Application Form

Application Number AC045334

Post applied for Assistants/Clerks in Civil Courts of the State of Jharkhand

Name of Applicant SOURAV SUMAN

Father's/Husband's Name UTTAM PRASAD RAY

Communication Address & Pin Code HOUSE NO.-9, VILL-KARMATANR POST+RAILWAY STATION-MATHURAPUR DEOGHAR DEOGHAR JHARKHAND 814114

Permanent Address & Pin Code HOUSE NO.-9, VILL-KARMATANR POST+RAILWAY STATION-MATHURAPUR DEOGHAR DEOGHAR JHARKHAND 814114

Basic Details :

District Preference1 :DEOGHAR District Preference2 :RANCHI District Preference3 :DHANBAD

Domicile of Jharkhand :Yes Domicile Certificate No. :JHLRCO/2020/44138 Issue Date :08-06-2020
Category :EWS Caste Certificate No. :JHEWS/2023/05593 Issue Date :08-02-2023
PwD : No PwD Type : PwD % :
Date of Birth :28-12-2001 Age as on 01-01-2024 :22 years, 0 months and 4 days Place of Birth :DEOGHAR
Gender :Male Marrital Status :Single Nationality :INDIAN
Mobile Number :9835958734 Email Id :SUMANSOURAV964@GMAIL.COM Game and Sports Quota :No
Ex. Serviceman :No
Educational and Professional Qualifications :

Examination Passed Name of Board/University Year of Passing % of Marks Class/Division

10th CBSE 2017 85.50 First
Graduation/Equivalent Degree ARTS from SKMU DUMKA 2022 66.60 First
Special Qualification, if any :

Year of
Examination Passed Name of Board/University % of Marks Class/Division
Passing

Diploma in Computer Application / DCA + (At least 06 months duration from a recognized institute or higher degree in computer)

Name of Institute Year of Passing Duration of Course

VIBHA COMPUTER SCIENCE INSTITUTE 2023 12

Whether presently serving in any Govt. Institution/Undertaking (Yes/No) : No

Name of Department/Institutions Name of Post Held Since

Work Experience (Yes/No) : No

Name of Department/Institution Name of Post Held Joining Date Leaving Date

Fees Details :

Order Id Payment Id Amount of Fee Paid Date & Time

order_O7rH6fLk0Kh4Lf pay_O7rkbcGOn7p0We 500 08/05/2024 09:56:22 AM

Declarations :

It is hereby declared that the information furnished by me herin above is true to my personal knowledge and belief. It is also declared that neither Criminal case is
pending against me nor I have ever been punished by any court of law, nor am I involved in or related with any criminal case for any offence involving moral turpitude. I
know that if anything stated herein above turns out to be false, the High court of Jharkhand may cancel my candidature at any stage of Selection process and may
debar me from appearing in the examination at its sole discretion. I further declare that if I obtain appointment on any false or incorrect information, my appointment
shall be terminated / cancelled and I shall be liable for prosecution under the Law.

I accept the above mentioned declaration : Yes

Date : 05-05-2024

Place :DEOGHAR ( Signature of the Candidate )

10th Board Certificate
Graduation Certificate

Other Qualification Certificate

Diploma in Computer Application / DCA +
Residence Certificate
Caste Certificate
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