HIGH COURT OF BOMBAY
Application Form for The Post of PEON/HAMAL/FARASH
Registration-ID :- PEN17674
Name of Establishment :- Bench at Aurangabad
for which applied
Name of the Applicant :- Shri. VISHAL KHANDUJI NARWADE
Address for correspondence :- AT KOLI SIRASGAON PO
DONGAON TQ AMBAD DIST
JALNA
District of Postal Address :- JALNA - 431204
Aadhar Card No. :- 570312805970
Mobile No. :- 8805032195
Email :- vn1694102@[Link]
Nationality :- Indian
Is the Candidate Domicile :- Yes
of Maharashtra
Gender :- Male
Religion, Category/Caste :- Hindu, Schedule Castes (mahar)
Date of Birth :- 07/02/2002
Place of Birth :- KOLISIRASGAON
Age as on 08/12/2025 :- 23 Years 10 Months 1 Days
Marital Status :- Single
Whether Candidate is :- No
Differently-abled Person?
Does the candidate have 7 :- No
Standard (passed)
marksheet issued by the
School Authority?
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Educational Qualification :-
Course/Degree Board/University Year of Marks Out of Class Percent
Passing Obtained Marks %
Below S.S.C. (7th ZP SCHOOL 2015 50 100 IInd 50.00
STD.)
S.S.C. (S.S.C.) MSBSHSE PUNE 2018 331 500 Ist 66.20
H.S.C. (MCVC) MSBSHSE PUNE 2020 379 650 Ist 58.31
Special Skills :- No
Language Known :-
Read Write Speak
Marathi Yes Yes Yes
Hindi Yes Yes Yes
English Yes Yes No
Does candidate work in any :- No
Government Department ?
Whether candidate has :- No
enrolled his/her name at
Employment Exchange?
(a) Is there any criminal :- No
proceeding pending against
the candidate?
(b) Is he/she convicted by a :- No
Criminal Court?
(c) Is he/she facing :- No
disciplinary/deparment
enquiry?
Whether permanently :- No
debarred or disqualified by
any Court/MPSC/UPSC or
any State Service
Commission from
appearing in any
examination conducted by
them?
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Name and address of two :- 1) RAHUL BHAGWAN TUPE
respectable persons who GRAMPANCHAYAT MEMBAR
know the candidate. 9022678050
at kolisirasgaon tq ambad dist jalna
2) BHASKAR UGHADE
POLICE PATIL
8625011979
at kolisirasgaon tq ambad disr jalna
Fee Details :- Payment Gateway:- SBI Collect
Payment Type :- EPAYMENT
SBCollect Ref. No.
:- DUO9817736
Date :- 23/12/2025
Amount :- Rs. 1000
Signature of Applicant
FOR OFFICE USE
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Signature of Applicant
Printed on 23/12/2025 12:56:20
Page 3/4
DECLARATION - I
1) I the applicant, Shri. VISHAL KHANDUJI NARWADE do hereby declare that no criminal prosecution pending
against me or I have not been convicted by a Criminal Court or held guilty or facing disciplinary enquiry.
2) I further affirm that all the details filled in the application are true and correct as per my knowledge. If any
information is found to be false/incorrect, I will be liable to be disqualified from the process of selection and if
selected/appointed, my services would be liable to be terminated without any notice.
VISHAL KHANDUJI NARWADE
Place : JALNA
Date : 23/12/2025
Name and Signature of Applicant
DECLARATION - II
Form-A
(See Rule 4 of Maharashtra Civil Services (Declaration of Small Family) Rules, 2005)
I, Shri./Smt./Kum. Shri. VISHAL KHANDUJI NARWADE son/daughter/wife of Shri KHANDUJI NARWADE
aged 23 years, resident of JALNA do hereby declare are follows :
1) That I have filled my application for the post of Peon/Hamal/Farash.
2) I have -NA- (Number) living children as on today. Out of which -NA- No. of children born after 28/03/2005 is
-NA- (mentioned dates of birth, if any)
3) I am aware that, if any total number of living children are more than two due to the children born after 28/03/2005, I
am liable to be disqualified for the same post.
VISHAL KHANDUJI NARWADE
Place : JALNA
Date : 23/12/2025
Name and Signature of Applicant
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