Application of Job: SSC [SSC(ATC)],SSC [SSC(OBS)],SSC [SSC(PILOT)(MR)],SSC

[SSC(PILOT)(OTHER THAN MR)],SSC [SSC(IT)],SSC [SSC{GS(X)}],SSC [SSC(HYDRO)],SSC

[GS(ENGINEERING)],SSC [GS(ELECTRICAL)],SSC [SSC(EDU)],SSC [SSC(NAIC)],SSC [SSC(LOG)] -
01/2021

Application No: SGD211F001570 Application Date: 19/12/2019

PRIORITY

1. SSC [SSC(EDU)] 01/2021

2. SSC [SSC(ATC)] 01/2021
3. SSC [SSC(LOG)] 01/2021
4. SSC [SSC(NAIC)] 01/2021
5. SSC [SSC(OBS)] 01/2021

PERSONAL PARTICULARS

Name: GAGANA G
Father's/Mother's Name: GANGADHAR SHET
Guardian's Name:
Nationality: INDIAN
A DARK MOLE ON RIGHT
Identification Mark 1:
SIDE OF NOSE
Identification Mark 2: MOLE ON
Pancard: ---------
Date of Birth: 21/09/1998
Aadhar Verified: Yes

EDUCATION PARTICULARS

Details of Graduation

Second Highest Candidate

B.E Stream : COMPUTER SCIENCE In Final year
Qualification : Status :
University KLE TECHNOLOGICAL KLE TECHNOLOGICAL
Candidate Type : Regular College Name :
Name : UNIVERSITY HUBLI UNIVERSITY HUBLI
College District
Marks Available In : CGPA College State : KARNATAKA DHARWAD
:
Aggregate CGPA till 5
7.72 Passing Year : 2020
semester :
Aggregate CGPA
Percentage till 5 69.7
semester :
Details of 12th Commerce/humanity/Diploma in Science

Total Marks: 5025 Marksheet Serial Number: 121CS14015

Obtained Marks: 3692 State Conduct: KARNATAKA
Percentage: 73.47 Board Conduct: State Board

Details of 10th

Total Marks: 625 Marksheet Serial Number: 20140370447

Obtained Marks: 492 State Conduct: KARNATAKA
Percentage: 78.72 Board Conduct: Karnataka Secondary Education
Examination Board

MILITARY RECORD

Have you ever been enrolled in

NO
Armed Forces before?:
Have you attended
any Services
NO
Selection Board
(SSB) before?:
Have you been
discharged from
NO
Armed forces
before?:

COMMUNICATION PARTICULARS

Details of Permanent Address

Address 1: GOKUL ROAD Address 2: HOSUR

State: KARNATAKA District: DHARWAD Pincode: 580021
Phone No.: 8147564858 Mobile No.: 8147564858
Email id: gaganag98@gmail.com Alternate Email id: ---------

Details of Correspondence Address

Same as Permanent Address

Alternate Mobile Number: ---------

A. I hereby declare that I am unmarried, governed by nationality condition as laid down by the Government of Indian and
have never been debarred from appearing at any examination. I have never been arrested/ prosecuted and convicted by a
criminal court or involved in any other case registered by the Police.
B. I hereby, solemnly declare that all the statements made in the above application are true and correct to the best of my
knowledge and belief.
C. I fully understand that in the event of my information being found false or incorrect, appropriate action can be taken
against me.
D. Eligibility criteria will be verified on reporting at the selection centres. I found ineligible, I understand that criminal
proceedings can be initiated against me for fraudulent entry and falsification of Government of Indian documents. I also
accept that no TA/ DA will be admissible to me in such cases.