7/16/22, 8:57 AM Services Selection Board - Jammu & Kashmir

J&K SERVICES SELECTION BOARD

GOVERNMENT OF JAMMU & KASHMIR

APPLICATION FORM FOR DIVISION/DISTRICT CADRE POSTS

NAME OF POST - Junior Engineer (Civil)
Application ID - 1404165
Date - 17-11-2021 21:20:39
ADVERTISEMENT NUMBER - 5 OF 2021

Post Department Sub Department Cadre/Item No.

Junior Engineer(Civil) Jal Shakti Jal Shakti UT (Item No. 689)

PERSONAL DETAILS
Full Name Father's Name

Mr. ATHER FAROOQ BHAT Farooq Ahmed Bhat

Mother's Name Gender

Dilshada Begum Male

Date Of Birth Age as on 01.01.2021

01-June-1994 26

Mobile Number Email Whether Married

8825058092 HASIMATHER@GMAIL.COM No

Division District

kashmir Baramulla

Domicile Certificate Detail

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

Certificate Number Certificate Issuing Authority

Dom/1805/04feb2021/120801281 Tehsildar

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

32 Naseembagh Naseembagh sopore

Division District Tehsil

kashmir Baramulla Sopore

Block Panchayat Pincode

Sopore Sopore 193201

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

32 Naseembagh Naseembagh

Division District Tehsil

kashmir Baramulla Sopore

Block Panchayat Pincode

Sopore Sopore 193201

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7/16/22, 8:57 AM Services Selection Board - Jammu & Kashmir

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 Organizations against you?

No

Qualification Details
10th Board 10th Percentage 10th Result Date

Jammu & Kashmir Board Of School Education 49.8 12/01/2011

10th Obtain Marks 10th Maximum Marks

249 500

12th Board 12th Percentage 12th Result Date

Jammu & Kashmir Board Of School Education 58.8 23/01/2013

12th Obtain Marks 12th Maximum Marks

294 500

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7/16/22, 8:57 AM Services Selection Board - Jammu & Kashmir

Diploma

Yes

Diploma Name Diploma Institution/University Percentage Result Date

Degree in Civil Engineering I.K GUJRAL PUNJAB TECHNICAL UNIVERSITY JALANDHAR 68.67 22/02/2018

Obtain Marks Maximum Marks

4395 6400

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

Yes Kashmir 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/-
(Three Hundred Fifty only) 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

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