Professional Documents
Culture Documents
DAF Sample
DAF Sample
1/9
1. Details of Fee paid : Fee to be paid is Rs. 200/-(Two hundred only)(Female/SC/ST/Physically challenged
candidates are not required to pay any fee)
Name of Post Office / Value of CRF Stamps
Indian
/ Indian
Mission with complete
Mission Receipt
address.
Total Value :
N.B : Indian Postal Orders/Bank Draft/Money Orders/Crossed Cheque/Treasury Challan/Currency Notes/Postage/
Revenue/Court Fee Stamps etc. are not acceptable.
| Candidate Signature :
| RAWISEN GURIA
3. (a) Address for correspondence to which | HOUSE NO. 61, 3RD MAIN, 11TH CROSS, SHREYAS
COLONY,
communication is to be sent
| JP NAGAR 7TH PHASE
Post Office:
| JP NAGAR
District:
| BANGALORE
State :
| KARNATAKA
Pin Code :
| 560078
(b) Telephone No. with STD Code
| 080-41161849
(c) Mobile No.
| 09007376510
(d) Fax No.
(e) E-mail address
(f) Permanent Postal Address
|
|
|
|
|
|
|
Post Office:
District:
State :
Pin Code :
RAWISEN@GMAIL.COM
VILLAGE - GUTUHATU
BARDA
KHUNTI
JHARKHAND
| 835227
4. Gender :
| MALE
5. Marital Status :
| UNMARRIED
6. Citizenship :
| A CITIZEN OF INDIA(1)
7. Mother tongue :
| MUNDARI
| 21-02-88
9. Place of Birth :
Town/Village
District
State
| No
| GUTUHATU
| KHUNTI
| JHARKHAND
| ST (2)
10. (a) Community
Note 1: Candidate belonging to OBCs but coming in the 'Creamy Layer' and thus not being entitled to OBC
reservation should indicate their community as 'General Category (others) Code No.4'.
Note 2: Candidates belonging to neither SC,ST nor OBC Communities should write 'General'
Category(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 a candidate in his / her application form for this
examination will ordinarily be allowed by the Commission.
Note 4: In case you are a 'SC, ST or OBC' candidate, enclose a copy of certificate in support of your claim.
| Candidate Signature :
| BANGALORE
| ENGLISH
Note : In case of candidates opting for literature in any of the Indian Language as optional subject for papers
VI & VII , they would have to write these two papers (VI & VII) in the script specified for that particular
language as given in Annexure IV of Instructions to candidate.
(b)Language Medium for Interview
Test(c.f. para 27 of the Instructions)
to Candidates)
| ENGLISH
| NO
|
15. (a) Name of Father
(b) Name of Mother
|
(c) Nationality of Father
|
(d) Nationality of Mother
|
(e) Father's present postal Address
|
(If deceased give last address)
|
Post Office:
|
District/City:
|
State :
|
Pin Code :
|
(f) Mother's present postal Address
|
(If deceased give last address)
|
Post Office:
|
District/City:
|
State :
|
Pin Code :
|
(g) Father's Profession:
|
(h) Mother's Profession:
|
(i) 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)
|
(j) 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)
|
Roll No. :- 082646
RUSHEN GURIA
RUPAI GURIA
A CITIZEN OF INDIA
A CITIZEN OF INDIA
VILLAGE - GUTUHATU
BARDA
KHUNTI
JHARKHAND
835227
VILLAGE - GUTUHATU
BARDA
KHUNTI
JHARKHAND
835227
RETIRED
HOME MAKER
OFFICE SUPERINTENDENT
NA
| Candidate Signature :
RS.200000
RS.0
KHUNTI
JHARKHAND
KHUNTI
JHARKHAND
17. Educational Qualifications : Commencing with Matriculation or equivalent examination till Graduation:Examination
Passed
Class/ Percentage
CGPA
Year of
Division
of
Score Out of
/Grade Marks(%)
Passing
10th or Equivalent
70.83
12th or Equivalent
76.40
Graduation or
Equivalent
Subject(s)
Name of
School/College
/Institution
Name of
Board/University
2005
| NO
20. In case you are considered for appointment to IAS/IPS ,your order of preference for various State cadres
for which you would like to be considered.
Roll No. :- 082646
| Candidate Signature :
Order of preference
ANDHRA PRADESH
AGMUT
ASSAM,MEGHALAYA
BIHAR
CHHATTISGARH
GUJRAT
HARYANA
HIMANCHAL PRADESH
JAMMU & KASHMIR
JHARKHAND
KARNATAKA
KERALA
MADHYA PRADESH
MAHARASHTRA
MANIPUR TRIPURA
NAGALAND
ORISSA
PUNJAB
RAJASTHAN
SIKKIM
TAMILNADU
UTTARAKHAND
UTTAR PRADESH
WEST BENGAL
IAS
21
3
22
6
2
20
11
12
13
1
14
15
4
10
23
24
9
16
7
17
18
5
8
19
IPS
8
3
9
5
2
10
11
12
13
1
14
15
4
16
17
18
19
20
6
21
22
7
23
24
21. Your order of preference against the Services/Posts given below , for which you would like to be
considered for appointment .,
Note : It is clarified that the below order of services does not reflect their relative importance in the
eyes of the Govt. and the candidates are advised to use their discretion while indicating preferences for
various services.
S.N.
1.
2.
3.
4.
5.
6.
7.
8.
Name of Services/Post
Indian Administrative Service
Indian Foreign Service
Indian Police Service
Indian P&T Accounts & Finance Service Group "A"
Indian Audit & Accounts Service, Group "A"
Indian Revenue Service,(Customs and Central Excise)Group "A"
Indian Defence Accounts Service ,Group "A"
Indian Revenue Service, (I.T.) Group "A"
| Candidate Signature :
Order of Preference
1
2
3
9
7
6
8
4
| NO
| YES
17
19
10
11
12
13
14
18
20
22
5
21
15
16
23
Roll. No.
CIVIL SERVICES
EXAMINATION 2012
NIL
306369
YES
NO
|1
| NO
| Candidate Signature :
| JHARKHAND
| Rs. 0
| Candidate Signature :
| Candidate Signature :
ROLL NUMBER :NAME OF EXAMINATION :NAME :DATE OF BIRTH :OPTIONAL SUBJECT:PLACE OF BIRTH :TOWN/VILLAGE
DISTRICT
STATE
|
|
|
|
|
082646
CIVIL SERVICES(MAIN) EXAMINATION, 2013
RAWISEN GURIA
21-02-88
LAW
| GUTUHATU
| KHUNTI
| JHARKHAND
(b) Team/Games/Sports/N.C.C.
/Hitchhiking/Mountaineering etc.
(c) Position(s) of distinction Leadership held in
School/College
(d) Other extra curricular activities and interests (Such
as hobbies etc.)
Class/ Percentage
CGPA
Year of
Division
of
Score Out of
/Grade Marks(%)
Passing
10th or Equivalent
70.83
12th or Equivalent
76.40
Graduation or
Equivalent
2005
Subject(s)
Name of
School/College
/Institution
Name of
Board/University