STAFF SELECTION COMMISSION

BLOCK NO. 12, CGO-COMPLEX, LODHI ROAD, NEW DELHI

110003
CONSTABLE(EXECUTIVE) MALE AND FEMALE IN
DELHI POLICE EXAMINATION
2020
REGISTRATION NO: 71000680098

APPLICATION IS PROVISIONALLY ACCEPTED

1. NAME AS PER 2. NEW/ CHANGED 3. FATHER'S NAME 4. MOTHER'S NAME
MATRICULATION NAME
CERTIFICATE
ABHIJIT KAIRI - SANJIB KUMAR KAIRI SABITRI KAIRI
5. DATE OF BIRTH
6. AGE AS ON 01/07/2020 7. GENDER 8. CATEGORY
(DD/MM/YYYY)
01/03/1994 26.4 MALE SC
9. NATIONALITY 10. MARK OF VISIBLE IDENTIFICATION
CITIZEN OF INDIA A BLACK MOLE ON NECK RIGHT SIDE
11. MATRICULATION (10th CLASS) EXAMINATION 12. MATRICULATION (10th 13. MATRICULATION (10th
BOARD CLASS) ROLL NO CLASS) YEAR OF PASSING
TRIPURA BOARD OF SECONDARY EDUCATION 28858 2010
14. DO YOU BELONG TO A CASTES NOT INCLUDED IN CENTRAL LIST OF OBCs BUT NOTIFIED AS OBC BY THE GOVT
OF NCT OF DELHI ?
-
15. WHETHER DEPARTMENTAL CANDIDATE OF DELHI POLICE ?
NO
16. WHETHER SON/ DAUGHTER OF SERVING, RETIRED OR DECEASED PERSONNEL/ MULTI-TASKING STAFF OF DELHI
POLICE
NO
17. HAVE YOU REPRESENTED A STATE AT THE NATIONAL LEVEL OR THE 17.1. IF YES, INDICATE DISCIPLINE OF
COUNTRY AT THE INTERNATIONAL LEVEL IN SPORTS DURING PRECEEDING YOUR SPORT
3 YEARS FROM THE CLOSING DATE OF RECEIPT OF ONLINE APPLICATIONS?
NO -
18. PREFERENCE OF EXAMINATION CENTERS
EXAMINATION CENTER EXAMINATION CENTER EXAMINATION CENTER
(FIRST PREFERENCE) (SECOND PREFERENCE) (THIRD PREFERENCE)
AGARTALA ( 5601 ) SILCHAR ( 5111 ) GUWAHATI (DISPUR) ( 5105 )
 19.WHETHER EX- 19.1. DATE OF DISCHARGE 19.2. HAVE YOU ALREADY JOINED A CIVIL POST BY
SERVICEMAN (ESM)? FROM ARMED FORCES AVAILING BENEFIT OF RESERVATION FOR EX-
(DD/MM/YYYY) SERVICEMAN (ESM) ?
NO - -
19.4. LENGTH OF SERVICE IN ARMED FORCES (IN
19.3. DATE OF JOINING THE CIVIL POST (DD/MM/YYYY) YEARS)

- -
20. WHETHER ELIGIBLE FOR SPECIAL QUOTA AS ESM FOR DELHI POLICE ?

21. WHETHER SEEKING AGE 21.1. IF YES,INDICATE CODE

RELAXATION ?

YES 01-SC/ST

22. ARE YOU A NATIONAL CADET CORPS (NCC) CERTIFICATE HOLDER ? 22.1. TYPE OF CERTIFICATE

YES NCC "B" CERTIFICATE

24. DETAILS OF QUALIFYING
23. HIGHEST QUALIFICATION
EDUCATIONAL QUALIFICATION
B. COM. (7) 12TH
BOARD/ YEAR OF
ROLL NO SUBJECTS PERCENTAGE CGPA
UNIVERSITY PASSING
TRIPURA
BOARD OF
35401 ACCOUNTANCY 2012 34.4 -
SECONDARY
EDUCATION
ADDRESS DETAILS
25. POSTAL ADDRESS 26. PERMANENT ADDRESS
VPO - MARACHARA, PS - KAMALPUR, DISTT - DHALAI, VPO - MARACHARA, PS - KAMALPUR, DISTT - DHALAI,
TRIPURA, PIN - 799285 TRIPURA, PIN - 799285
DISTRICT: DHALAI DISTRICT:DHALAI
STATE: TRIPURA STATE: TRIPURA
PIN : 799285 PIN : 799285
MOBILE NO: 9436572353 EMAIL: amazonsabhi@gmail.com
FEE PAYMENT AMOUNT TRANSACTION NO TRANSACTION DATE
EXEMPTED - - -
DECLARATION
1. I HAVE READ THE NOTICE OF EXAMINATION AND ACCEPT ALL THE TERMS & CONDITIONS MENTIONED
THEREIN.

2. I 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
INFORMATION BEING FOUND SUPPRESSED/FALSE OR INCORRECT OR INELIGIBILITY BEING DETECTED
BEFORE OR AFTER THE EXAMINATION, MY CANDIDATURE/ APPOINTMENT IS LIABLE TO BE
CANCELLED.I AM WILLING TO SERVE ANYWHERE IN INDIA.
PRINT TAKEN ON: 26/08/2020 11:08:25 PM IP ADDRESS: 157.40.169.62