Acknowledgement Slip for the Post of Engineer

Ackn. No. Discipline 12739785 Electronics 2012-01-21 00:28:56.0 GATE 2012 Regn NO.

Trainee in BHEL ( through GATE-2012)

2012-01-21 00:28:51.0

Acknowledged Date. EC3156143

Gen

Personal Particulars
Name Date of Birth Gender Marital Status Father's Name Nationality Minorty Status Category Ex-Serviceman Physically Challenged Whether domicile in J&K between 01/01/1980 and 31/12/1989 ANKUSH MAHAJAN 27/10/1990 M Unmarried VINAY MAHAJAN Indian Not Applicable Gen N None N Years of Service % (or) Decibels 0 0 Please Paste Your Photo Here

12739785

Address for Correspondence

Address Line 1 Address Line 2 Address Line 3 Address Line 4 C/O G.L. VERMA C-80 BAKHTAWAR RAM NAGAR NEAR TILAK NAGAR INDORE (M.P) State Country Pincode Madhya Pradesh INDIA 452001

Permanent Address
Address Line 1 Address Line 2 Address Line 3 Address Line 4 Email id Mobile No. WARD NO.-1,HOUSE NO.-110 BEHIND OLD BUS STAND NAGROTA ,BAGWAN KANGRA ankushbliss27@gmail.com 9407146541 Alternate Phone No 01892252309 State Country Pincode HIMACHAL PRADESH INDIA 176047

Educational Qualifications
Graduation Degree Month / Year of Passing Name of Institute Name of University B E 4 Yrs JUN 2012 Others RAJIV GANDHI PROUDYOGIKI VISHWAVIDYALAYA, BHOPAL 6000 Total Scored Type of Course Type of University Full Indian Branch Electronics & Communication

Total Marks Post Graduation Degree Marks Obtained Month / Year of Passing Name of Institute Name of University

4659

Percentage

77.65

Branch 0 Type of Course Type of University

Processing Fee Payment Details

Challan Journal No. Bank Branch Name Whether BHEL Employee Present Employee Details Preference of Posting Caste Name Y. N ROAD INDORE (M.P) N Staff No. Not Employed 0 Unit null 010107565 Date Designation 16/01/2012 null

1) AP

2) BP

3) CE

4) RV

5) HY Caste State

I hereby Declare that all the information given above are true to the best of my knowledge.
Date: Place: SIGNATURE ( ANKUSH MAHAJAN )

Encl: BHEL Challan Copy [ ] Please tick

Note: All candidates are required to use copies of the same photgraph used in GATE-2012 application form, for the entire process of recruitment and selection. Hence, it is advised to keep sufficient number of copies of photograph

BHEL Copy

Acknowledgement Slip for the Post of Engineer

Ackn. No. Discipline 12739785 Electronics 2012-01-21 00:28:56.0 GATE 2012 Regn NO.

Trainee in BHEL ( through GATE-2012)

2012-01-21 00:28:51.0

Acknowledged Date. EC3156143

Gen

Personal Particulars
Name Date of Birth Gender Marital Status Father's Name Nationality Minorty Status Category Ex-Serviceman Physically Challenged Whether domicile in J&K between 01/01/1980 and 31/12/1989 ANKUSH MAHAJAN 27/10/1990 M Unmarried VINAY MAHAJAN Indian Not Applicable Gen N None N Years of Service % (or) Decibels 0 0 Please Paste Your Photo Here

12739785

Address for Correspondence

Address Line 1 Address Line 2 Address Line 3 Address Line 4 C/O G.L. VERMA C-80 BAKHTAWAR RAM NAGAR NEAR TILAK NAGAR INDORE (M.P) State Country Pincode Madhya Pradesh INDIA 452001

Permanent Address
Address Line 1 Address Line 2 Address Line 3 Address Line 4 Email id Mobile No. WARD NO.-1,HOUSE NO.-110 BEHIND OLD BUS STAND NAGROTA ,BAGWAN KANGRA ankushbliss27@gmail.com 9407146541 Alternate Phone No 01892252309 State Country Pincode HIMACHAL PRADESH INDIA 176047

Educational Qualifications
Graduation Degree Month / Year of Passing Name of Institute Name of University B E 4 Yrs JUN 2012 Others RAJIV GANDHI PROUDYOGIKI VISHWAVIDYALAYA, BHOPAL 6000 Total Scored Type of Course Type of University Full Indian Branch Electronics & Communication

Total Marks Post Graduation Degree Marks Obtained Month / Year of Passing Name of Institute Name of University

4659

Percentage

77.65

Branch 0 Type of Course Type of University

Processing Fee Payment Details

Challan Journal No. Bank Branch Name Whether BHEL Employee Present Employee Details Preference of Posting Caste Name Y. N ROAD INDORE (M.P) N Staff No. Not Employed 0 Unit null 010107565 Date Designation 16/01/2012 null

1) AP

2) BP

3) CE

4) RV

5) HY Caste State

I hereby Declare that all the information given above are true to the best of my knowledge.
Date: Place: SIGNATURE ( ANKUSH MAHAJAN )

Encl: BHEL Challan Copy [ ] Please tick

Note: All candidates are required to use copies of the same photgraph used in GATE-2012 application form, for the entire process of recruitment and selection. Hence, it is advised to keep sufficient number of copies of photograph

Applicant Copy

Page 3

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ACKNOWLEDGEMENT SLIP- ENGINEER TRAINEE 2012-13 Acknowledgement No. - 12739785 Discipline - Electronics ______________________________ From - ANKUSH MAHAJAN C/O G.L. VERMA C-80 BAKHTAWAR RAM NAGAR NEAR TILAK NAGAR INDORE (M.P) TO THE SENIOR MANAGER ROOM NO.29, HR DEPARTMENT MAIN ADMIN BUILDING HEEP, BHEL, RANIPUR HARIDWAR - 249403 UTTRAKHAND.

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Important: 1.Cut the above address slip and paste it on the envelope containing your signed Acknowledgement Slip and send.