Odisha Sub-ordinate Staff Selection Commission (OSSSC) Page No.

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Copy of the Provisional Re-Registration Form submitted online for the Post of
Combined Recruitment Examination(IV)-2023 for the district cadre posts of RI, Supervisor (ICDS),
ARI, Amin and SFS -2023

Re-Registration Number : 01546638

Re-Registration Date and Time : 01/02/2024
10:14:45
Advertisement Details
Advertisement Number : IIE-60/2023-938(C)/OSSSC
Advertisement Date : 29/12/2023
Registered Username & Contact Details
Registered Username : Narayan5151
Registered Password : As filled by you during registration
Mobile Number : 9777097445
Email ID : goutam515191@gmail.com
Post & Category Registration Details
Applied to : Odisha Sub-ordinate Staff Selection Commission (OSSSC)
Post Applied : COMBINED RECRUITMENT EXAMINATION(IV)-2023 FOR THE DISTRICT
CADRE POSTS OF RI, SUPERVISOR (ICDS), ARI, AMIN AND SFS
Post Preference : 1) REVENUE INSPECTOR
: 2) ASSISTANT REVENUE INSPECTOR

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: 3) AMIN
: 4) STATISTICAL FIELD SURVEYOR

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District wherein you want to appear in the : ANGUL
Recruitment Examination.
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Category Applied : SCHEDULED CASTE (SC)
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Sub-category of the applied Category :
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HADI
Benefits claimed as per applicable rules. : 1. My appointmnt as RI/ARI/AMIN in Balangir district has been terminated by
-G -C

the Govt. in Revenue & Disaster Management Department

vide letter no 7467/R&DM dated 04.03.2016.
Special Category applied
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1) VISUALLY IMPAIRED
i) Nature of Disability : PERMANENT
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ii) Percentage of Disability : 100%

iii) Functional Classification/ Sub- : LOW VISION/PARTIALLY BLIND
Category of Disability
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Physical Requirements Fulfilled : 1. B-WORK PERFORMED BY BENDING

2. CCHCF-WORK PERFORMED BY CONDUCTING CROP CUTTING
AND HARVESTING IN THE CROP FIELD
3. F-WORK PERFORMED BY MANIPULATING (WITH FINGERS)
4. H-WORK PERFORMED BY HEARING / SPEAKING
5. L-WORK PERFORMED BY LIFTING
6. MCF-WORK PERFORMED BY TAKING AREA MEASUREMENTS OF
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THE CROP FIELD

7. MPP-WORK PERFORMED BY MOVING FROM PLOT TO PLOT IN
DIFFERENT SEASONS
8. PP-WORK PERFORMED BY PULLING AND PUSHING
9. R & W-WORK PERFORMED BY READING AND WRITING
10. RW-WORK PERFORMED BY READING AND WRITING
11. S-WORK PERFORMED BY SITTING (ON BENCH OR CHAIR)
12. SE-WORK PERFORMED BY SEEING
13. ST-WORK PERFORMED BY STANDING
14. W-WORK PERFORMED BY WALKING
Personal Details
Name of the Applicant : GOUTAM Naik
Father's Name : GOVINDA CHANDRA Naik
Mother's Name : SUMITRA NAIK
Gender : MALE
Date of Birth : 28/04/1994
Age (as on 01/01/2023) : 28 Years 8 Months 3 Days
Restrictions, if any, imposed by any Recruitment Commissions/Boards
Have you been debarred from appearing the : NO
 Odisha Sub-ordinate Staff Selection Commission (OSSSC) Page No. 2
Copy of the Provisional Re-Registration Form submitted online for the Post of
Combined Recruitment Examination(IV)-2023 for the district cadre posts of RI, Supervisor (ICDS),
ARI, Amin and SFS -2023

recruitment examination of any

Commission/Board?
Odia Language Knowledge
What are the activities you can perform in Odia : Speak , Read & Write
language ?
Your Odia language Passing Standard : Passed Matriculation or equivalent Examination with Odia as the medium of
examination in non-language subjects
Undertaking
I do hereby solemnly declare that I have carefully gone through the Recruitment Advertisement of the Commission for the post mentioned
above and I fulfill all the conditions of eligibility prescribed for admission to the examination. I further declare that the information furnished and the
copies of the documents uploaded by me for registration/reregistration of my name for the recruitment examination for the post mentioned above are
true and relevant. If any such information or document or undertaking provided by me is/are found false or irrelevant during or after selection, my
candidature/selection shall be cancelled and I shall be liable to penal action as per law. Further I declare that whenever required the information
furnished and to be furnished by me during the course of Registration and Application may be used by the Commission or may be shared for bonafide
Government Purpose only.

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Signature of Applicant

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Note : TA 4
1) It may be noted that mere Registration/Re-registration does not mean complete filing of online Application.
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Hence you are advised to fill up and submit the online Application as per the guidance of the system after
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completing the Registration/Re-registration.Incomplete applications shall be summarily rejected.
-G -C

2) This is a computer report generated through OSSSC portal (www.osssc.gov.in) and does not require any seal
and signature of the issuing authority.
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