8/25/2021 Uttarakhand Public Service Commission

Personal Information

Combined State (Civil) Lower Subordinate Service

Exam Name
Examination- 2021
Application No. LPC258230

Application Status Paid

Candidate's Name MOHIT UPADHYAY

Father's Name/Husband's Name RAJENDRA UPADHYAY

Mother's Name NIRMLA UPADHYAY

Date of Birth 01/11/1991

st
Age (As on 01 July, 2021) 29 Years, 8 Months, and 0 Days

Gender Male

Marital Status Married

Email Id mohitupadhyay91@gmail.com

Mobile No. 8923149474

Domicile of Uttarakhand Yes

Nationality

Nationality Indian

Required Eligibility

1. Is your name registered in any District Employment Office located in Uttarakhand State Yes

1(i). Registration No. UA2322018975

1(ii). Employment Office District. Employment Office,Kashipur

1(iii). Date of Registration. 04/08/2021

1(iv). Registration Date Valid Up To. 31/10/2024

2. Are You Employed? Yes

2(i). Type of Organization Others

2(ii). Date of Applying NOC 10/08/2021

3.Have you passed your High School and Intermediate or any other equivalent exams from any
Yes
recognized institution situated in the State of Uttarakhand

4(i). Are you or your spouse or your parents regular employees of the Armed Forces/Paramilitary
Forces serving in the state of Uttarakhand and whose services cannot be transferred outside the No
state of Uttarakhand

4(ii). Are you or your spouse or your parents regular employees of the State Government/Semi
Government organisation serving on a regular basis in the state of Uttarakhand and whose Yes
services cannot be transferred outside the state of Uttarakhand

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4(iii). Are you or your spouse or your parents regular employees of Central Government
organisation/ Central Government public service undertaking and are working regularly on the Yes
state of Uttarakhand and whose services cannot be transferred outside the state of Uttarakhand.

5(i). Are you permanent resident of Uttarakhand but residing outside Uttarakhand for
No
livelihood/education purposes.

5(ii). Is your spouse or your parents permanent residents of Uttarakhand but are residing outside
No
Uttarakhand for livelihood/education purposes

Category / Sub Category Reservation Details

Category Unreserved/General 

Valid Upto

Sub Category Details

Differently abled(PH) No

Ex-Servicemen No

Dependent of Freedom Fighter (DFF) No

Are you an orphan child, and are voluntary

residing in State homes operated under
No
Uttarakhand State Women Empowerment and
Child Development Department

Claimed Category/Sub Category Unreserved

Address Details

Present Address Permanent Address

R K PURAM 1 GALI NO 6
R K PURAM 1 GALI NO 6

BEHIND STADIUM MANPUR ROAD

BEHIND STADIUM MANPUR ROAD

KASHIPUR
KASHIPUR

UDHAM SINGH NAGAR

UDHAM SINGH NAGAR

Uttarakhand
Uttarakhand

244713 244713

Educational Qualifications Details

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Qualification Type Name of Degree University University Date of Subject Marks Marks Maximum Grade Percentage
State / Board issuing of Type Obtained/CGPA Marks/CGPA
Final year
Marksheet

High School(10th) High School(10th) Others Central 29/05/2007 High School Marks 256 500 51.20
Board of Subjects
Secondary
Education

Intermediate(12th) Intermediate(12th) Others Central 22/05/2009 Science Marks 268 500 53.60
Board of
Secondary
Education

Graduation Bachelor of Uttarakhand Uttrakhand 30/08/2014 Machanical Marks 3057 5000 61.14
Technology(B.Tech.) Technical Engineering
University

 Preferential Qualification 

Do you possess graduation degree in law No

Have you Served in the Territorial army for a minimum period of two years No

Do You Possess NCC ‘B’ Certificate No

Do You Possess NCC ‘C’ Certificate No

Do You Possess NSS 'C' Certificate No

Other Details

Exam Centre Preference 1  : Haldwani Exam Centre Preference 2  : Udhamsingh Nagar

Do you possess thorough knowledge of Hindi in Devnagri script Yes

Do You want relaxation in Height on Physical standards? No

Is there any criminal case pending against you No

Whether debarred or Black Listed for Examination/ Selection held by

No
UKPSC / UPSC / Other State Public Service Commission

Candidate ID Proof : Aadhaar Card ID Proof Number : xxxxxxxx0832

Application Fee Details

Bank Reference No. Transaction Date Application Fee Processing Fee Total Amount Paid

IGALVOKKZ7 25/08/2021 20:33:23 150.00 26.55 176.55

Declaration

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1. I MOHIT UPADHYAY
hereby declare that I have carefully read all the eligibility conditions mentioned in the advertisement and the above
mentioned information in this application form. I accept and complete those requirements.

मैं एतद् द्वारा घोषणा करता/करती हूँ की मैंने विज्ञापन में वर्णित पात्रता की सभी शर्तें एवं इस आवेदन पत्र में ऊपर उल्लिखित सूचनाएं सावधानी पूर्वक पढ़ी हैं। वे मुझे
मान्य हैं और मैं यह शर्तें पूरी करता/करती हूँ।
2. I also declare that all the details / information given in this application form is true and correct and I have not hidden any facts in these
particulars / information. If any details / information is found to be false or incorrect or if any facts are hidden by me, then my candidature should
be canceled. If such situation comes to light after the appointment, then my services should be terminated.

मैं यह भी घोषणा करता/करती हूँ की इस आवेदन पत्र में दिए गए सारे विवरण/सूचनाएं सत्य एवं सही हैं और मैंने इन विवरणों/सूचनाओं में कोई तथ्य छिपाया नहीं है। यदि
कोइ विवरण/सूचना असत्य या गलत पाए जाने या कोई तथ्य मेरे द्वारा छिपाया जाना पाया जाये तो मेरा अभ्यर्थन निरस्त कर दिया जाये। यदि नियुक्त किये जाने के
उपरान्त ऐसी स्थिति प्रकाश में आये तो मेरी सेवाएँ समाप्त कर दी जायें।
3. I am / am not a regular employee of State Government / Government of India and I have informed the competent authority about sending my
application, on (Date) 10/08/2021 for providing No Objection Certificate.

मैं राज्य सरकार/भारत सरकार का नियमित कर्मचारी हूँ/ नहीं हूँ और मैंने अपना आवेदन पत्र भेजने की सूचना सक्षम प्राधिकारी को दिनांक 10/08/2021 को विधिवत
अनापत्ति प्रमाण पत्र प्रदान करने के लिए प्रस्तुत कर दी है।

Submitted Date : 25/08/2021 20:33:23

Place of filling form : BETALGHAT

Print Date : 25-08-2021 20:36:19

Signature of the Candidate

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