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2. Name of Applicant:
10. Address:
11. Disable: yes No 12. Govt. Servant: Yes No 13. Marital Status:
Certificate Degree Year of Passing Board / University Division /Grade Marks Obtained
I hereby solemnly affirm that I have read and understood the conditions for applying in the above
mentioned Post and that I have filled the form as per instructions given above and in the event any
information contained herein is found to be untrue, I shall be liable to disciplinary action which may result
in cancellation of my candidature & test at any stage even after employment and that a legal action shall be
taken against me.