J&K SERVICES SELECTION BOARD

GOVERNMENT OF JAMMU & KASHMIR

APPLIED APPLICATION FORM FOR DIVISION/DISTRICT CADRE POSTS

NAME OF POST - Wild Life Guard
Application ID - 714798
Date - 21-06-2021 12:13:51
ADVERTISEMENT NUMBER - 3 OF 2021

Post Department Sub Department Cadre/Item No.

Wild Life Guard Forest ,Ecology and Chief Wildlife Warden, J&K Div.Jammu (Item No. 605)

Environment Department

PERSONAL DETAILS
Full Name Father's Name

Mr. Ajay Singh Subash Chander

Mother's Name Gender

Anita Devi Male

Date Of Birth Age as on 01.01.2021

03-September-1996 24

Mobile Number Email Whether Married

6005323160 singhajjay00@gmail.com No

Division District

jammu Udhampur

Domicile Certificate Detail

NOTE :- Domicile Certificate needs to be produced at the time of Document Verification.

Certificate Number Certificate Issuing Authority

DOM/0404/01jul2020/105751552 Tehsildar

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

No 08 Hartaryan

Division District Tehsil

jammu Udhampur Ramnagar

Block Panchayat Pincode

Ghordi Hartaryan 182124

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

No 08 08

Division District Tehsil

jammu Udhampur Ramnagar

Block Panchayat Pincode

Ghordi Hartaryan 182124

Category of Applicant
Category

OM

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
10th Board 10th Percentage 10th Result Date

Jammu & Kashmir Board Of School Education 54.8 30/05/2011

10th Obtain Marks 10th Maximum Marks

271 500

12th Board 12th Percentage 12th Result Date

Jammu & Kashmir Board Of School Education 54.8 10/05/2013

12th Obtain Marks 12th Maximum Marks

271 500

Physical Standards.

(1) Male -163 cms height.

(2) Female -150 cms height

Yes
Physical Fitness Test Walk to be completed in four hours on Foot.

(a) Male -25 kms.

(b) Female -16 kms

Yes

Physical fitness certificate from CMO

Yes

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 JAMMU AND KASHMIR Services Selection Board,
JAMMU AND KASHMIR. All the disputes related to refund of excess payment, if any, are subject matter of the JAMMU AND KASHMIR Service Selection
Board. Candidates are advised to apply for refund of excess payment, if any, through official portal www.ssbjk.org.in only. No chargeback request shall be
entertained. Do you agree?
*

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