Application Form

1. Applying for Grade*

2. Applying for Department*

3. Applying for Post *

4. Applying for State/Union Territories*

5. Literacy/Illiteracy Details*

6. Personal Details:
(i) Name: Mr./Mrs./Ms.*

(ii) Date of Birth*

Disability: Physically Handicapped

Visually Impaired

(iii) Father's/Husband Name*

(iv) Father's/Husband Occupation*

Annual Income*

(v) Mother's Name*

(vi) Mother's Occupation*

(vii) Gender:* Male Female Transgender

(viii) Religion:* Hindu Muslim Sikh Christian

Caste/Category:* General OBC SC ST Caste Certificate *
(Upload Format - PDF, JPEG, JPG)

(Mandatory only for OBC, SC & ST Candidates)

(ix) Marital Status:* Single Married Divorced

(x) Visible Identification Mark*

(xi) Nationality:*Indian Foreigner/Non Resident Indian

(xii) Permanent Address/Present Address:*

Town*

District*

Post*

State*

Pin Code*

Same as Permanent Address

(xiii) Address For Communication:*

(xiv) Town*

District*

Post*

State*

Pin Code*

(xvi) Mobile No*

Landline/Alternate Mobile No

(xv) Email*

(xvii) Aadhaar No*

(xviii) PAN No

(xix) Passport No

(xx) Voter Card No

7. Educational Qualification Details:

S.No Examination Passed Name of Institution/University/Board Year of Passing % of Marks

1

2

3

4

8. Professional/Additional Qualification Details:

S.No Examination Passed Name of Institution/University/Board Year of Passing % of Marks

1

2

3

4

Computer Knowledge:- DCA ADCA HDCA JAVA C++

Typing Speed:- Word / Min.

9. Employment Experience:

S.No Organization Designation Pay Scale(CDA) with Grade Pay/IDIA(or CTC) Period From-To Job Description

1

2

3

4

10. Write the Details of Attached Proof Of Educational, Professional Qualifiations With Employment Experience if any Seperated by Commas(,).*

11. I have read the Column No. 8 present in the Detailed Advertisment No. IA-17/2018 very carefully regarding the application form fees according to Caste/Category and I want to proceed for the Application Form fee.

Declaration:
12. I certify that the information given above / furnished in the application form by me are true & correct according to the best of my knowledge & belief. I have carefully read the detailed advertisement and I agree to abide by the terms & conditions mentioned there in.

L.T.I

Left Hand Thumb Impression

Candidate Signature