JAMMU AND KASHMIR PUBLIC SERVICE COMMISSION, SRINAGAR/ JAMMU. ---(APPLICATION FORM FOR EXCISE & TAXATION (S.I.) DEPARTMENTAL EXAMINATION) Registration No. PSC/Ex/SI / 1. Details of Bank Draft (attached original Bank Draft) Name of the Bank ______________________________ _____________________________________________ PHOTO SPACE (To be attested by the Competent Authority) B. D. No._________________________________ ________________________________________ Dated: __________________________________ Amount Rs. ______________________________ 2. Name of the candidate : _____________________________________________ (in block letters) 3. Parentage : ______________________________________________ 4. Permanent Address : ______________________________________________ ______________________________________________ 5. Address for correspondence : ______________________________________________ ______________________________________________ 6. Qualifications : ______________________________________________ 7. Post held at present : ______________________________________________ 8. Scale of pay of the post held : ______________________________________________ 9. Date of appointment to the post with total service in the grade : ______________________________________________ 10. Have you passed any other departmental examination, if so, give Roll No. & Session etc. : _____________________________________________ _____________________________________________ 11. Have you appeared in this examination before (If YES please give the following information) : _____________________________________________ S.No. Session Roll No. Paper in which appeared Papers passed 12. Papers in which candidates wants to appear in this examination : _____________________________________________ 13. Centre at which the candidate wants to take the examination : JAMMU / SRINAGAR 14. Have you ever been debarred by the Public Service Commission, if so, state period of debarment, if any. : _____________________________________________ 15. Are you exempted from appearing in any paper in this examination. (Please attach a copy of the document/certificate in support of your claim) : _____________________________________________ 16. Date of submission of application form. : _____________________________________________ I, __________________________________ certify that the statements made hereinabove are true to the best of my knowledge and belief and I undertake that if any information is found incorrect at any stage, I shall be liable to any action as the Commission may deem fit. Signature of the Candidate Date: __________________ ELIGIBILITY CERTIFICATE TO BE ISSUED BY THE COMPETENT AUTHORITY VIZ. HEAD OF THE DEPARTMENT CONCERNED. Forwarded in original to the Secretary, Jammu and Kashmir Public Service Commission. It is certified that Shri ____________________________ working as __________________________ in this department is, as per rules, eligible to appear in the __________________________________ Departmental Examination. Signature Designation Office seal JAMMU AND KASHMIR PUBLIC SERVICE COMMISSION, JAMMU/SRINAGAR ---- (To be filled in by the Candidate) ADMIT CARD (Candidate will be admitted in the examination hall only on production of this card.) NAME OF THE EXAMINATION : ___________________________________ CENTRE : SRINAGAR/JAMMU Affix attested NAME OF THE CANDIDATE : ______________________________________ passport size FATHER'S NAME : ______________________________________ photograph. ADDRESS : ______________________________________ FOR OFFICE USE ONLY ROLL NUMBER : ________________________ VENUE : _______________________________________ DATE : _______________________________ TIME : _________________________________________ DEPUTY SECRETARY J&K PUBLIC SERVICE COMMISSION JAMMU AND KASHMIR PUBLIC SERVICE COMMISSION, JAMMU/SRINAGAR ---- (To be filled in by the Candidate) ADMIT CARD (Candidate will be admitted in the examination hall only on production of this card.) NAME OF THE EXAMINATION : ___________________________________ CENTRE : SRINAGAR/JAMMU Affix attested NAME OF THE CANDIDATE : ______________________________________ passport size FATHER'S NAME : ______________________________________ photograph. ADDRESS : ______________________________________ FOR OFFICE USE ONLY ROLL NUMBER : ________________________ VENUE : _______________________________________ DATE : _______________________________ TIME : _________________________________________ DEPUTY SECRETARY J&K PUBLIC SERVICE COMMISSION JAMMU AND KASHMIR PUBLIC SERVICE COMMISSION, JAMMU/SRINAGAR ---- ATTENDANCE SHEET NAME OF THE EXAMINATION : ___________________________________ NAME OF THE CANDIDATE : ______________________________________ Affix attested passport size CENTRE : SRINAGAR/JAMMU photograph. ROLL NUMBER : ____________________________________ (To be filled in by the Commission) This sheet will be present to the candidate at the beginning of each paper. The candidate has to fill in the columns in his own handwriting. In case the candidate is absent in any paper/papers, the Supervisor will fill the columns and write "ABSENT" in the last column. DEPUTY SECRETARY J&K PUBLIC SERVICE COMMISSION (TO BE FILLED IN BY THE CANDIDATE AT THE TIME OF EXAMINATION.) DATE PAPER SIGNATURE OF THE CANDIDATE JAMMU AND KASHMIR PUBLIC SERVICE COMMISSION, JAMMU/SRINAGAR -----APPLICATION FORM FOR ACF EXAMINATION. 1. NOTIFICATION NO. __________________________ DATED: _____________________ 2. DETAILS OF THE POSTAL ORDER/BANK DRAFT. Postal order/bank draft no. _____________________ Affix attested passport Dated: _____________________________________________ size photograph. Amount: ____________________________________________ Name of the Bank/Post Office: _________________________________ 3. NAME OF THE CANDIDATE : _____________________________________________________ 4. PARENTAGE : _____________________________________________________ 5. PERMANENT ADDRESS : _____________________________________________________ ________________________________________________________________________________ 6. ADDRESS FOR CORRESPONDENCE : _______________________________________________ ________________________________________________________________________________ 7. DATE OF BIRTH : ____________________________________________________ (IN WORDS) : ____________________________________________________ 8. ARE YOU A MEMBER OF ANY RESERVED CATEGORY : YES/NO IF YES SPECIFY THE CATEGORY : _________________________________________________ 9. DETAILS OF EDUCATION QUALIFICATIONS:- Examination Marks Obtained Percentage Year of passing Board/University CONTD. ON PAGE 2 -2 10. ARE YOU EMPLOYED? IF YES GIVE FOLLOWING DETAILS. 11. HAVE YOU EVER BEEN DEBARRED / DISQUALIFIED / DISMISSED /PENALIZED? ______________ IF YES GIVE DETAILS: _____________________________________________________________ 12. ANY OTHER DISTINTION ACHIEVED THAT YOU WOULD LIKE TO MENTION: _______________ (Attach a separate sheet if needed) 13. OPTIONAL PAPERS IN WHICH YOU WANT TO APPEAR: _________________________________ _________________________________________________________________________________ 14. CENTRE AT WHICH YOU WANT TO APPEAR: SRINAGAR / JAMMU DETAILS OF ENCLOUSERS: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Full Address of the Employer Post Held From - To Pay Scale Reasons for Relinquishing I ____________________________________________ certify that the statements made hereinabove are true to the best of my knowledge and belief and I undertake that if any information is found incorrect at any stage, shall be liable to any action that the Commission may deem fit. SIGNATURE OF THE CANDIDATE DATE:
