Application of Job: NCO [SSR] - 08/2017

Application No: SSR17834103233N Application Date: 17/12/2016

PRIORITY

1. NCO [SSR] 08/2017

PERSONAL PARTICULARS

Name: SURAJ SANWAL

Father's Name: GOPAL DUTT SANWAL
Guardian's Name:
Identification Mark 1: SCAR MARK IN NECK
Identification Mark 2: BLACK SPOT ON LEFT LEG
Nationality: INDIAN
Aadhaar No.: ---------
Date of Birth: 31/01/1997

EDUCATION PARTICULARS

Details of 12th Qualification

Subjects Total Marks Obtained Marks

Physics 100 68

Maths 100 73

Chemistry 100 67

12th Marks 500 370

12th Percentage: 74.00%

Appeared for JEE NO

Ranking?:
12th Standard Serial no. of
0% 107361
Percentage: Marksheet:
State Conducted Board Conducted
UTTARAKHAND CBSE
Exam: Exam:

Details of 10th Qualification

State Conducted Board Conducted Serial no. of
UTTARAKHAND CBSE 12345
Exam: Exam: Marksheet:
Percentage in 10th: --------- Grades in 10th: ---------

MILITARY RECORD

Have you ever been enrolled in Armed Forces before?: NO

Have you been discharged from Armed forces before?: NO

COMMUNICATION PARTICULARS

Details of Permanent Address

Address 1: VILL. GARSARI TEHSIL. BHIKYASEN Address 2: DISTT. ALMORA

State: UTTARAKHAND District: ALMORA Pincode: 263625
Domicile: UTTARAKHAND Phone No.: 7060638530 Mobile No.: 7060638530
surajsanwal1997@g
Email id: surajsanwal54321@gmail.com Alternate Email id:
mail.com

Details of Correspondence Address

VILL. LALPURNAYAK, P/O HARIPURNAYAK

Address 1: Address 2: HALDWANI DISTT. NANITAL
,R.T.O ROAD
State: UTTARAKHAND District: NAINITAL Pincode: 263139
Alternate Mobile Number: 7060638530

A. I hereby declare that I am unmarried, governed by nationality condition as laid down by the Government of Indian and
have never been debarred from appearing at any examination. I have never been arrested/ prosecuted and convicted by a
criminal court or involved in any other case registered by the Police.
B. I hereby, solemnly declare that all the statements made in the above application are true and correct to the best of my
knowledge and belief.
C. I fully understand that in the event of my information being found false or incorrect, appropriate action can be taken
against me.
D. Eligibility criteria will be verified on reporting at the selection centres. I found ineligible, I understand that criminal
proceedings can be initiated against me for fraudulent entry and falsification of Government of Indian documents. I also
accept that no TA/ DA will be admissible to me in such cases.