CENTRAL SELECTION BOARD OF CONSTABLE, BIHAR, PATNA

RECRUITMENT FOR PROHIBITION CONSTABLES (Advt. No. 02/2022)

ACKNOWLEDGEMENT
REGISTRATION ID : 20169080 POST APPLIED FOR : PROHIBITION CONSTABLE

DATE & TIME : 24-11-2022 10:56:34

APPLICANT NAME : RUCHIKA KUMARI FATHER'S NAME : NARENDER KUMAR NIRALA

MOTHER'S NAME : SITA DEVI NATIONALITY : INDIAN

MOBILE NUMBER : 7050752117 EMAIL ADDRESS : RUCHIKAKTR2003@GMAIL.COM

ARE YOU A DOMICILE OF BIHAR STATE : YES RESERVATION CATEGORY : EBC

GENDER : FEMALE DATE OF BIRTH : 08-10-2003

MARITAL STATUS : UNMARRIED

AADHAR NO : 349330984787 IDENTIFICATION MARKS : A MOLE MARK ON FACE

ARE YOU A WARDS OF FREEDOM FIGHTER : NO

ARE YOU AN EX-SERVICEMAN : NO ARE YOU A GOVERNMENT EMPLOYEE OF BIHAR : NO

EDUCATION QUALIFICATION DETAILS

EXAM PASSED SCHOOL/ UNIVERSITY/ BOARD/ INSTITUTE PASSING CERTIFICATE NO CERTIFICATE ISSUED DATE
10 BSEB PATNA 140001208 26-06-2018
10+2 BSEB PATNA 209401309 24-03-2020

ADDRESS DETAILS

PERMANENT ADDRESS CORRESPONDENCE ADDRESS

HOUSE NO WARD NO-06 HOUSE NO WARD NO-06

STREET/MOHALLA JHARNA TOLA STREET/MOHALLA JHARNA TOLA

VILLAGE/TOWN JHARNA TOLA VILLAGE/TOWN JHARNA TOLA

POST OFFICE KEHUNIA POST OFFICE KEHUNIA

DISTRICT KATIHAR DISTRICT KATIHAR

STATE BIHAR STATE BIHAR

PIN CODE 854116 PIN CODE 854116

DECLARATION OF CRIMINAL CASES

HAVE YOU EVER BEEN DEBARRED BY UPSC, SSC OR SPSC OR ANY RECRUITMENT BOARD FROM APPEARING IN ANY EXAM : NO

CRIMINAL PROCEEDING DETAILS, IF ANY

A) WHETHER ANY FIR OR CRIMINAL CASE(S) HAS EVER BEEN REGISTERED AGAINST YOU : NO

B) WHETHER ANY CRIMINAL COMPLAINT CASE OR FIR OR CRIMINAL CASE(S) IS PENDING

AGAINST YOU IN COURT OF LAW,

NO
OR WITH POLICE AT THE TIME OF SUBMITTING THE
APPLICATION FORM :

C) HAVE YOU EVER BEEN ARRESTED/DETAINED IN ANY CRIMINAL CASE(S) : NO

D) HAVE YOU EVER BEEN TRIED & ORDERED OR ACQUITTED BY A COURT OF LAW IN ANY CRIMINAL CASE(S) : NO

E) HAVE YOU EVER BEEN TRIED & ORDERED BY THE COURT BY FILLING ANY BOND FOR GOOD BEHAVIOUR ETC. : NO

DECLARATION BY THE CANDIDATE

I HEREBY DECLARE THAT THE INFORMATION GIVEN ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF AND NOTHING HAS BEEN CONCEALED THEREIN. I AM
WELL AWARE OF THE FACT THAT IF THE INFORMATION GIVEN BY ME IS PROVED NOT TRUE, I WILL HAVE TO FACE THE CONSEQUENCES AS PER THE LAW. ALSO, ALL THE
BENEFITS AVAILED BY ME SHALL BE SUMMARILY WITHDRAWN.

English Signature Hindi Signature