J&K SERVICES SELECTION BOARD

GOVERNMENT OF JAMMU & KASHMIR

APPLIED APPLICATION FORM FOR DIVISION/DISTRICT CADRE POSTS

NAME OF POST - Animal Keeper
Application ID - 464017
Date - 2021-05-08 10:22:45
ADVERTISEMENT NUMBER - 2 OF 2021

Post Department Sub Department Cadre

Animal Keeper Health & Medical Education (Indira Gandhi Govt Dental Div.Jammu (Item No. 412)
college Jammu)

PERSONAL DETAILS
Full Name Father's Name

Mr. subash chander Tara chand

Mother's Name Gender

phambi devi Male

Date Of Birth Age as on 01.01.2021

03/15/1994 26

Mobile Number Email Whether Married

8492809721 subashchander2012@gmail.com Yes

Whether you are Domicile of Jammu and Kashmir or not? Division District

yes jammu Udhampur

Has Domicile Certificate been issued

(Domicile Certificate needs to be produced at the time of Document Verification)

yes

Certificate Number Certificate Issuing Authority

DOM/0401/14aug2020/16841501 Tehsildar Chenani

Permanent Address
House No./ Room No. Locality/ Mohalla/ Ward Number Village/ Town/ City

mandlote 02 mandlote

Division District Tehsil

jammu Udhampur Chenani

Block Panchayat Pincode

Chenani pachote 182142

Correspondence Address
House No./ Room No. Locality/ Mohalla/ Ward Number Village/ Town/ City

mandlote 02 mandlote

Division District Tehsil

jammu Udhampur Chenani

Block Panchayat Pincode

Chenani pachote 182142

Category of Applicant
Category

ST

Date of Issue of Certificate Issuing Authority

23/02/2011 TEHSILDAR chenani

Are you Specially Abled Person (PH)?

No

Are you an employee of J&K Government?

No

Are you an Ex-Servicemen?

No

Have you ever been selected for any other Government Job under ESM Category?

No

Criminal Proceedings
Whether any FIR has been lodged/registered against you?

No

Whether any prosecution is pending in any Court of Law against you?

No

Whether any Chargesheet has been filed against you?

No

Whether you have been convicted by any court of competent jurisdiction in any offence?

No

Was any Court Case been filed against you?

No

Whether any disciplinary action has been initiated by Government/Semi-Government Organisations against you?

No

Qualification Details
Middle School/Institute/Board Name Middle Percentage Middle Result Date

govt gms mandlote 40 29/11/2008

Obtain Marks Maximum Marks

100 250

Other Details
Do you possess the prescribed educational qualifications as per the advertisement / notification? Choice of Examination Center at

Yes Jammu Division

Declaration
I hereby declare that I have carefully read the Advertisement Notification for this post and all the terms and conditions indicated therein and undertake to
abide by the terms and conditions of the advertisement / notification for participating in the selection process. I fulfill all the terms and conditions
mentioned in the advertisement notification and the information provided by me herein is true and correct to the best of my knowledge. I also undertake
that in case of failure to possess the qualification prescribed in the advertisement notification, the board will be fully competent to debar me from the
selection process. I further stipulate that I have carefully read the Government notification and assure that I am not barred by the provisions of the said
notification. I further undertake that I shall not claim any benefit of any qualification/category that have not specifically indicated in this online application
form. Further, I am aware that I will be liable for appropriate penal action, disqualification from the selection process or loss of the job in the event of
selection having been made, if the information provided by me is proved to be incorrect at any stage. The charges for filling up the form are Rs.350 and
are non-refundable. I am aware that I shall not have claim over the charges, once successfully paid to J&K Services Selection Board, J&K. All the disputes
related to refund of excess payment, if any, are subject matter of the J&K Service Selection Board. Candidates are advised to apply for refund of excess
payment, if any, through official portal www.ssbjk.org only. No chargeback request shall be entertained. Do you agree(Yes)?

-
ONLY FOR INSERVICE CANDIDATES
SIGNATURE WITH
CERTIFIED THAT S/O W/O D/O
STAMP OF HEAD OF
IS WORKING AS______________________________________________________________________
DEPARTMENT
IN
From
To _________________________
ON BASIS

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