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UTTAR PRADESH SECONDARY EDUCATION SERVICES SELECTION BOARD

I declare that I have Read the detailed User Manual and Notification
Notification Details (Examination)
Advertisement/Notification Number : 02/2021/ General

Uttar Pradesh Secondary Education Service Selection Board / PGT -

Applied For Post :
AGRICULTURE

Applied Under :
बालक वग� -कॉलेज / सं�थान (Boys Category - College /
Institute)

Candidate's Personal Details Photo and Signature

Application ID : UP0020091333002000414
Candidate Registration No. : UP00230020030752
Candidate Name : SUNIL KUMAR

Father's/Husband's Name : DHARAMPAL SINGH

Mother's Name : OMWATI

Gender - Date of Birth : Male - 04/06/1977

Are you Domicile of UP? / Category : Yes / OBC NON CREAMYLAYER

Are you Married? : Yes

Contact No./ Email-ID : XXX-XXX-7983 / ****ltomar0131@rediffmail.com

Bank Transaction Details

Bank Name - Payment Mode : State Bank Of India - INB

Fees, Transaction ID - Date : Rs. 750.00 , CPAASOLUO3 - 19/03/2021

High School & Intermediate Board,Year of passing & Roll Number Details

Examination Year of Roll Obtained Total

Board Name
Passed Passing Number Marks Marks

UTTAR PRADESH BOARD OF HIGH SCHOOL AND INTERMEDIATE

High School 1994 1319166 285 600
EDUCATION

UTTAR PRADESH BOARD OF HIGH SCHOOL AND INTERMEDIATE

Intermediate 1996 107005 549 1000
EDUCATION

Essential Qualification Details

Evalation
Year Certificate/ Roll Type
Sr. Equivalent State Name/
Essential Qualification Affirmation Of Number Obtained Percentage
No. Qualification Board/ Institution/ University
Passing Issuance Date Marks/
Total Mark

UTTAR PRADESH -
Graduation from a
Choudhary Charan Singh MARKS
recognized university D718177
1. Yes University, Meerut-250 004, 2000 1126.00 57.74
established by law in 09/02/2001
Uttar Pradesh. (State 1950.00
India.
University).

UTTAR PRADESH -
M.Sc. (Agriculture) from
Choudhary Charan Singh MARKS
a recognized university J714016
2. Yes University, Meerut-250 004, 2002 638.00 63.80
established by law in 23/06/2002
Uttar Pradesh. (State 1000.00
India.
University).

Preferential Qualification Details

Qualification Acquired

भारत म� �व�ध �वारा �था�पत �कसी मा�यता �ा�त �व�व�व�यालय से बी0एड0 उपा�ध अथवा एल0ट�0 उपा�ध। No

भारत म� �व�ध �वारा �था�पत �कसी मा�यता �ा�त �व�व�व�यालय से एम0एड0 उपा�ध । No

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भारत म� �व�ध �वारा �था�पत �कसी मा�यता �ा�त �व�व�व�यालय से डी0�फल0 उपा�ध या पी0एच0डी0 अह� ता । Yes

↓ Address Details ↓ Candidate's Permanent Address Candidate's Correspondence/Mailing Address

Name (C/O) : DHARAMPAL SINGH DHARAMPAL SINGH

House no./Village : 242 VILL POST MAKHIYALI 242 VILL POST MAKHIYALI

Street No./Post Office : MAKHIYALI MAKHIYALI

UTTAR PRADESH UTTAR PRADESH

State / District Name :
MUZAFFAR NAGAR MUZAFFAR NAGAR

Tahsil : SADAR SADAR

Police Station : NAI MANDI NAI MANDI

Block : MUZAFFARNAGAR MUZAFFARNAGAR

Village : NA NA

PIN : 251001 251001

�कस वग� के कॉलेज / सं�थान (बालक / बा�लका ) के �लए आवेदन ��तत ु करना चाहते है?
(For which Category of College / Institute (Boys / Girls ), do you want to submit the Application? )

आप अपना आवेदन �कस वग� के कॉलेज / सं�थान (बालक / बा�लका ) के �लए ��तत
ु
करना चाहते ह�? बालक वग� -कॉलेज / सं�थान (Boys Category - College / Institute)
For which Category of College / Institute (Boys / Girls ), do you want to submit
your Application? :

आपके �वारा भरा गया आवेदन प� केवल बालक वग� -कॉलेज / सं�थान (Boys Category - College / Institute) के �लए ह� चयन बोड� �वारा
अ��म काय� वाह� हे त ु �वीकाय� होगा | - Yes (हाँ)

Ad-hoc Teacher Details (तदथ� �श�क �ववरण) :

Are you currently an ad-hoc teacher in aided nongovernment secondary school of Uttar Pradesh?
No
( �या आप वत�मान म� उ�तर �दे श के सहायता �ा�त अशासक�य मा�य�मक �व�यालय म� तदथ� �श�क ह� ?) :

Declaration
1. I hereby declare that I have read all the provisions in the notice/advertisement of the examination carefully and hereby undertake to abide by them.

2. I further declare that I fulfill all the conditions of eligibility regarding age limits,educational qualifications etc. prescribed for admission to the examination.

3. I decalre that my claim for reservation as SC /ST/OBC candidate's are true and correct and I am in possession of my caste certificate in the prescribed format given in
the notice/advertisement of the examination .I also declare that as per Govt. order No.22/16/92/T.C.-III DATED 22-10-2008 I do not belong to the person/sections
(creamy layer) mentioned in it.

4. I (for male candidates ) also declare that I have no more than one wife living/(for female candidates) have not married a man already having a wife living.

5. I also declare that I have never been convicted by any court of law. I also declare that no criminal case is pending against me. Further declare that I have never been
dismissed or removed from Govt. Service or my service been terminated during probation.

6. I hereby declare that all the entries /statements made in this application are true ,complete and correct to the best of my knowledge and belief. In the event of any
information being found false or incorrect or ineligibility being detected before or after selection the Board can take action against me as per rules in case it is detected
that I have mislead the Board on any issue then I will solely responsible for all penal consequences thereof.

I accept the above declaration : Yes

↓ Current status of application ↓

Your application is under processing.
Application Form Submission Date : 20/03/2021 , Time : 7:11:35 PM
Application Form printing Date & Time : [ 20/03/2021 ,7:17:33 PM ]

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