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BSSC Application

This document is the application form for the Bihar Staff Selection Commission's Second Inter Level Combined Competitive Exam-2023 for the candidate Ankush Kumar. It includes personal details, educational qualifications, technical skills, and payment information. The candidate is 20 years old, belongs to the General category, and has completed relevant educational and technical training.

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ankushbharadwaj8
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0% found this document useful (0 votes)
315 views2 pages

BSSC Application

This document is the application form for the Bihar Staff Selection Commission's Second Inter Level Combined Competitive Exam-2023 for the candidate Ankush Kumar. It includes personal details, educational qualifications, technical skills, and payment information. The candidate is 20 years old, belongs to the General category, and has completed relevant educational and technical training.

Uploaded by

ankushbharadwaj8
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

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BIHAR STAFF SELECTION COMMISSION


P.O.-VETERINARY COLLEGE, PATNA - 800014
ADVERTISEMENT NO. 02/2023
SECOND INTER LEVEL COMBINED COMPETITIVE EXAM-2023
PERSONAL DETAILS
REGISTRATION NO.: 2300546971
FORM NO. : 3300546971
NAME OF APPLICANT : ANKUSH KUMAR
FATHER'S NAME : CHANDARASHEKHAR AZAD
MOTHER'S NAME : RINKU DEVI
GENDER : MALE
MOBILE NO. : 8521872714
EMAIL ID : KUMARANKUSH0390@[Link]
DATE OF BIRTH : 15-01-2003 LIVE PHOTO

AGE AS ON 01-08-2023 : 20 YEARS, 6 MONTHS, 17 DAYS


NATIONALITY : INDIAN
CATEGORY : GEN
DO YOU BELONG TO EWS? : YES
(EBC/BC-NCLC CERTIFICATE NUMBER) / (SC/ST-CASTE CERTIFICATE
EWSCO/2023/710822
NUMBER) / (EWS-CERTIFICATE NUMBER) :
ISSUE DATE OF CERTIFICATE : 28-10-2023
CERTIFICATE ISSUING AUTHORITY : CO
DOMICILE OF BIHAR STATE : YES
PHOTO
ISSUE DATE OF DOMICILE CERTIFICATE: 02-08-2019
ISSUE NUMBER OF DOMICILE CERTIFICATE : BRCCO/2019/306883
DOMICILE CERTIFICATE ISSUING OTHER COMPETENT AUTHORITY : CO
ARE YOU PERSON WITH DISABILITY? : NO
SIGNATURE IN ENGLISH

SIGNATURE IN HINDI

DO YOU HAVE AADHAR CARD? : YES (AADHAR CARD NUMBER: 930623281213)


ID PROOF : PAN CARD ID PROOF NO : IRGPK1398G
BIHAR GOVERNMENT EMPLOYEE WHO HAS RENDERED NOT LESS THAN 3 YEARS REGULAR AND
NO
CONTINUOUS SERVICE? :
WHICH ATTEMPT IS OF INTER LEVEL EXAMINATION? : 01
IDENTIFICATION MARK OF THE CANDIDATE : A MOLE ON LEFT SIDE NECK
ARE YOU AN EX-SERVICEMAN? : NO
WARD OF FREEDOM FIGHTER? : NO
HAVE YOU EVER BEEN DEBARRED FROM ANY COMPETITIVE EXAMINATION (UPSC/BOARD/STATE
NO
COMMISSION/ANY OTHER)? :
WORKED/WORKING AS CONTRACTUAL EMPLOYEE IN BIHAR GOVERNMENT: NO
ADDRESS DETAILS

CORRESPONDENCE ADDRESS PERMANENT ADDRESS

ADDRESS: ARKDHIBARIYA,TEKARI,GAYA,BIHAR ADDRESS: ARKDHIBARIYA,TEKARI,GAYA,BIHAR


VILLAGE/MOHALLA: ARKDHIBARIYA VILLAGE/MOHALLA: ARKDHIBARIYA
POST OFFICE: ARKDHIBARIYA POST OFFICE: ARKDHIBARIYA
POLICE STATION: TEKARI POLICE STATION: TEKARI
DISTRICT: GAYA DISTRICT: GAYA
STATE: BIHAR STATE: BIHAR
PIN CODE: 824236 PIN CODE: 824236
EDUCATIONAL QUALIFICATIONS
EDUCATION SUBJECT BOARD / TOTAL MARKS MARKS PERCENTAGE PASSINGDATE CERTIFICATE
UNIVERSITY / OBTAINED NUMBER
INSTITUTE
MATH SCIENCE
10TH / EQUIVALENT SOCIAL SCIENCE CBSE 500 349 69.80 06-05-2019 0753669
ENGLISH HINDI
12TH / EQUIVALENT MATH PHYSICS
12TH/INTERMEDIATE CHEMISTRY BSEB PATNA 500 318 63.60 16-03-2022 0273364
(SCIENCE) ENGLISH HINDI
TECHNICAL SKILL
SKILL NAME OF INSTITUTE PASSING DATE CERTIFICATE NUMBER
HINDI TYPING GIIT COMPUTER INSTITUTE RIKABGANJ TEKARI GAYA 26-12-2022 123429
ENGLISH TYPING GIIT COMPUTER INSTITUTE RIKABGANJ TEKARI GAYA 26-12-2022 123429
HAVE YOU DONE ANY COMPUTER COURSE? YES
NAME OF INSTITUTE COURSE DETAILS PASSING DATE CERTIFICATE NO.
GIIT COMPUTER INSTITUTE ADCA 23-05-2022 123433
PAYMENT DETAILS:
PAYMENT BANK : SBI
TRANSACTION ID : 5864542576128
TRANSACTION DATE : 2023-11-17 [Link]
REGISTRATION FEE (RS.) : 540
DECLARATION DETAILS:
I HEREBY DECLARE THAT THE INFORMATIONS FILLED UP ABOVE BY ME ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I ALSO DECLARE
THAT I HAVE FILLED UP ONLY ONE APPLICATION FORM. I ALSO UNDERTAKE THAT IF ANY INFORMATION IS FOUND OTHERWISE, I SHALL BE LIABLE FOR
ANY LEGAL ACTION AND CANCELLATION OF MY CANDIDATURE.
DATE : 24-11-2023 [Link]
PLACE: PATNA
DECLARATION ACCEPTED : YES

NOTE: PLEASE KEEP YOUR REGISTRATION NO.,PASSWORD,MOBILE NO AND EMAIL-ID CAREFULLY FOR FURTHER REFERENCE.

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