KARNATAKA STATE POLICE
RECRUITMENT - 2014
( ISO : 9001 - 2008 Certified Recruitment Process )
APPLICATION FOR THE POST OF SPECIAL RESERVE POLICE CONSTABLE-K.S.R.P ( MEN & WOMEN)-2014
j Pm - P.J.Dg. (g v ) zU Cf - 2014
Notification No /CZ AS
: 14/Pw-4/2013-14
01.
Name of the Battalion /WlPz g
: 8th Battalion Shimoga
02.
Application No / Cf AS
: 1408817
03.
Name of the Applicant/Cfzgg
g
: PRASHANTH S
04.
Gender / AU
: Male
05.
Email Id / E-
: [email protected]
06.
Mobile No / AS.
: 9448124818
07.
Mother's Name / vAi g
: VIJAYA
08.
Father's Name / vAzAi g
: SAMY GOWDA D
09.
Address /
: S/O SWAMY GOWDA D
Street /
: 3RD CROSS
Area /
: SHANTHINAGARA
Taluk / vP
: RAGIGUDDA
District / f
: SHIMOGA
State / gd
: KARNATAKA
Pin Code / AS
: 577201
10.
Native District /Av f
: Shimoga
11.
Category / U
: 2A
11a.
Sub Caste / Gew
: kuruba
12.
Are You an Ex-servicemen? / if : No
Pg ?
12a
Height As Per Discharge Certificate
/Jvg, Aid it
vzgAv
: NIL
Service rendered in Army/Air
: NIL
Force/Navy / Aii Ai
Vz(s/Ai/P)
Description
12c. NOC issue date
: NIL
12d. Date of Discharge /Az
AidUAq AP
: NIL
12f. Years of Service rendered / z : NIL
z
12g. Whether availed ex-servicemen benefit : No
previously for any other post in
government / Az AidUAq
Avg if P w qz
Pj zU Pw Agg
13. Only for Ex-servicemen Children ( For : No
children of Ex-servicemen Permanently
disabled or died in action) /if P
PU iv (Pvz vV zP
Pv Cx gt Az Pg
PU)
SlNo
: 25/02/2014
11b. Certificate Issue Date / it v : 19 Nov 2011
vgt AP
12b. Are you presently serving in force ? : NIL
/ Ai wg?
12e.
Date / AP
: NIL
(i)
Death while in service /Pv
U gt Azg.
(ii)
Permanently disabled while in Service : NIL
/ Pv U v Pv
Azg
Remarks
No
Certification issue Date
NIL
14.
P.D.P /Aid gv
15.
Kannada Medium / Pq izs.
Yes
11 Feb 2014
16
Rural/ Ut
No
NIL
1/2
Are you a Govt. Employee ? / Pj : No
17.
Pgg?
: NIL
17b. Years of Service /z
17a. Department / ES
: NIL
17c. NOC issue Date / J.N..,
: NIL
vgt AP
18.
Date of Birth /nz AP
: 29 Mar 1993 ( Your Age to last date of submitting application 27/03/2014 is 21 Years 0
Months 1 Days)
No
Have you been involved in any Criminal :
Case / Department Enquiry? /
Aiizzg Cgzs Pgtz /
ES ZguAi zAiiVg
zVz g
19.
20.
Have you been convicted in a criminal
case ? / Cgzs PzAi
PU Mngg ?
: No
QUALIFICATION DETAILS
21. Are you holder of PUC or Equivalent
Qualification ? / Ai Cx
vvi zv Agg?
: No
21a. Equivalent Qualification, : NIL
if specify / vvi
zv Azg
22a. Educational Qualification / zv
: SSLC - STATE BOARD
22b. Year of Passing /
Gwtgz
: 2008
22c. Maximum Marks / Uj CAPU
: 625
22d. Secured Marks / Uz CAPU
: 292
23e. Percentage /
: 46.72
BANK PAYMENT DETAILS
23.
Date of Challan Generation / Z
fz AP
: 19 Mar 2014
23a.
Fee Paid /wz
23b.
Date of Payment / AzAi
irz AP
: 24-Mar-2014
23c.
Journal No. / d AS
: 1073089
23d.
Bank Branch Code / AP AZ : 40132
Pq
23e.
Bank /AP
: SBM
23f.
Bank Address / AP
: SHIMOGA BRANCH,P B NO 7,B H ROAD,SHIMOGA
24.
Have you submitted any application
for same post in other units /
zj zU Evg WlPU
Cf g
: No
24a.
Application No (Unit) / Cf AS
(WlP)
: NIL
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Date
29-Mar-2014 02:10:36 PM
IP
122.166.141.204
U AtV wgvz. Pw QAi Aq
I Agree/ Mgv.
2/2
Candidate's Signature /CsyAi