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SSC - Gov.in-Candidate Portal

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KAMLESH KUMAR
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34 views

SSC - Gov.in-Candidate Portal

Uploaded by

KAMLESH KUMAR
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
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Candidate Portal

ssc.gov.in/candidate-portal/steno-application-form/print-application/qlspr0h5ruudvfmz/d2t11slplvx6og4

STAFF SELECTION COMMISSION

BLOCK NO. 12, CGO COMPLEX, LODHI ROAD, NEW DELHI

110003

Stenographer Grade 'C' and 'D' Examination, 2024

REGISTRATION NO: 10017461392

Application Completed(Contents Not Verified)

1. CANDIDATE'S NAME
(AS PER THE 2. NEW/
MATRICULATION CHANGED
CERTIFICATE) NAME 3. GENDER 4. CATEGORY

1/5
PRATIK DAVE - Male UR

7. DATE OF BIRTH (DD/MM/YYYY)


6. MOTHER'S (AS PER THE MATRICULATION
5. FATHER'S NAME NAME CERTIFICATE)

KAMAL NARAYAN MANJU 02/07/1999

9.
8. AGE AS ON 01/08/2024 NATIONALITY 10. VISIBLE IDENTIFICATION MARK

25 Years 1 Month 0 Days Citizen of India NO

11. WHETHER A PERSON WITH 11.1. IF YES, TYPE OF DISABILITY


BENCHMARK DISABILITY (PwBD) ? (OH, HH, VH, OTHERS)

No -

13.
MATRICULATION 14.
(10th CLASS) MATRICULATION
12. MATRICULATION (10th CLASS) YEAR OF (10th CLASS)
EXAMINATION BOARD PASSING ROLL NO.

Board of Secondary Education, Rajasthan 2014 2843961

ADDRESS DETAILS

15.1 CORRESPONDENCE ADDRESS 16.1 PERMANENT ADDRESS

UNDRIYON KI GALI CHANDPOL UNDRIYON KI GALI CHANDPOL


BRAHARAMPURI JODHPUR BRAHARAMPURI JODHPUR

15.2. STATE: Rajasthan 16.2. STATE: Rajasthan

15.3. DISTRICT: Jodhpur 16.3. DISTRICT: Jodhpur

15.4. PIN: 342001 16.4. PIN: 342001

17. EMAIL [email protected] 18. MOBILE NUMBER 7220087944

19. HIGHEST EDUCATIONAL QUALIFICATION

Post Graduation

20. DETAILS OF QUALIFYING EDUCATIONAL QUALIFICATION

Equivalent to 12th Standard

20.1. EQ STATUS 20.2. PASSING YEAR 20.3. STATE/ UT of BOARD

Passed 2017 Rajasthan

20.4. NAME OF BOARD

2/5
BOARD OF SECONDARY EDUCATION, RAJASTHAN

20.5. ROLL NUMBER 20.6. PERCENTAGE 20.7. CGPA

2829679 58.80

21.1 DATE OF JOINING


21. WHETHER YOU ARE AN EX-SERVICEMAN (ESM) THE ARMED FORCES
OR SERVING IN THE ARMED FORCES? (DD/MM/YYYY)

No -

21.3. LENGTH OF
21.2. DATE OF DISCHARGE FROM ARMED FORCES SERVICE IN ARMED
(DD/MM/YYYY)? FORCES

- -

21.4. HAVE YOU ALREADY JOINED A CIVIL POST BY 21.5. DATE OF JOINING
AVAILING BENEFIT OF RESERVATION FOR EX- TO CIVIL POST
SERVICEMAN (ESM) ? (DD/MM/YYYY)

No -

22.1. IF YES, AGE


22. WHETHER SEEKING AGE RELAXATION ? RELAXATION CODE

No

23. DO YOU WANT TO MAKE YOUR PERSONAL INFORMATION AVAILABLE FOR


ACCESSING JOB OPPORTUNITIES IN TERMS OF DOP&T'S OM NO.39020/1/2016-
ESTT.(P) DATED 21/06/2016?

Yes

24. PREFERENCE OF EXAMINATION CENTER

24.1. EXAMINATION 24.2. EXAMINATION 24.3. EXAMINATION


CENTER (FIRST CENTER (SECOND CENTER (THIRD
PREFERENCE ) PREFERENCE ) PREFERENCE )

NR-Jodhpur (2406) NR-Ajmer (2401) NR-Jaipur (2405)

25.1. ARE YOU A PERSON WITH BENCHMARK DISABILITIES (40% OR MORE) IN


THE CATEGORY OF BLINDNESS (VH)?

No

25.2. ARE YOU A PERSON WITH BENCHMARK DISABILITIES (40% OR MORE) IN


THE CATEGORY OF BOTH ARMS AFFECTED (BA) OR CEREBRAL PALSY (CP)?

No

3/5
25.3. DO YOU HAVE PHYSICAL LIMITATION TO WRITE AS PER PARA 7.2 OR 7.3
OF THE NOTICE?
(CERTIFICATE TO THIS EFFECT FROM COMPETENT ATHORITY AS PER
FORMAT AT ANNEXURE-1/ANNEXURE-1A TO THE NOTICE OF EXAMINATION,
WOULD BE REQUIRED AT THE TIME OF EXAMINATION)?

No

25.4. WHETHER SCRIBE IS REQUIRED?

No

25.5. WILL YOU MAKE YOUR ARRANGEMENT OF SCRIBE?

No

25.6. IF SCRIBE IS TO BE ARRANGED BY SSC, THEN INDICATE MEDIUM?

26. Do you possess knowledge of Stenography?

Yes

27. Medium of Skill Test

Hindi

28. Post(s) Applying for

Stenographer Grade 'C' & Stenographer Grade 'D'

FEE PAYMENT AMOUNT TRANSACTION NO TRANSACTION DATE

NOT EXEMPTED 100 2407da40b5733949d2 01/08/2024

DECLARATION

1. I HAVE READ THE NOTICE OF EXAMINATION AND ACCEPT ALL THE TERMS &
CONDITIONS MENTIONED THEREIN.

2. I HEREBY DECLARE THAT ALL STATEMENTS MADE IN THIS APPLICATION ARE


TRUE, COMPLETE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND
BELIEF. I UNDERSTAND THAT IN THE EVENT OF ANY INFORMATION BEING
FOUND SUPPRESSED/FALSE OR INCORRECT OR INELIGIBILITY BEING
DETECTED BEFORE OR AFTER THE EXAMINATION, MY CANDIDATURE/
APPOINTMENT IS LIABLE TO BE CANCELLED.I AM WILLING TO SERVE
ANYWHERE IN INDIA.

3. I AGREE TO AUTHORIZE SSC TO USE MY AADHAR DATA FOR VERIFICATION


PURPOSE.

PRINT TAKEN ON: 01-08-2024 3:54 PM


NUMBER OF ATTEMPT(s): 1

4/5
(Signature)

IP ADDRESS: 220.158.144.122

5/5

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