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Delhi Police ESM Eligibility Application

The document contains an application form for the Sub-Inspector in Delhi Police and Central Armed Police Forces Examination, 2023. It provides personal details of the applicant such as name, father's name, date of birth, gender, category, address, education qualifications, photograph details, and declaration.

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Nikhil Choudhary
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0% found this document useful (0 votes)
75 views3 pages

Delhi Police ESM Eligibility Application

The document contains an application form for the Sub-Inspector in Delhi Police and Central Armed Police Forces Examination, 2023. It provides personal details of the applicant such as name, father's name, date of birth, gender, category, address, education qualifications, photograph details, and declaration.

Uploaded by

Nikhil Choudhary
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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STAFF SELECTION COMMISSION

BLOCK NO. 12, CGO-COMPLEX, LODHI ROAD, NEW DELHI


110003
SUB-INSPECTOR IN DELHI POLICE AND CENTRAL
ARMED POLICE FORCES EXAMINATION,
2023
REGISTRATION NO: 20005906346

APPLICATION RECEIVED (CONTENTS NOT VERIFIED)


1. NAME AS PER 2. NEW/ CHANGED NAME 3. FATHER'S NAME 4. MOTHER'S NAME
MATRICULATION
CERTIFICATE

MAHESH KUMAR - SHABHA CHAND KAMALA


5. DATE OF BIRTH
6. AGE AS ON 01/08/2023 7. GENDER 8. CATEGORY
(DD/MM/YYYY)
02/12/1973 49.7 MALE OBC
9. NATIONALITY 10. MARK OF VISIBLE IDENTIFICATION
CITIZEN OF INDIA BLACK EYE
11. MATRICULATION (10th CLASS) EXAMINATION 12. MATRICULATION (10th CLASS) 13. MATRICULATION (10th
BOARD ROLL NO CLASS) YEAR OF PASSING
BOARD OF SECONDARY EDUCATION, RAJASTHAN 718543 1991
14. DO YOU BELONG TO CASTES NOT INCLUDED IN CENTRAL LIST OF OBCs BUT NOTIFIED AS OBC BY THE GOVT OF NCT
OF DELHI (SUCH CANDIDATES WILL BE CONSIDERED AS OBC FOR DELHI POILICE AND UR FOR OTHER POSTS)?
NO
15. DO YOU BELONG TO CASTES NOT INCLUDED IN CENTRAL LIST OF OBCs BUT NOTIFIED AS OBC BY THE GOVT OF NCT
OF DELHI (SUCH CANDIDATES WILL BE CONSIDERED AS OBC FOR DELHI POILICE AND EWS FOR OTHER POSTS)?
NO
16. ARE YOU A DEPARTMENTAL CANDIDATE OF DELHI POLICE ?
NO
17.1. ARE YOU A NATIONAL CADET CORPS (NCC) CERTIFICATE HOLDER ? 17.2. TYPE OF CERTIFICATE
NO -
18. PREFERENCE OF EXAMINATION CENTERS
EXAMINATION CENTER EXAMINATION CENTER EXAMINATION CENTER
(FIRST PREFERENCE ) (SECOND PREFERENCE) (THIRD PREFERENCE)
JAIPUR ( 2405 ) SIKAR ( 2411 ) DELHI ( 2201 )
[Link] YOU ARE AN EX- 19.2 DATE OF JOINING THE ARMED 19.3. DATE OF DISCHARGE/ LIKELY DATE OF
SERVICEMAN (ESM) OR SERVING FORCES (DD/MM/YYYY) DISCHARGE FROM ARMED FORCES
IN THE ARMED FORCES? (DD/MM/YYYY)
YES 24/10/1996 24/07/2024
19.5. HAVE YOU ALREADY JOINED A 19.6. DATE OF JOINING TO CIVIL POST
19.4. LENGTH OF SERVICE IN CIVIL POST BY AVAILING BENEFIT OF (DD/MM/YYYY)
ARMED FORCES RESERVATION FOR EX-SERVICEMAN
(ESM) ?

27 YEARS 09 MONTHS 01 DAY - -

20. WHETHER ELIGIBLE FOR SPECIAL QUOTA AS ESM FOR DELHI POLICE?

NO

21.1. WHETHER SEEKING AGE RELAXATION ? 21.2. IF YES,AGE RELAXATION CODE

YES 06-EX-SERVICEMEN (ESM) (UNRESERVED/OBC)

22. HIGHEST EDUCATIONAL QUALIFICATION


BA (5)
23. DETAILS OF QUALIFYING EDUCATIONAL QUALIFICATION
GRADUATION
STATUS PASSING YEAR STATE/ UT OF NAME OF BOARD/ ROLL NO PERCENTAGE CGPA
BOARD/ UNIVERSITY
UNIVERSITY
PASSED 2022 UTTAR PRADESH SWAMI VIVEKANAND W13120553 65.5 -
SUBHARTI UNIVERSITY
24. DO YOU WANT TO MAKE AVAILABLE YOUR PERSONAL INFORMATION FOR ACCESSING JOB OPPORTUNITY IN TERMS
OF DoP&T'S O.M NO.39020/1/2016-ESTT.(B) DATED 21.06.2016 ?
NO
ADDRESS DETAIL
25. CORRESPONDENCE ADDRESS 26. PERMANENT ADDRESS
VILL PO-GHARDANA KHURD VILL PO-GHARDANA KHURD

DISTRICT: JHUNJHUNU DISTRICT:JHUNJHUNU


STATE: RAJASTHAN STATE: RAJASTHAN
PIN : 333514 PIN : 333514
MOBILE NO: 8949377607 EMAIL: maheshlokeshrao73@[Link]
28. WHETHER PHOTOGRAPH HAS BEEN TAKEN ON OR AFTER 23-April-2023?
YES
FEE PAYMENT AMOUNT TRANSACTION NO TRANSACTION DATE
EXEMPTED - - -
DECLARATION
1. I HAVE READ THE NOTICE OF EXAMINATION AND ACCEPT ALL THE TERMS & CONDITIONS MENTIONED
THEREIN.

2. I HEREBY DECLARE THAT ALL STATEMENTS MADE IN THIS APPLICATION ARE TRUE, COMPLETE AND
CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THAT IN THE EVENT OF ANY
INFORMATION BEING FOUND SUPPRESSED/FALSE OR INCORRECT OR INELIGIBILITY BEING DETECTED BEFORE
OR AFTER THE EXAMINATION, MY CANDIDATURE/ APPOINTMENT IS LIABLE TO BE CANCELLED.I AM WILLING
TO SERVE ANYWHERE IN INDIA.

3. I DECLARE THAT THE PHOTGRAPH UPLOADED IN APPLICATION FORM IS NOT MORE THAN 3 MONTHS OLD.

4. I AGREE TO AUTHORIZE SSC TO USE MY AADHAAR DATA FOR VERIFICATION PURPOSE.

VERIFICATION WILL BE SUBJECT TO AUTHORIZATION FROM COMPETENT AUTHORITY.


PRINT TAKEN ON: 06/08/2023 [Link] PM IP ADDRESS: [Link]
NUMBER OF ATTEMPT: 1

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