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Bian conse Guard Application for Assistant Commandant CGCAT-2025 EB) Application Status Name Registration No. Post Applied Mr Shivam 2402608004071 General Duty (6D) Date of Birth category Payment Status 10-May-1999 Other Backward Class (OBC) Paid (Non-creamy) Date of application form submitted on 23-Feb-2024 & Personal Information Notes: + Name as recorded inthe matrculation/secondary examination certiiate + Name (Candidate's/Father’s/Mother's Name) given in the application and all the uploaded documents Le ID Card, educational certificates, category certfiate(SC/ST/OBC/EWS) or any ether uploaded document should be same or else the candidature will be cancel + Gender can't be changed further at any subsequent stage of recruitment. E-mail ID and mobile number once entered can't be changed during the entire recruitment process. Hence, please use a working E-mail ID {& mobile number Candidate iste ring same 1D card (provided here) in riginal at all tages of recruitment. ‘wo different Permanent Identification Marks on the Body such as birthmark, mole and burs/injury mark i to be entered a5 text candi Scanned document should be saved in jpeg /jpg format and size should be between SOKB to 150KB. All the uploaded documents must be in Hindi or English Hf, the document is in any language other than English oF Hindi then candidate is to upload both eriginal and English translation of document as one file/document (after merging beth documents) in the online application, + lickers for specimen of document. class 10% marksheet/certiicate with date of birth mentioned a5 date of birth proof se Birth cetifiate to be + Candidates belonging to OBC but coming in the ‘Creamy layer’ are to apply as unreserved candidate. + OBC certificate shall be as per Govt. of india format (No other format will be entertained). + OBC candidate availing their respective quota, must ensure that valid category certificate should have been issued (date of issue) on or before the closing date of application. + Validity of OBC certificate has to be atleast upto 30 Nov 24, Name Name as on Id Card Father's Name Mother's Name Mr Shivam, Shivam Dinesh Kumar Pramila Email Id Mobile Nationality Marital Status rohillashivam299@gmail.com — XXXXXXXXXX Indian Unmarried Gender De You Have Aadhaar Card? Id Card Id Card Number Male ve Aadhaar Card 2OOKXXHNK23S6 Permanent Identification Permanent Identification Category Date of Issue of Category Mark 1 on the Body Mark 2 on the Body Other Backward Class (OBC) Certificate Mole On Hand Mole On Neck (Non-creamy) 22-Jul-2016 Category Certificate Valid Date of Birth Date of Birth Certificate Type Age Relaxation Upto 10-May-1999 10th Class Availed Always Valid Marksheet/Certificate Fee Waiver Cl Employment Type Got information about Indian Not Availed Unemployed Coast Guard recruitment Official ICG website JS Class 12" Details Notes: *+ 12 class marksheet and certificate need to be uploaded at Stage + If your education board is not listed in the dropdown, then select “OTHERS” option from dropdown. Provision is aval Name of the Education appropriate stage of qualifier inthe recruitment process. + Please check aggregate percentage before submission, any wrong cancellation. + You need to submit aggregate percentage upto 3 deck you have to fil "63.377 ONLY" and "NOT 63. Central Board of Secondary Education 12° Certificate Number 039531 Aggregate Percentage 72.800 F Graduation Details Notes: * Gr places without ble to enter the ard, in case of "OTHERS" option is selected, Relevant original certificates and markshests are to be produced at lulation of percentage will lead to application/ Candidature nding off. ef your aggregate percentage Is 63.3779 then Grading System Indicated in Year of Passing Marksheet 2016 Percentage ‘Subject ‘Mathematics Physics Obtained Marks n rR ‘Maximum Marks 100 100 luaton Year/ Semester/ Trimester wise marksheet and degree certificate need to be uploaded at Stage-Il + If your university is not listed in the dropdown, then select "OTHERS" option from dropdown. Provision is ava le to enter the Name of the University, in case of “OTHERS” option is selected. Relevant original certificates and marksheets are to be produced at appropriate ler inthe recruitment process. + Please check aggregate percentage before submission, any wrong calculation of cancellation. + While determining the minimum percentage of marks for igiblty, only the original wh ercentage will lead to application/ Candidature umber (without rounding off) of the percentage shall be taken inte account. Fractional value shall not be considered for determining eligibiliy. 9. UR/OBC candidates scoring 58.9% or SC/ ST candidate scoring $4.9% in degree are not eligible. + Fo eligible candidates, rounded off of percentage is tobe carried out a nly whole number isto be entered in the online cation form. Procedure for carrying out rounding off of percentage (ony for eligible candidates) sas follows: [If the first fractional digit after decimal 60.5 will rounded off as 60. the firs fraction = 60.9 will be rounded off 3861 nt is from 0 to 5, the percentage will rounded to the original whole number. Eg. 60.1 ligit after decimal point is from 6 to 9, the percentage will be rounded to the next higher whole number. Eg. 60.6, Course Duration Graduation Degree Graduation Stream Name of University 3 Years Reiner cee Metenene Guru Jambeshwar University of Science Year of Passing Grading System Indicated in Aggregate Percentage of all 2022 Marksheet Years/Semesters/Trimesters Percentage 6 Yearm/ Semester(S)/ Y-1S-1) -¥-1-2)¥-2(8-1)—¥-2(S-2)¥-3(6-1)_—¥-3(8-2) ‘Timester(T) Obtained Marks 496 522 408 321 408 356 Maximum Mares 900 900 550 550 550 550 © Post Selection Post Applied General Duty (GD) @Ad al Details 1. Whether having NCC ‘A/B/C’ Certificate ? No 2. Has any warrant or summons for your appearance as witness been issued and pent 19 before a court of law for the time being in force? No 3. Are any proceedings in respect of an offence alleged to have been committed by you pending before a criminal court in India ? No 4, Has any warrant or summons for your offence been issued and pending before a court of law for the time being in force? No 5. Has a warrant for your arrest been issued by a court under any law for the time being in force ? No 6. Have you, at any time preceding the date of this application, been convicted by a court of India for any offence and sentenced in respect thereof to imprisonment ? No 7. Have you applied in higher court for acquittal against the conviction of lower court? No 8. Have you ever been debarred by ICG / Army / Navy / Air Force / UPSC / Central or State govt. during any recruitment process ? No 3% Communication Details Notes: + In case of reserved category applicants, availing age relavation, ether current or permanent address of online application should be same as the address mentioned in easte/eategory certiieate (SC, ST and OBC (Non-Creamy Laye)) Permanent Address House/Street Landmark. Post Office Country HNO. 2 \VPO DHIGAWA JATAN \VPO DHIGAWA JATAN India State/ UT ict Pin Code HARYANA Bhiwani 127201 Phone no with Area Code NA. Present/Current Address House/Street Landmark Post Office Country H.NO. 2 \VPO DHIGAWA JATAN, \VPO DHIGAWA JATAN India State/ UT District Sub District Pin Code HARYANA Bhiwani Loharu 127201 Phone ne with Area Code NA. {@ Photo and Signature Notes: + Glickhuere for specimen of photograph. *+ While uploading Photo / Signature / Thumb image, file nomenclature should be as followed: sspert photograph: Passport, Photograph Ii. Scanned signature image: Signature ii, eft and thumb impression image: Left-Thumb Impression |v. Right hand thumb impression image: Right Thumb Impression Photograph Live Photograph Scanned Left Hand Thumb Right Hand Signature Impression Thumb E ' Impression i I Exam City Preferences for Stage-1 *+ Your selected 5 preferences must be nearest to present address in increasing order of distance. *+ Non-compliance to these instructions may lead to cancellation of your candidature during document verifeatio 1.Delhi and NCR 2.Noida/Greater Noida 3.Chandigarh AJaipur labad IM Exam City Preferences for Stage-Il Noi 2.Goa 3.Chennai A.Kolkata List of Uploaded Documents Notes: *+ Uploading of documents/additional documents is restricted upto prior downloading of E-admit card for Stage-lI, No documents can be uploaded by the candidate after downloading Stage-IIE-admit card, Fallure of uploading of documents within the time promulgated by G will lead to the cancellation of candidature. Any request fo uploading new document after downloading of E-admit card for Stage will not be entertained. *+ Affidavits uly signed by the candidate accepting their mistake of false information in online application will not be considered at various stages of examination and their candidature willbe cancelled. + Documents in Digitocker will nt be accepted at any stage of the examination as electronic devices are not permitted in examination mises. Candidates to bring ther original dacuments at all stages of CGCAT examination. Il candidates wil be compulsorily subjected to identity check prior commencement of the examination in all stages of recruitment (CGCAT. The identity check wil include verfiation/matching of Photograph, biometric, signature id and Permanent Identification Marks on the Body as mentioned inthis application. Documents uploaded before stage-I: 1. 1d Proof (Aadhaar Card) 2. Date of Birth Certificate (10th Class Marksheet/Cert {= Declaration 1a. [hereby declare that all the above information provided by m ince to the sovereignty, unity and integrity of Indi citizenship of India. . Laffirm that the information and particulars given by me in this form are true and correct. I further state that | am not suppressing any materi regard | am liable to be penalized or prosecuted and my candidature will be cancelled if found otherwise. is correct. - L have not lost, surrendered or been deprived of the b. Lowe alle; d.1 declare to remember my mobile number and E-mail ID used during filling of online application, as, the pri mode of communication of ICG with me will be either through ICG website or E-mail e.| understand that Coast Guard will be uploading E-admit card, result of various stages of recruitment in my login dashboard and will also be publishing various updates/announcements regarding recruitment on Coast Guard recruitment website. Hence, | declare to visit ICG website and my lagin dashboard on regular/daily basis. ICG will not be responsible if | fail to visit ICG website on a daily basis and comply with the instructions therein given from time to time and will not claim re-examination. J understand that capturing and verification of biometric impression is mandatory for appearing at all stages of recruitment. g.| understand that my candidature will be cancelled and I will be debarred from future Coast Guard Recruitment examinations in case | am found to be involved in malpractice during any stage of current recruitment process. hit declare that my SC/ST/OBC (non-creamy layer)/EWS cé advertisement regarding the format of certificate for appointment to the post under Government of India. If my candidature is cancelled on account of incorrect category decument then | shall net be considered against unreserved vacancy as | have submitted false information. that | am in posse: als of all the documents uploade tion. Failure to present the original document as uploaded in online application on account of loss of documents will lead to cancellation of candidature, | understand that no request in this regard will be entertained by ICG even if | produce an F! theft of my documents and my candidature will stand cancelled. | understand that | can submit only one application in one cycle.tn case, if multiple applications are detected by ICG then my latest application will be accepted and all previously filled applications will be rejected and the application fees for all the submitted application forms will not be refunded by ICG. k.I declare that the form is filled by myself and not any other person, and for any mismatch/wrong correct photo/signature/thumb image uploads, | will be responsible. | am aware that, my candidature ‘can be Cancelled, in case of any mismatch/wrong information. I have completely checked the print preview of the application and | certify that my appl aspects as per the advertisement. m, NO CLAIM / RISK UNDERTAKING: consent at my own risk that | shall not be entitled to claim any compensation or other relief from the government in respect of any injury or disability which | may sustain in the course of or as the result of any of the tests (both physical fitness test and medical test) administrated to me or attended by me during the recruitment procedure, whether due to my own negligence or any other person or otherwise. 1. If the candidate fills multiple applications in one particular cycle,then his latest fil all previously filled application will be rejected. ion of origi formation, correct in all = 1am a candidate for recruitment in Indian Coast Guard. | give my full and free sd application will be accepted and Candidate's Signature Verified by (ICG Candidate's Signature Verified by (ICG Candidate's Upload Signature 1a, stage Officer) at Stage Il for Stage Ill Officer) at Stage Il STAMP STAMP anise Name: Name: Rank: Rank: Note:- Candidate will have to bring the same application form which is verified at Stage Il by ICG for further recruitment stages or else the candidature will be cancelled. Stage | Uploaded Document Id Proof (Aadhaar Card) Date of Birth Certificate (10th Class Marksheet/Certificate)

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