Hkkjrh; i’kqikyu fuxe fyfeVsM

Mhyj vkosnu i=
RECENT PASSPORT
fuEu tkudkjh vko’;d :i ls HkjsaA SIZE COLORED
PHOTOGRAPH
vkosnd dk uohure
jaxhu ikliksVZ lkbZt+
QksVks
vkosnd dk uke

vkosnd dk O;olk;

firk dk uke

eksckbZy uEcj

esy vkbZ-Mh-
Mh-

rglhy

ftyk

i= O;ogkj vkSj Mkd Hkstus dk irk

¼foi.ku foHkkx½
Hkkjrh; i’kqikyu fuxe fyfeVsM
, lh 4] xk;=h lnu] xk;=h ekxZ] ftyk ifj"kn ds lkeus
lokbZ t;flga gkbos] cuhikdZ]t;iqj]jktLFkku fiu& 302016
Website-www.bharatiyapashupalan.com/Email-bharatiyapashupalan@gmail.com
 PERSONAL INFORMATION
(IN CAPITAL LETTERS)
1. ekrk dk uke .……………………………………………….
2-tUe frfFk ¼DD/MM/YY)------------------------------------------------------¼’kCnksa esa½-----------------------------------------------------------
1 uoEcj 2021 dks iw.kZ dh xbZ vk;q & o"kZ------------------- eghus-------------------------- fnu--------------------------
LFkkbZ Mkd dk irk ----------------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
3- ’kS{kf.kd ik=rk
d{kk cksMZ@fo’ofo|ky; dk uke mrh.kZ o"kZ izkIrkad izfr’kr

¼mijksDr dh vadrkfydk ,ao izek.k i=kas dh LogLrk{kfjr izfr;k¡ layXu djas½

4- dk;Z vuqHko
laxBu dk uke in dk uke dc ls dc rd mÙkjnkf;Ro

5- vkosnu ’kqYd & vkosfnr in rFkk 'kqYd ds ckWDl esa d`i;k mfpr fpUg ¼ ½yxk;s
Ø-l- in vkosnu ’kqYd
1- Mhyj 1180 :-

Hkkjr ljdkj ds funsZ’kkuqlkj vkosnu ’kqYd esa 18%

18 GST ’kkfey
esjs }kjk ------------------------------------gsrq vkosnu fd;k x;k gSA eSa rglhy ----------------------------------- ftyk ---------------------------
---dh Mhyj’khi ysuk pkgrk gw¡A ftldk vkosnu ’kqYd : 1180@& tfj;s -----------------------------cSad ds pkyku
}kjk ftldh Payment I.D ---------------------------------------gS rFkk pkyku dh fuxe izfr bl vkosnu i= ds lkFk
layXu dj jgk gw¡@dj jgh gw¡ d`i;k Lohdkj djsaA

uksV%& ICICI/UNION cSad utnhd es ugh gksus dh voLFkk esa fdlh Hkh cSad ls mfpr ’kqYd dk fMek.M
Mªk¶V Bhartiya Pashupalan Nigam Limited Jaipur ds uke lyaXu dj Hkstk tk ldrk gSA

fnukad% vkosnd ds gLrk{kj

6- in vuqlkj dk;Z nkf;Ro
1- vkids }kjk fuxe ds mRikn Lis’ky xksYM nw/k/kkjk dSfY’k;e lhji ¼5 yhVj½ QhM lIyhesaV dk izR;sd ekg dqy
¦ ¦ 1]00]000 dk vkWMZj ykuk gSA
2- ;g vkWMZj vki fdlh Hkh easfMdy LVksj] [kkn cht Hk.Mkj] Ms;jh] nqX/k laxzg.k dsUnz] fdjkuk LVksj laLFkk] xkS’kkyk]
¦ ¦ fdlku@i’kqikyd ;k vU; fdlh Hkh foØsrk ds ek/;e ls yk ldrs gSA
3- vkidk dk;Z {ks= laEiw.k iapk;r Lrj esa gksxk vki iapk;r esa dk;Z dj y{; iwjk djsaxsA

7- Mhyj ykHk %&

1- Lis’ky XkksYM nw/k/kkjk dSfY’k;e ¼5 yh- dSu½ ,d lhji gSA 5 yhVj dSu dh MRP 925/- fu/kkZfjr gSA Mhyj
dks ;g dSu MLdkmaV ds lkFk 525/- :i;s esa vkids }kjk crk;s x;s utnhdh VªakLkiksVZ ij miyC/k djok;h
tk;sxh A

vU; ykHk %&

¼1-½ Mhyj }kjk N% ekg dk LVkWd ,d lkFk mBkus ij eksVj lkbZfdy QhYM mi;ksx gsrq miyC/k djkbZ tk;sxh rFkk
vU; NwV ykHk Hkh fn;sa tk;sxsA

8- ik=rk ,ao ’kS{kf.kd

{k{kf.kd ;ksX;rk %&
¼1-½ Mhyj ’kS{kf.kd ;ksX;rk
¦¦¦ ¼i) Hkkjr es fdlh Hkh ekU;rk izkIr cksMZ@LkaLFkk ls nloha d{kk mRrh.kZ
¦ ¼ii½ i’kq fpfdRlk@i’kq ikyu esa fMxzh@fMIyksek ,ao vuqHko j[kus okys vkosnd dks p;u esa izkFkfedrk nh ¦
¦¦ tk;sxhA
¼2-½ vk;q lhek &U;wure 25 o"kZA
vU; ;ksX;rk,sa %&
¦¦¦¦ ¼i½ LokLF; & fuxe es fjDr inks ij HkÙkhZ ds fy, mEehnokj vPNs ekufld vkSj ’kkjhfjd LokLF; gksuk
¦¦¦¦¦ pkfg, ¦
¦¦¦¦ ¼ii½ pfj= & fuxe es lh/kh HkÙkhZ ds fy, vkosnd dk pfj= vPNk@mRre gksuk pkfg,A

?kks"k.kk
"k.kk i=
eSa mijksDr vkosnd ?kks"k.kk djrk@djrh gw¡ fd
¼1-½ pkgs x;s ekin.Mkuqlkj vk;q iw.kZ djrk@djrh gq¡ ,oa esjh fdlh Hkh izdkj dh vkijkf/kd i`"BHkwfe ugha gS]
¼2-½ mijksDr Js.kh ftl gsrq eSuas vkosnu fd;k gS dh vko';d tkudkjh] fu;e ,oa ’krsZa esjs }kjk HkyhHkkafr i<+ ,oa le>
¦ yh xbZ gS]
¼3-½ mijksDr of.kZr esjs }kjk nh xbZ tkudkjh lgh o lR; gSA esjs }kjk dksbZ Hkh rF; fNik;k ugha x;k gSA eSa ¦¦ ¦
¦¦tkurk@tkurh gw¡ fd vkosnu 'kqYd dh jkf'k vizfrns; gS]
¼4-½ ;g eSaus Lo;a dh bPNk ls mijksDr of.kZr lHkh tkudkjh Lohdkj ,oa gLrk{kfjr dh gSA ;g eSaus fdlh ckgjh ncko
¦ esa] tcjnLrh ls ;k cgdkos esa vkdj ugha fd;k gSA leLr izdkj ds dkuquh fooknksa ds lEcU/k esa U;k; {ks= mRrj]
¦ {kS=h; dk;kZy; t;iqj ¼jktLFkku½ gh gksxkA

fnukad% vkosnd dk uke o gLrk{kj

 vko';d lwpuk,sa
vkosnu izkFkZuk i= ds lkFk lyaXu fd;s tkus ;ksX; nLrkost %&

1- Loa; }kjk lR;kfir 'kS{kf.kd vadrkfydk ,ao vuqHko izek.k i= dh izfr

2- ,d ikliksVZ lkbt QksVks vkosnu i= ij fpidk;as] nks vfrfjDr QksVks lyaXu djasA
3- igpku ,ao irs ds lR;kiu gsrq vk/kkj dkMZ @ igpku i= dh izfr lyaXu djsaA
4- cSad }kjk cuk;s x;s pkyku dh fuxe izfr lyaXu djsA

lkekU; tkudkjh %&

1 futh {ks= dh ifCyd fyfeVsM+ dEiuh Hkkjrh; i’kqikyu fuxe fy0 dh LFkkiuk 2009 esa dh xbZ FkhA
2- i'kqikyu ds {ks= esa mRikn fcØh dks lapkfyr djus gsrq izns’k ds lHkh ftyksa esa dk;Z fd;k tkuk
¦izLrkfor gSaA
3- lyaXu cSad pkyku dks Hkjdj in vuqlkj fu/kkZfjr pkyku QkeZ dks ’kqYd lfgr utnhdh ICICI/ UNION
¦ cSad esa tek djkosaA vkosnu i= ds lkFk cSad }kjk cuk;s x;s pkyku dh fuxe izfr lyaXu djsA
4- vkosnu laca/kh leL;kvks ds fy, gsYi ykbu uEcj 0141&2202271@9351899199 ij LkEidZ djsaA
5- vkosnu 'kqYd dh jkf’k vizfrns; gS ¼okilh ns; ugha gSA½
6- Mhyj gsrq mRikn fuos’k jkf’k ¼mRikn izkfIr gsrq tek dh tkus okyh jkf’k½ fuEu izdkj gSA
Mhyj & 1]00]000@&
;g jkf’k ?kks"k.kk i= ds lkFk layXu pkyku ds }kjk tek djokukh gSA
p;u dk vk/kkj %&

1- vkosnu i= izkfIr ds i’pkr dkxtkr ,ao vuqHko ds vk/kkj ij p;fur djus ,ao lk{kkRdkj dh lwpuk
Mkd@bZ esy ¦vkbZ&Mh ds }kjk nh tk;sxhA
2- p;fur vkosnd dks p;u lwpuk dh esy ds lkFk dk;Z ds laca/k esa vuqca/k ?kks"k.kk i= Hkstk tk;sxk
ftls 100 : ds ¦LVkEi ij uksVsjh djokdj e; fu/kkZfjr fuos’k jkf’k ds lkFk tek djkuk gksxk A
3- 100% mRikn jk’kh tek djokus ,oa ?kks"k.kk i= Hkstus ij vkosnd dks ,d fnolh; izf’k{k.k fn;k
tk;sxk A

(SIGNATURE OF APPLICANT)
¦¦¦ vkosnd ds gLrk{kj
 GENERAL SLIP GENERAL SLIP GENERAL SLIP
Bhartiya Pashu Palan Nigam Limited Bhartiya Pashu Palan Nigam Limited Bhartiya Pashu Palan Nigam Limited
Bank Copy Applicant Copy Nigam Copy
Payment ID No: Payment ID No: Payment ID No:
A/C No. 678105117913 A/C No. 678105117913 A/C No. 678105117913
Bank Name: ICICI BANK Bank Name: ICICI BANK Bank Name: ICICI BANK
Branch: S.P. MARG Branch: S.P. MARG Branch: S.P. MARG
JAIPUR JAIPUR JAIPUR
Name: Name: Name:
POST: POST: POST:
Father’s Name: Father’s Name: Father’s Name:
Session: 2021-22 Session: 2021-22 Session: 2021-22
……………………………………………………..……………………… ………………………………………...…………………………………… ………………………………………….…………………………………
…. …. ….
Payment: CASH Payment: CASH Payment: CASH
Bank Name: ICICI Bank Name: ICICI Bank Name: ICICI
Branch: Branch: Branch:
Amount: Amount: Amount:
Denomination Rs. Ps. Denomination Rs. Ps.
Denomination Rs. Ps.
500 x 500 x
500x
100 x 100 x
100x
50 x 50 x
50x
Total Total
Total
Deposit Date: Deposit Date:
Deposit Date:
Sing. & Seal of Bank Sing. & Seal of Bank
Sing. & Seal of Bank
Sing. & Mob. No. of Candidate Sing. & Mob. No. of Candidate
Sing. & Mob. No. of Candidate
POST CODE :- BPNL POST CODE :- BPNL POST CODE :- BPNL
 GENERAL SLIP GENERAL SLIP GENERAL SLIP
Bhartiya Pashu Palan Nigam Limited Bhartiya Pashu Palan Nigam Limited Bhartiya Pashu Palan Nigam Limited
Bank Copy Applicant Copy Nigam Copy
Payment ID No: Payment ID No: Payment ID No:
A/C No. 755301010050034 A/C No. 755301010050034 A/C No. 755301010050034
Bank Name: UNION BANK
Bank Name: UNION BANK Bank Name: UNION BANK Branch: JHOTWARA
Branch: JHOTWARA Branch: JHOTWARA JAIPUR
JAIPUR JAIPUR Name:
POST:
Name: Name:
POST: POST: Father’s Name:
Session: 2021-22
Father’s Name: Father’s Name:
………………………………………….…………………………………
Session: 2021-22 Session: 2021-22
……………………………………………………..……………………… ………………………………………...…………………………………… ….
Payment: CASH
…. ….
Bank Name: UNION
Payment: CASH Payment: CASH
Branch:
Bank Name: UNION Bank Name: UNION
Branch: Branch: Amount:
Denomination Rs. Ps.
Amount: Amount:
Denomination Rs. Ps. 500 x
Denomination Rs. Ps.
500 x 100 x
500x
100 x 50 x
100x
50 x
50x
Total
Total
Total
Deposit Date:
Deposit Date:
Sing. & Seal of Bank
Deposit Date:
Sing. & Seal of Bank
Sing. & Seal of Bank
Sing. & Mob. No. of Candidate
Sing. & Mob. No. of Candidate
Sing. & Mob. No. of Candidate
POST CODE :- BPNL POST CODE :- BPNL POST CODE :- BPNL