ONLINE APPLICATION FORM

  Application No. : AR-2022/333781 Affix recent  

1. Name of the Trade Applied for : Havildar (Clerk) [CLK] passport size  
2. Applied Under Caste*: General colour  
Religion, Caste Belongs to* :         (if
Photo(Size -
3. HINDU  -  GENERAL 4.5cm x  
belongs to SC/ST/OBC)
4. Domicile State : UTTAR PRADESH 3.5cm)  
5. Gender, Marital Status  : MALE  /  Single    
6. Name of the Candidate & Date of Birth MR.   HARSHIT KUMAR SINGH  / 
(as in Matriculation Certificate) :  
15 May 1998
Father's Full Name  (as in
7. Matriculation Certificate) : SHANKAR SINGH
8. Correspondence Address: L 41 VDA COLONY SHIVPUR, VARANASI, PIN - 221003
(UTTAR PRADESH)
9. Permanent Address: HNO 112 SHIVPUR KAPUR DIAR (DERA)( C/O NAND JI
SINGH), BALLIA, PIN - 277216 (BALLIA)
10. Mobile No., Email & Aadhaar Card No. 9616799691   harshitkrsingh98@gmail.com  
904187706966
11. Details of Educational Qualification* (Govt./Govt. Recognised Institute/Organization only)
Compulsary
Qualification Univ/Board PassingYear MarkObtained TotalMarks Percentage
Subject/Trade
  CBSE
12th --NA-- 2016 405 500 81.00
BOARD
  Experience if any* (Govt./Govt. Recognised Institute/Organization only) :
Exp Period of
Experience InstituteName
Trade Experience
  Typing speed 35 WPM in English and 30 GALAXY TYPE WRITING & ANSULIPI 0 YEAR 2
--NA--
WPM in Hindi TRAINING CENTRE MONTH
13. Whether Ex-ServiceMan* : NO
 
14. Whether Sport Man* : NO    
 
15. Recruitment Type : Advt Applied Candidate
 
STATE
Bank Challan Bank Challan 02
BANK
16. No/Online Payment DUJ2963428 Date/Online Payment Jul Amount: 100 Bank:
OF
Challan No: Challan Date: 2022
INDIA
17. Community Certificate : --NA--
18. Criminal Proceedings details, if any : --NA--
Is EWS(Economically Weaker
19. Sections) : --NA--
  Declaration :
  I, hereby solemnly declare that, all the statement made in the above application are true
and correct to the best of my knowledge and belief. I fully understand that in the event of
any information/document being found false/incorrect or ineligibility being detected at any
stage, appropriate action can be taken against me and my candidature be rejected/made
null and void by the Assam Rifles authorities.
Note:- *Date, Time and location/site for PST/PET and Written Examination will be
intimated through Assam Rifles official website www.assamrifles.gov.in. You are instructed
  to check your status after two weeks of last date and time for receipt of online applications.
You are requested to bring this form with photocopies of all required certificates at the
time of reporting to PST, PET and Written Examination Board.
 
App Date :   
Place :   VARANASI Signature :   
02/07/2022
Date :   28/09/2022 Name of the Applicant :   HARSHIT KUMAR SINGH
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