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

1
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 : 01321789

Re-Registration Date and Time : 25/02/2024
21:37:15
Advertisement Details
Advertisement Number : IIE-60/2023-938(C)/OSSSC
Advertisement Date : 29/12/2023
Registered Username & Contact Details
Registered Username : Shivraj5
Registered Password : As filled by you during registration
Mobile Number : 6371423162
Email ID : [email protected]
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

K
: 2) ASSISTANT REVENUE INSPECTOR

YA
: 3) STATISTICAL FIELD SURVEYOR
: 4) AMIN
District wherein you want to appear in the : SAMBALPUR

NA
Recruitment Examination. AJ 4
Category Applied : SOCIALLY EDUCATIONALLY BACKWARD CLASS (SEBC)
VR R E
Sub-category of the applied Category : AGHARIA
Personal Details
HI - C

Name of the Applicant : SHIVRAJ NAYAK

Father's Name : UMESH NAYAK
Mother's Name : NAMITA NAYAK
- S SC)

Gender : MALE
Date of Birth : 30/12/2001
Age (as on 01/01/2023) : 21 Years 0 Months 2 Days
17 (OSS

Restrictions, if any, imposed by any Recruitment Commissions/Boards

Have you been debarred from appearing the : NO
recruitment examination of any
Commission/Board?
89

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
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examination in non-language subjects

Undertaking
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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.

Signature of Applicant
 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

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

K
YA
NA
AJ 4
VR R E
HI - C
- S SC)
17 (OSS
89
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