Position Applied :- Junior Engineer (Tech1) FORM NO : Tech1-103728 Testing Center Location Personal Details First Name Gender

Category Postal Details: Address Email -Id F 81 SECOND FLOOR LADOSARAI District Others (DELHI) 8103849844 Pin Code 110030 KHIR Male Open Middle Name Date of Birth Person with disability SAGAR 30-Dec-1986 No Last Name Age as on (31/08/2012) PATEL 25 Year 8 Month Nagpur Degree/Diploma In Electrical

khirsagarp3@gmail.com Mobile No No No No

Whether departmental of Mahagenco ? Whether registered with any Govt. employment Agency Whether applied for Sports reservation ? Whether project affected Person of Mahagenco/Other PAP

Whether applied for Ex. Serviceman reservation ?

No

No

Qualification Details
Qualification SSC/CBSC/ICSE B.E./B.Tech Marks in % 73 % 75 % Year of Passing 2003 2012 Board / University cgbse raipur dr cv raman university bilaspur Specialization Electrical

Other Qualification

Experience Details
Sr.No Organisation Working Period From To Designation Gross Salary (Rs.) Nature of Job Total Work Exp

Check List
103.1.115.16/mahagenco12-AD02/candidate/RegisteredDetails.aspx

1 Secondary School Certificate (SSC/CBSC/ICSE) for Date of Birth

Yes

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1 Secondary School Certificate (SSC/CBSC/ICSE) for Date of Birth 2 Degree/Provisional Degree in support of Educational qualifications 3 Attached Certificate of Professional qualification 4 Post applied for is written on the envelope. 5 Signed the undertaking. 6 Pasted recent photograph at appropriate place. 7 Certificate of Experience. 8 Caste Certificate and caste validity certificate for Reserved Category Candidates. 9 Certificate of Dist. Resettlement Officer attached for PAP 10 Non Creamy Layer certificate for VJ(A)/NT(B)/NT(C)/NT(D)/SBC/OBC 11 Domicile Certificate of Maharastra State 12 Certificate Related to Horizontal Reservation 13. Certificate Related to Sports is attached ? 14. Certificate Related to Ex. Serviceman is attached ? Declaration : I declare that all the above information and particulars are correct and that I will stand disqualified if any information is found to be incorrect at any stage.

Yes Yes No Yes No Yes No No No No No No No No

I declare that I have 0 Number of living children as on today, out of which no. of children born after 28.03.2005 is 0. I am aware that if any total number of living children are more than two due to the children born after 28.03.2006, I am liable to be disqualified for the post applied. I declare that I am ready to serve any where in the Company. I undertake to abide by all the conditions & General conditions mentioned in the advertisement given by the Company. Place :

Date :

Signature

103.1.115.16/mahagenco12-AD02/candidate/RegisteredDetails.aspx

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