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Document 34

The document is an application form for the post of Assistant System Officer. It requests biographical information such as name, address, contact details, date of birth, gender, marital status, category, language proficiency, religion, educational qualifications and experience. Applicants must attach self-attested photocopies of certificates to support their application. The applicant also must sign a declaration that the information provided is true and correct.

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Arun Kumar Panda.
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50 views4 pages

Document 34

The document is an application form for the post of Assistant System Officer. It requests biographical information such as name, address, contact details, date of birth, gender, marital status, category, language proficiency, religion, educational qualifications and experience. Applicants must attach self-attested photocopies of certificates to support their application. The applicant also must sign a declaration that the information provided is true and correct.

Uploaded by

Arun Kumar Panda.
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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OFFICE OF THE ADVOCATE GENERAL, ODISHA, CUTTACK

APPLICATION FORM FOR THE POST OF ASSISTANT SYSTEM OFFICER


BIO-DATA

(1) Full Name of the candidate :


(In block capital)
(2) Father's/Husband's Name :

(3) Address for communication : (4) Permanent address:

……………………………………………………….. ………………………………………………………….

………………………………………………………… …………………………………………………………..

………………………………………………………… …………………………………………………………..

Pin- Pin-

Telephone: ………………………………………….. Telephone:……………………….

Mobile: ………………………………………………. Mobile: …………………………….

E-Mail ID: …………………………………………… E-Mail ID:…………………………

(5) Date of birth (As recorded in the High School Certificate):

(6) Nationality:

(7) Sex: (Male/Female):

(8) Mother tongue:

(9) Marital Status: Married/ Unmarried

(10) Category: UR/SEBC/SC/ST

(Attached authenticate Caste Certificate from the competent authority)

(11) Language Known

Language Proficiency Speak Read Write


(12). Religion:

(13). Nationality:

(14). Employment Exchange Registration No:

(15) Educational Qualification

Name of Aggregate % of
Name of the Examination the Board/ Year of Full of Marks Grade/ Marks
Passed University Passing Marks secured Division secured
H.S.C.

+2 Arts / Commerce / Science

+ 3 Arts / Commerce / Science

B.Tech

Computer Qualification

Self-attested photo copies of certificates must be attached in support of evidence for consideration of
candidature.

Experience :

DECLARATON
I hereby declare that the information furnished above is true and correct to the best of my knowledge
and belief.

Place: Full signature of the Applicant

Date:

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