CENTRAL INDUSTRIAL SECURITY FORCE

APPLICATION FORM FOR RECRUITMENT OF ASI/STENO AND HC/MIN-2022

1.Registration ID CISF2203252362

2. Name of the POST applied for BOTH

(Candidates applyimg for BOTH post Should add Preference1:ASI/STENO
Preference) Preference2:HC/MIN

3.NAME TUSHAR SHARMA

4.FATHER'S NAME OMPAL SHARMA

5.MOTHER'S NAME SEEMA SHARMA

6.CATEGORY EWS

7.Name of the State Belongs to UTTAR PRADESH

8.GENDER MALE

9.NATIONALITY INDIAN

10.Educational Qualification(Min 12th required) CIVIL

Civil education details GRADUATION

11.RELIGION HINDU

12.Whether falling under the category of children NO

and dependents of victim KILLED in 1984
riots/communal riots of 2002 in Gujarat?

13.Do you belong to Hill area? NO

14.Whether you are an Ex-Serviceman NO

15.For CISF personnel who intend to compete NO

against the vacancies meant for LDCE

16.Whether you are an employee of NO

Govt.Dept/Public Sector Undertaking/Autonomous
Bodies

17.Date of Birth 15-06-2003

18.Visible Identification Marks MOLE ON NOSE

1)

2) MOLE ON FACE
19. Permanent address KHATTA PRAHLADPUR BAHGPAT
Village/Ward

Post KHATTA PRAHLADPUR

State UTTAR PRADESH

District BAGHPAT

PINcode 250515

20. Correspondence address KHATTA PRAHLADPUR BAHGPAT

Village/Ward

Post KHATTA PRAHLADPUR

State UTTAR PRADESH

District BAGHPAT

PINcode 250515

21.a)Mobile 8791996979

b)Phone number,if any with STD code

22.Email TUSHARSHARMA727272@GMAIL.COM

23.Medium opted for skill test HINDI

(Typewriting/Stenography)

24.Type of Id Card AADHAR CARD

24.1.Id card No/Details 711813947417

25.Whether the date printed on the photograph NO

Taken

26.Have you ever been convicted by any court of NO

law or any other judicial Institution?

26.4 Have you ever been dismissed from any NO

service under the Central or State Govt?

26.5 Have your services ever been terminated NO

while on probation?
 27. Application Fee Status
Reference CPACDUZOF8
No:

Application CISF2203252362HCST22
No:

Amount 100.00

Status Success

(Signature of the applicant)

DECLARATION
TO BE SIGNED BY ALL THE CANDIDATES COMPULSORILY
1. I hereby certify that all the statements made in the application are true, complete and correct to the best of
my knowledge and belief. In the event of the information or part thereof being found false or detected incorrect
during the process of recruitment or at any stage thereafter and that I am not satisfying the eligibilty criteria
prescribed in this notice, my candidature/appointment is liable to be cancelled/terminated automatically without
any notice to me and action can be taken against me by the CISF.
2. I have read the provisions in the Notice of the examination carefully and I hereby undertake to abide by them.
3. I further declare that, I fulfill all the conditions of eligibility regarding age limits,educational qualifications, etc
prescribed for admission to the examination. I have enclosed photocopies of certificates in support of claim of
Educational Qualifications and age.
4.I also declare that, I do not stand debarred from Government Service as on the date and have never been
convicted by any court of law.
5.I have not submitted any other application for this examination. I am aware that if I contravene this rule, my
application will be rejected summarily.

(Signature of the applicant)

(Application not signed by the candidate will not
be entertained)
Date: 25-10-2022