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HARYANA CIVIL SERVICE (EXECUTIVE BRANCH) & OTHER ALLIED

SERVICES EXAMINATION 2021

Personal Details

Personal Details

Application Number
2103632

Post Name Advertisement Number

Haryana Civil Service (Executive Branch) and Other Allied 3/2021
Services

Advertisement Date Name of the Applicant

26.02.2021 AMIT KUMAR

Date of Birth Age as on 01.01.2021

31/Aug/1993 27Years 4Months 1Days

Father's Name Mother's Name

LAKHMI CHAND SEEMA

Gender Mobile Number

Male 9017726221

Email ID
1000moments1000@gmail.com

Nationality Are you domicile of Haryana?

Citizen of India Yes

Category Are you PwBD i.e. Person with Benchmark Disabilities of Haryana with at
least 40% disability ?
BC-A of Haryana
No
 Are you child or grand child of Freedom Fighter of Haryana? Have you ever been debarred by UPSC/HPSC/other State PSCs or any
other Government Department?
No
No

Have you ever been convicted by Criminal Court? Are you an employee of Govt. of Haryana?
No No

Have you worked or are you presently working on adhoc/contract/work-

charged/daily wages basis in any Department/Board/Corporation of
Haryana Government?
No

Correspondence Address

Address Line 1 Address Line 2

225/9 JAIN GALI,GANAUR

State District
HARYANA SONIPAT

City/Town/Village Tehsil
GANAUR GANAUR

Pincode Is Permanent Address same as Correspondence address?

131101 YES

Permanent Address

Address Line 1 Address Line 2

225/9 JAIN GALI,GANAUR

State District
HARYANA SONIPAT

City/Town/Village Tehsil
GANAUR GANAUR

Pincode
 131101

Qualification Details

Do you possess a Degree of Bachelor of Arts / Science /Commerce or Number of attempts availed after upper age limit of 42 years (if you are
an equivalent degree from a recognized University. seeking age relaxation as an employee of Haryana Government or High
Court or any Court subordinate thereto).
Yes
0

Optional subject for Main written examination

Political Science and International Relations

Matriculation (10th) Details

Name of the Board School/Institute Name

C.B.S.E RANUAQ PUBLIC SCHOOL

Subject Marks Obtained

ALL 352

Maximum Marks Percentage of Marks

500 70.40

Year of Passing Division

2010 First

Intermediate (12th) Details

Name of the Board School/Institute Name

C.B.S.E RANUAQ PUBLIC SCHOOL

Subject Marks Obtained

PCM 297

Maximum Marks Percentage of Marks

500 59.40

Year of Passing Division

2012 Second

Graduation Details

Qualification Degree Institute Passed from

B.A UNIVERSITY OF DELHI .S.O.L
 Month and Year of Passing Subject
12/2020 POLITICAL SCIENCE HONS

Marks Obtained Maximum Marks

543 1100

Percentage of Marks Division

49.3636 Second

Candidate Documents/Images Upload Details

Signature

Declaration By The Candidate

I hereby declare that all the statements made in this application form are true, complete and correct to the best of my knowledge &
belief. In the event of any information being found false or incorrect, or any ineligibility being detected before or after the
examination (Preliminary, Main or on selection), my candidature may be cancelled and action can be taken against me by the
Commission.

I have read the advertisement and the relevant Services Rules related to this examination carefully and I hereby undertake to abide
by them. I fulfill all the conditions of eligibility regarding age limit, educational qualifications etc. prescribed in the advertisement and
relevant Rules.

I'm in possession of all the Certificates / documents in support of my claim made above in the application form.

Date :

Place :

[Signature
of
the
Candidate]

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