CENTRAL SELECTION BOARD OF CONSTABLE, BIHAR, PATNA

RECRUITMENT FOR BIHAR POLICE CONSTABLES (Advt. No. 01/2023)

ACKNOWLEDGEMENT
REGISTRATION ID : 82294812 DATE & TIME : 18-07-2023 12:51:26

POST PREFERENCES: 1. DISTRICT POLICE     2. BSAP     3. OTHER UNITS    
APPLICANT NAME : SHAMSHAD ALAM FATHER'S NAME : SARFUDDIN HUSSAIN

MOTHER'S NAME : ZAHIDA KHATOON NATIONALITY : INDIAN

MOBILE NUMBER : 9123113487 EMAIL ADDRESS : ALAMSHAMSHAD619@GMAIL.COM

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

ARE YOU HOMEGUARD OF BIHAR STATE: NO

GENDER : MALE DATE OF BIRTH : 11-09-1997

MARITAL STATUS : UNMARRIED

AADHAR NO : IDENTIFICATION MARK : MOLE IN RIGHT LEG

ARE YOU A WARDS OF FREEDOM FIGHTER? NO

EDUCATION QUALIFICATION DETAILS

EXAM PASSED SCHOOL/ UNIVERSITY/ BOARD/ INSTITUTE PASSING CERTIFICATE NO CERTIFICATE ISSUED DATE

10 DAV CENTENARY PUBLIC SCHOOL BANIAHIR 1024240 30-05-2013

10+2 DAV CENTENARY PUBLIC SCHOOL BANIAHIR 620604 25-05-2015

ADDRESS DETAILS

PERMANENT ADDRESS CORRESPONDENCE ADDRESS

HOUSE NO HOUSE NO. 134 HOUSE NO HOUSE NO 43

STREET/MOHALLA BHULLO STREET/MOHALLA AT LODNA ISLAMPUR NEAR MADARSA

VILLAGE/TOWN SIKANDRA VILLAGE/TOWN JHARIA

POST OFFICE SABALBIGHA POST OFFICE LODNA

DISTRICT JAMUI DISTRICT DHANBAD

STATE BIHAR STATE JHARKHAND

PIN CODE 811315 PIN CODE 828131

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 & CONVICTED OR ACQUITTED BY A COURT OF LAW IN ANY CRIMINAL CASE(S)? NO

E) HAVE YOU EVER BEEN TRIED & CONVICTED 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SHALL BE SUMMARILY WITHDRAWN.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