..:: Online Appliaction Form ::..

Page 1 of 4

Online Application Form

User Id : 12LAB12870

Paste Recent passport

size photograph (not
more than 3 months
To,
The General Manager, old) duly self

Ordnance Factory, attested partially on
MURADNAGAR - 201 206
application and
partially on
photograph

,
,

,
- 201 206
Subject: Application for the Post of LABOUR Semi-Skilled.
: - .

Ref : Advertisement published in the Employment News No. davp 10201/11/1926/1213

Dated 24/11/2012

1. Post applied for: * LABOUR (SEMI-SKILLED)

2. Name of applicant: (First, AMIT GAURAV

Middle, Last) *.

3. Father's Name: (First, ANAND MOHAN SINGH
Middle, Last) *

4. Date of Birth: * 12-09-1989

(a)

4. Age as on the last date of 23 YEARS 3 MONTH(S) 3 DAY(S)

(b) receipt of application:

5. Details of Educational and other qualifications:- *

(a)

Name of Year of
Board/University
Examination Passing
/

Xth BIHAR SCHOOL EXAMINATION BOARD, PATNA 2004

6. Higher Qualification (If any) XII

( )
7. Whether Ex-serviceman, if so

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furnish details:* NO
- , Served in which unit
: NA
: *
Total period of service
: NA

Designation
: NA

8. Whether PWD/PC, if so NO
furnish details along with %
of disability: *
VH not applicable HH/ OH : NA
/ , % of disability : NA %

9. Original Category UR
UR/SC/ST/OBC
(attach caste certificate in
case of reserved category) *
/ / /
( )
Demand Draft/Indian Postal
10. IPO
order No.
/ /

IPO Date : 04-12-2012

IPO Amount : Rs. 50

/
IPO Issuing Branch
Name
: JAGATPURA, JAIPUR

/
IPO NO

68G329065

11. Language Option for English

Examination *
*
12. Nationality: * INDIAN
( ,

) *
Present address for
13. C/O- SAGARMAL, PLOT NO-12, KAMLA VIHAR,
communication: *

NEAR POWER HOUSE, JAGATPURA

City *
JAIPUR

State *
RAJASTHAN

Pincode *

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302017

14. Permanent address: * S/O- ANAND MOHAN SINGH, VILL-PATAHI, PO- PATAHI

BELSAND, SITAMARHI.

City *
SITAMARHI

State *
BIHAR

Pincode *
843316

15. Nearest Railway Station: * JAIPUR

16. Email amit_gaurav2008@yahoo.in

AMIT GAURAV
SIGNATURE OF THE CANDIDATE

DECLARATION
I do 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 particulars or information
furnished by me, found false/ incorrect/ incomplete or ineligible, my candidature for the examination

is
liable to be rejected or cancelled and in the event of any statement/ information found false even after
appointment; my service are liable to be terminated without any notice.

/ ,

/ /

, ,

SIGNATURE :

Left Thumb Impression NAME : AMIT GAURAV

DATE : 04-12-2012

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Enclosures:

1. Educational Qualification Certificate

2. Proof of Date of Birth

3. One Copy of Pass Port size Photo.

4. IPO/ DD /

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http://ofm.gov.in/view.php 12/4/2012