FORMAT OF APPLICATION FORM

1. Name: Khetrabasi Biswal

2. Father's Name : Sh. Suman Biswal
3. Date of Birth: 19-06-1963
4. Correspondence address (including e-mail): Ministry of Law &
Justice (Legislative Department), Shastri Bhawan, Room No. 423, A-
Wing,New Delhi-110001
5. Telephone No. 9868212872
6. Educational qualification (With supporting documents): B.A.
(Hons), LL.B. LL.M.
7. Experience (with supporting documents): As per Annexure-A’.
8. In case of retired/serving Govt. employee, present/last post held and
office: Additional Secretary, Ministry of Law & Justice, Legislative
Department, Shastri Bhawan, New Delhi.
9. List of self certified documents attached with the application:
I certify that the above information is correct to the best of my
knowledge and belief. If anv information is found incorrect, my
candidature may be cancelled.

(KHETRABASI BISWAL)
(Name and signature of the candidate)
Place:
Date:

Note: Please enclose supporting papers (viz. proof of date of birth,

education qualification and experience in respective fields, resume etc.).