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SASH ASTRA SEEM A BAL RECRUITMENT

R E C R U I T M E N T F O R C o n s t a b l e ( D r i v e r ) E X A M I N AT I O N , 2 0 1 8

ACKNOWLEDGEMENT
REGISTRATION ID : 20198045 DATE & TIME : 03-09-2020 13:59:41

POST APPLIED FOR : CONSTABLE (DRIVER) APPLICANT NAME : MILEEND BALKRUSHAN BARAHATE

FATHER'S NAME : BALKRUSHAN MOTHER'S NAME : NANDA

DATE OF BIRTH : 31-01-1993 GENDER : MALE

RELIGION : HINDU MARITAL STATUS : UNMARRIED

NATIONALITY : INDIAN CATEGORY : OBC

IDENTITY CARD NO : 388444816011 (AADHAR CARD) IDENTIFICATION MARKS : MOLE ON FACE
MOBILE NUMBER : 8485880974 EMAIL ADDRESS : MILEEND31@GMAIL.COM
COMMUNITY BELONGING TO ANY : NO
WHETHER DOMICILED ORDINARY IN J&K DURING 1980 TO 1989 : NO
WHETHER AFFECTED IN 1984 RIOTS OR COMMUNAL RIOTS OF 2002 GUJARAT : NO
WHETHER EX-SERVICEMAN : NO
WHETHER DEPARTMENTAL CANDIDATES WITH THREE YEARS CONTINUOUS SERVICE NO
IN CENTRAL GOVERNMENT :

EDUCATION QUALIFICATION DETAILS

AGGREGATE
SCHOOL/ UNIVERSITY/ BOARD/ YEAR OF
EXAM PASSED ROLL NO CERTIFICATE NO DATE OF ISSUED SUBJECT PERCENTAGE OF
INSTITUTE EXAM
MARKS/ GRADING

MATRICULATION PUNE 2009 C185193 145763 25-06-2009 OTHERS 79.53

ADDRESS DETAILS
PERMANENT ADDRESS CORRESPONDENCE ADDRESS
VILLAGE/TOWN KOLGAON VILLAGE/TOWN KOLGAON

POST OFFICE KOLGAON POST OFFICE KOLGAON

TEHSIL SHRIGONDA TEHSIL SHRIGONDA

POLICE STATION 413728 POLICE STATION 413728

DISTRICT AHMEDNAGAR DISTRICT AHMEDNAGAR

STATE MAHARASHTRA STATE MAHARASHTRA

PIN CODE 413728 PIN CODE 413728

DECLARATION OF CRIMINAL CASES

HAVE YOU EVER BEEN DEBARRED BY UPSC, SSC OR SPSC OR ANY RECRUITMENT BOARD FROM APPEARING IN ANY EXAM? NO
CRIMINAL PROCEEDING DETAILS, IF ANY
A) WHETHER ANY FIR OR CRIMINAL CASE(S) HAS EVER BEEN REGISTERED AGAINST YOU? NO
B) WHETHER ANY CRIMINAL COMPLAINT CASE OR FIR OR CRIMINAL CASE(S) IS PENDING AGAINST YOU IN COURT OF LAW,
NO
OR WITH POLICE AT THE TIME OF SUBMITTING THE APPLICATION FORM?
C) HAVE YOU EVER BEEN ARRESTED/DETAINED IN ANY CRIMINAL CASE(S)? NO
D) HAVE YOU EVER BEEN TRIED & CONVICTED OR ACQUITTED BY A COURT OF LAW IN ANY CRIMINAL CASE(S)? NO
E) HAVE YOU EVER BEEN TRIED & CONVICTED BY THE COURT BY FILLING ANY BOND FOR GOOD BEHAVIOUR ETC.? NO

DECLARATION BY THE CANDIDATE

I HEREBY DECLARE THAT THE INFORMATION GIVEN ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF AND NOTHING HAS BEEN CONCEALED THEREIN. I AM WELL AWARE
OF THE FACT THAT IF THE INFORMATION GIVEN BY ME IS PROVED NOT TRUE, I WILL HAVE TO FACE THE CONSEQUENCES AS PER THE LAW. ALSO, ALL THE BENEFITS AVAILED BY ME
SHALL BE SUMMARILY WITHDRAWN.

DATE : 03-09-2020 13:59:41