column 21 and 22
of the DAF-I and uploaded scanned copies of all the documents relevant for me.

6. That I have read the Rules of Examination and the instructions carefully and I hereby undertake to abide
by them.

7. That I have informed my Head of the Office/Department in writing that I have applied for this
examination as required in Col. 15 (i) of the DAF-I.

Signature of the Candidate

[Note: Online submission of the DAF-I by the candidate within prescribed time period is
construed as his/her signed applicaion]

Roll No. :- 6409713 |

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 Page No. 1/14

UNION PUBLIC SERVICE COMMISSION

DETAILED APPLICATION FORM - II
CIVIL SERVICES EXAMINATION, 2020
[To be filled by candidates qualified for Personality Test(Interviews)]

RID. : 12016958472
Roll No. : 6409713
Name : MD MANZAR HUSSAIN ANJUM
Email : [Link]@[Link]
Mobile : 9670743467

1. Mother tongue : | HINDI

2. Place of Birth :
If born in India: | YES
Post Office | ISLAMPUR
City/Town/Village | ISLAMPUR
District | UTTAR DINAJPUR (NORTH DINAJPUR)
State | WEST BENGAL
Pincode | 733202

3. (a) Name of Father | LATE. MD MASLEHUDDIN

(b) Name of Mother | NIGAR SULTANA
(c) Nationality of Father | INDIAN
(d) Nationality of Mother | INDIAN
(e) Father's Profession: | DECEASED
(f) Mother's Profession: | HOUSEWIFE
(g) If your Father is in service,the post held
by him (if retired, indicate the post held
by him at the time of his retirement) | NA
(h) If your Mother is in service,the post held
by her (if retired, indicate the post held
by her at the time of her retirement) | NA
(i) Annual income of your Father | RS.0
(j) Annual income of your Mother | RS.180000
(k) State to which your Father originally | WEST BENGAL
belongs
(l) District to which your Father originally | UTTAR DINAJPUR (NORTH DINAJPUR)
belongs
(m) State to which your Mother originally | BIHAR
belongs
(n) District to which your Mother originally| KISHANGANJ
belongs
(o) Father's present postal Address | C15, VILLAGE CHHOWSIA

Roll No. :- 6409713 |

 Page No. 2/14
(If deceased give last address) |
Post Office: | ISLAMPUR
City: | ISLAMPUR
District: | UTTAR DINAJPUR (NORTH DINAJPUR)
State : | WEST BENGAL
Pin Code : | 733202
(p) Mother's present postal Address | C15, VILLAGE CHHOWSIA
(If deceased give last address) |
Post Office: | ISLAMPUR
City: | ISLAMPUR
District: | UTTAR DINAJPUR (NORTH DINAJPUR)
State : | WEST BENGAL
Pin Code : | 733202

(q) Whether your family owns or possesses

any of the following assets.
i. 5 acres of agricultural land and above;
ii. Residential flat of 1000 sq ft. and above;
iii. Residential plot of 100 sq. yards and
above in notified municipalities;
iv. Residential, plot of 200 sq. yards and
above in areas other than the notified
municipalities. | YES

4. Educational Qualifications : Commencing with Matriculation or equivalent examination till Graduation:-

Examination Class/ Percentage CGPA Year of Subject(s) Name of Name of

Passed Division of Score Out of School/College Board/University
/Grade Marks(%) Passing /Institution
10th or Equivalent I 93 2008 English, social The Scholar COUNCIL FOR
studies, science, THE INDIAN
hindi, environment SCHOOL
education, CERTIFICATE
mathematics, EXAMINATIONS
computer application
12th or Equivalent I 92 2010 English, Physics, Saiyyed Hamid Senior ALIGARH
Chemistry, Secondary School MUSLIM
Mathematics Boys AMU UNIVERSITY
Stream at Graduation Level :-- ENGINEERING
B. TECH. NA 6.5 10 2016 CIVIL INDIAN INSTITUTE INDIAN
ENGINEERING OF TECHNOLOGY INSTITUTE OF
KANPUR TECHNOLOGY
KANPUR, U.P.

5. Higher Educational Qualifications : Commencing with Post Graduation or equivalent examination :-

Examination Class/ Year of Date of Likely date CGPA Percentag Subject(s) College/Institution Board/
Passed/ Division Passing Joining of Score Out of e University
Appeared/ /Grade Completion of
Appearing Marks(%)
[Link]. NA 2016 25-07-2011 28-06-2016 7.4 10 CIVIL INDIAN INSTITUTE INDIAN
ENGINEERING OF TECHNOLOGY INSTITUTE OF
KANPUR TECHNOLOGY

Roll No. :- 6409713 |

 Page No. 3/14
KANPUR, U.P.

6. Having regard to answers given against

columns 1, 2, 3, 4 & 5 which is the State
/Union Territory that you would claim
as your home State/U.T. | WEST BENGAL

7. Please give Particulars at the University/State/National Level in respect of:-

(a)Prizes, Medals, Scholarships etc. | BOARD TOPPER IN SENIOR SECONDARY,

ALIGARH MUSLIM UNIVERSITY BOARD
(b) Sports/N.C.C. etc. | MEMBER OF IIT KANPUR FOOTBALL TEAM
(c) Position(s) of distinction Leadership held in | MESS SECRETARY OF HALL IX, IIT KANPUR
School/College
(d) Other extracurricular activities and interests (Such | PLAYING FOOTBALL, WATCHING ANIME
as hobbies etc.)

Roll No. :- 6409713 |

 Page No. 4/14
8. (A)Indicate below your order of preference for Zone and State Cadre within zones for which you would like to be considered for allotment in case you are selected for Indian
Administrative Service.

Note 1 : For allocation to Home cadre against an Insider vacancy, a candidate is mandatorily required to click 'Yes' otherwise he/she shall not be considered for his/her
Home cadre at all in case he/she opted 'No'.
Note 2 : Candidates are advised to visit the website of Department of Personnel & Training at the link [Link] for perusing the Cadre
Allocation Policy-2017. They are also advised to go through the details of the Cadre Allocation Policy 2017 extremely carefully before submitting their preferences for
Zones as well as Cadres thereunder. The preferences once opted and submitted cannot be modified or changed at a later stage. Therefore, the candidates are advised to
exercise due diligence while filling up the preferences for Zones as well as Cadres thereunder.
Note 3 : A candidate claiming benefit of reservation under Persons with Benchmark Disabilities quota has an additonal option to indicate his/her preference for any one
state/cadre(other than Home cadre) of his/her first preferred Zone as per the para 5 of Cadre Allocation Policy issued vide OM no. 13013/2/2016-AIS.I dated 5.9.2017.

Whether you want to consider your Home State West Bengal as your first preference as Home Cadre? - YES

Zones(with State Order of preference Order of Preference for State Cadre within Zone
Cadres) for Zones
Zone I 4 AGMUT Haryana Himachal Pradesh Punjab Rajasthan Uttarakhand
3 2 6 4 1 5
Zone II 2 Bihar Jharkhand Odisha Uttar Pradesh
2 3 4 1
Zone III 3 Chhattisgarh Gujarat Madhya Pradesh Maharastra
4 3 1 2
Zone IV 1 Assam-Meghalaya Manipur Nagaland Sikkim Tripura West Bengal
2 4 6 3 5 1
Zone V 5 Andhra Pradesh Karnataka Kerala Tamil Nadu Telangana
2 3 5 4 1

Roll No. :- 6409713 |

 Page No. 5/14
8. (B)Indicate below your order of preference for Zone and State Cadre within zones for which you would like to be considered for allotment in case you are selected for Indian
Police Service.

Note 1 : For allocation to Home cadre against an Insider vacancy, a candidate is mandatorily required to click 'Yes' otherwise he/she shall not be considered for his/her
Home cadre at all in case he/she opted 'No'.

Whether you want to consider your Home State West Bengal as your first preference as Home Cadre? YES

Zones(with State Order of preference Order of Preference for State Cadre within Zone
Cadres) for Zones
Zone I 4 AGMUT Haryana Himachal Pradesh Punjab Rajasthan Uttarakhand
3 2 6 4 1 5
Zone II 2 Bihar Jharkhand Odisha Uttar Pradesh
2 3 4 1
Zone III 3 Chhattisgarh Gujarat Madhya Pradesh Maharastra
4 3 2 1
Zone IV 1 Assam-Meghalaya Manipur Nagaland Sikkim Tripura West Bengal
2 4 6 3 5 1
Zone V 5 Andhra Pradesh Karnataka Kerala Tamil Nadu Telangana
2 3 5 4 1

Roll No. :- 6409713 |

 Page No. 6/14

9. Your order of preference against the Services/Posts given below , for which you would like to be
considered for appointment.
Note 1 : It is clarified that the below order of services does not reflect their relative importance in the eyes of the
Government and the candidates are advised to use their own discretion while indicating preferences for various
services.
Note 2: A candidate shall be required to mandatorily indicate order of preferences only for those services
participating in the Civil Services Examination for the year, for which he is interested to be
allocated to, in the application form for main examination.
Note 3: The services which are not required to be opted have been shown as 'NOT OPTED.'
Note 4: A candidate who is appointed to the Indian Police Service on the basis of the results of an earlier
examination and continues to be a member of that service shall not be eligible to opt for the
Indian Police Service in Civil Services Examination, 2020.

S.N. Name of Services/Post Order of Preference

1. Indian Administrative Service 01
2. Indian Foreign Service 03
3. Indian Police Service 02
4. Indian P&T Accounts & Finance Service, Group "A" 16
5. Indian Audit & Accounts Service, Group "A" 04
6. Indian Revenue Service (Customs and Central Excise),Group "A" 06
7. Indian Defence Accounts Service ,Group "A" 09
8. Indian Revenue Service, (I.T.),Group "A" 05
9. Indian Ordance Factories Service,Group "A" (Asstt. Works Manager- 21
Administration)
10. Indian Postal Service,Group "A" 12
11. Indian Civil Accounts Service ,Group "A" 08
12. Post of Asstt. Security Commissioner ,Group "A" in Railway Protection Force 17
13. Indian Defence Estates Service, Group "A" 07
14. Indian Information Service, (Junior Grade) Group "A" 15
15. Indian Trade Service,Group "A" (Grade III) 14
16. Indian Corporate Law Service ,Group "A" 13
17. Armed Forces Headquarters Civil Service ,Group 'B'(Section Officers' Grade) 18
18. Delhi ,Andaman and Nicobar Island,Lakshadweep,Daman & Diu and Dadra & 10
Nagar Haveli Civil Service,Group "B"
19. Delhi ,Andaman and Nicobar Island,Lakshadweep,Daman & Diu and Dadra & 11
Nagar Haveli Police Service,Group "B"
20. Pondicherry Civil Service, Group "B" 19
21. Pondicherry Police Service, Group "B" 20

10. List of Scanned documents uploaded by the candidate:

--> Documents/Certificates in support of Higher Educational Qualification (Post Graduation)/Achievements
in differents Fields/Service Experience, etc.
--> Any Other Document.

Roll No. :- 6409713 |

 Page No. 7/14
DETAILED APPLICATION FORM - II

DECLARATION

1. I have carefully read all the provisions under the Civil Services Examination Rules, 2020 and the guidelines for
filling up this Detailed Application Form-II and understand the same.

2. I, hereby declare that all the entries made in all the columns of this Detailed Application Form-II are my
conscious decision and I shall not request subsequently for any change in the order of preferences for the services
and the preferences for Zones/Cadres submitted by me in this Application Form.

Signature of the Candidate

Place : Name : MD MANZAR HUSSAIN

ANJUM
Date : Roll No. : 6409713
 Page No. 8/14

OBC ANNEXURE

1. Name of the Candidate | MD MANZAR HUSSAIN ANJUM

2. Roll No | 6409713

3. (a) Name of Father | MD MASLEHUDDIN

(b) Date of birth of Father | 15-07-1963
(c) Whether your Father is having Permanent Account | NO
Number(PAN)
(c) PAN No. of Father |

4. (a) Name of Mother | NIGAR SULTANA

(b) Date of birth of Mother | 05-02-1973
(c) Whether your Mother is having Permanent Account | YES
Number(PAN)
(c) PAN No. of Mother | EJCPS8228B

5.(a)(i) Profession of father | DECEASED

(ii) Whether your Father is/was in service. | NO

(b)(i) If in service whether he is/was working under |

Central Government/State
Government/Central Public Sector
Undertaking/ State Government Public Sector
Undertaking/ Autonomous Body/ Bank/
Insurance Organisation/ Universities/ Private
Organisation/Govt-Aided School/ Others

(ii) Please write full name and address of the |

concerned organization. In case of
PSU/Autonomous Body/Bank/Universities/
Insurance organizations and please provide
name and address of the Controlling
Department / Ministry/Government also.

(iii) Name of the post to which he was appointed |

by direct recruitment

(iv) Group of the post (viz. group A, B, C or D) to |

which he was appointed by direct recruitment
and the year of recruitment

Roll No. :- 6409713 |

 Page No. 9/14
(v) If post of the organization is not classified as | NO ()
Group A, B, C or D, whether the post to which
the father was appointed by direct recruitment
is comparable or equivalent to any Group A,
B, C or D post in Government as per DOPT
OM No. 36012/22/93-Estt.(SCT), dated
8.9.1993. If yes, to which it is comparable and
please upload the relevant Government
order/notification establishing such
equivalence / comparability of post if available

(vi) Complete employment details of all the posts

held by Father (From first employment till
present employment) :-

Name of the post and group of the post & Pay Scale of the post Date of Appoint Age at the Method of Recruitment
equivalence of post ment/promotion time of appoin /appointment[whether
to the post tment/promoti by Direct Recruitment/
on Promotion/Contract/oth
ers]
NA NA NA NA NA

(vii) If the father has retired/resigned or terminated |

from service, the details of present status from
the time of retirement/resignation/termination.
If reemployed, mode of re-employment.

(viii) Whether the father has/had been in | NO ()

employment in any International Organisation
like U.N., IMF, World Bank etc. If yes,
duration of such employment

(ix) If father is dead, date of his demise |

(x) If father suffers from permanent incapacitation | NO

while in service.

(xi) If father suffers from permanent incapacitation |

while in service, date from which he so suffers

6. (a) Whether father of the candidate holds or has ever held | NO

a Constitutional post
(b) If yes, name of the post (s) and duration of holding |
such post(s)

7. (a) If father is/was in the rank of Colonel and above | NO

in the army and to the equivalent posts in the
Navy and the Air Force and the Para Military
Forces.
If yes, upload the relevant appointment order.

8.(a)(i) Profession of mother | SHOP RENT

Roll No. :- 6409713 |

 Page No. 10/14

(ii) Whether your Mother is/was in service. | NO

(b)(i) If in service whether she is/was working under |

Central Government/State
Government/Central Public Sector
Undertaking/ State Government Public Sector
Undertaking/ Autonomous
Body/Bank/Insurance
Organisation/Universities/ Private
Organisation/Govt-Aided School/Others

(ii) Please write full name and address of the |

concerned organization. In case of
PSU/Autonomous Body/Bank/Universities/
Insurance organizations and please provide
name and address of the Controlling
Department / Ministry/Government also.

(iii) Name of the post to which she was appointed |

by direct recruitment

(iv) Group of the post (viz. group A, B, C or D) to |

which she was appointed by direct recruitment
and the year of recruitment

(v) If post of the organization is not classified as | NO ()

Group A, B, C or D, whether the post to which
the Mother was appointed by direct
recruitment is comparable or equivalent to any
Group A, B, C or D post in Government as per
DOPT OM No. 36012/22/93-Estt.(SCT), dated
8.9.1993. If yes, to which it is comparable and
please upload the relevant Government
order/notification establishing such
equivalence/comparability of post if available

(vi) Complete employment details of all the posts

held by Mother (From first employment till
present employment) :-

Name of the post and group of the post & Pay Scale of the post Date of Appoint Age at the Method of Recruitment
equivalence of post ment/promotion time of appoin /appointment[whether
to the post tment/promoti by Direct Recruitment/
on Promotion/Contract/oth
ers]
NA NA NA NA NA

Roll No. :- 6409713 |

 Page No. 11/14
(vii) If the Mother has retired/resigned or |
terminated from service, the details of present
status from the time of
retirement/resignation/termination. If
reemployed, mode of reemployment.

(viii) Whether the mother has/had been in | NO ()

employment in any International Organisation
like U.N., IMF, World Bank. If yes, duration
of such employment

(ix) If mother is dead, date of her demise |

(x) If Mother suffers from permanent | NO

incapacitation while in service.

(xi) If mother suffers from permanent |

incapacitation while in service, date from
which she so suffers

9. (a) Whether mother of the candidate holds or has ever | NO

held a Constitutional post
(b) If yes, name of the post (s) and duration of holding |
such post(s)

10.(a) If Mother is/was in the rank of Colonel and above | NO()

in the army and to the equivalent posts in the
Navy and the Air Force and the Para Military
Forces.
If yes, upload the relevant appointment order.

11. (A) Whether the parents of the candidate own | YES

agricultural land

(B) If yes,
(a) Area of the irrigated land owned by father, mother | 1.04 ACRE
and children put together

(b) Area of the unirrigated land owned by father, | 0.27 ACRE

mother and children put together

(c) Statutory ceiling limit of irrigated land holding at | 12 ACRES

the place where land owned is located

(d) Statutory ceiling limit of unirrigated land holding | 17 acres

at the place where land owned is located

(e) If the land is both irrigated and unirrigated, | NO

indicate whether condition given in clause (b) (i) of
Schedule V to the DOP&T O.M.
No.36012/22/93-Estt.(CST), dated 8-9-1993
applies. Give details

Roll No. :- 6409713 |

 Page No. 12/14

12. Annual income(in Rs.) of father for last three consecutive financial years (year-wise) :-

Financial Year Financial Year Financial Year

2018-2019 2017-2018 2016-2017
[Assessment Year [Assessment Year [Assessment Year
2019-2020] 2018-2019] 2017-2018]
(a) Income from salary 0 0 0
(b) Income from agriculture 0 0 0
(c) Income from other sources 0 0 0
(d) Whether your father has filed the ITR? NO NO NO
(d)(i) Whether the ITRs for the last 3 years in NO NO NO
respect of your father are available with you for
uploading?
(e) Undertaking ,I will submit the complete ITRs NO NO NO
to the Commission before/at the date of
interview

13. Annual income(in Rs.) of mother for last three consecutive financial years (year-wise) :-

Financial Year Financial Year Financial Year

2018-2019 2017-2018 2016-2017
[Assessment Year [Assessment Year [Assessment Year
2019-2020] 2018-2019] 2017-2018]
(a) Income from salary 0 0 0
(b) Income from agriculture 0 0 0
(c) Income from other sources 180000 200000 200000
(d) Whether your mother has filed the ITR? NO NO NO
(d)(i) Whether the ITRs for the last 3 years in NO NO NO
respect of your mother are available with you for
uploading?
(e) Undertaking ,I will submit the complete ITRs NO NO NO
to the Commission before/at the date of
interview

14. (a) Details of wealth held by parents | 1.04 ACRE OF AGRICULTURE LAND 0.27 ACRE

1
OF NON AGRICULTURE LAND
(b) Whether the wealth held is above in exemption limit | YES
as prescribed in Wealth Tax Act ?

15. Whether you have any documentary proof in support | NO

of service/status/land holding/income from different
sources/property held by parents have been attached?
If yes, upload documentary proof.

Roll No. :- 6409713 |

 Page No. 13/14

UNDERTAKING ANNEXURE-VI

I MD MANZAR HUSSAIN ANJUM son/daughter of Shri MD MASLEHUDDIN Resident of

village/town/city ISLAMPUR district UTTAR DINAJPUR (NORTH DINAJPUR) state WEST
BENGAL hereby declare that I belong to the NASHYA SEKH community which is recognized as a
backward class by the Government of India for the purpose of reservation in services as per orders
contained in Department of Personnel and Training Office Memorandum No. 36012/22/93-Estt.(SCT),
dated 8.9.1993. It is also declared that I have read and understood the instructions mentioned in the said
DOPT's Office Memorandum dated 08.09.1993, and OM No.36033/1/2013-Estt.(Res.) dated 13.09.2017
and I have reason to declare that I do not fall under OBC(Creamy Layer) category.

DECLARATION OF OBC ANNEXURE

Information furnished above is true to the best of my knowledge and I have not concealed any relevant information. I swear ,
that if it is found at any stage that information furnished by me is false or that I have concealed some relevant information,
I will forfeit the claim to appointment to any service on the basis of Civil Services Examination, 2020 and also be
liable for any other civil or criminal proceedings.

Place: (Signature of the Candidate)

Date: Name of Candiate: MD MANZAR HUSSAIN ANJUM

Roll No. : 6409713

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DECLARATION TO BE SIGNED BY THE CANDIDATE

I hereby declare that all statements and entries made in all the columns of this application are true, complete
and correct to the best of my knowledge and belief. I have read Rule 14 of the Rules of the
Examination published in the Gazette of India Extraordinary dated 12th February, 2020 and understand that in
the event of any information being found false or incorrect or ineligibility being detected before or after the
examination, action can be taken against me by the Commission.

I further declare that I fulfil all the eligibility conditions regarding age limits, educational
qualifications etc. prescribed for admission to the Examination. I have not exhausted the number of
attempts admissible to me under the Rule 4 of the said Rules of the Examination.

I have not withheld any information required as per this proforma.

I have read the rules and instructions carefully and I hereby undertake to abide by them.

I have informed my Head of the Office/Department in writing that I have applied for this
examination.

Place: (Signature of the Candidate)

Date:

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