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Big Boss

The document is an application for the AGNIVEER [SSR-M] position, submitted by Himanshu Yadav on 20/07/2022. It includes personal details, educational qualifications, and a declaration of eligibility and truthfulness of the provided information. The applicant has completed 12th grade with a percentage of 87.33 and has not previously been enrolled in the Armed Forces.

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36 views2 pages

Big Boss

The document is an application for the AGNIVEER [SSR-M] position, submitted by Himanshu Yadav on 20/07/2022. It includes personal details, educational qualifications, and a declaration of eligibility and truthfulness of the provided information. The applicant has completed 12th grade with a percentage of 87.33 and has not previously been enrolled in the Armed Forces.

Uploaded by

decokoh630
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

Application of Job: AGNIVEER [SSR-M] - 01/2022

Application No: SSRM22124225657N Application Date: 20/07/2022

PRIORITY

1. AGNIVEER [SSR-M] 01/2022

PERSONAL PARTICULARS

Name: HIMANSHU YADAV


Father's/Mother's Name: SUKHDEV SINGH
Guardian's Name: SUKHDEV SINGH
Nationality: INDIAN
Identification Mark 1: A MOLE ON THE LIPS
Identification Mark 2: ---------
Date of Birth: 10/07/2002
Aadhaar Number:
9675
(Last 4 digit)
PAN Number: ******328A
Voter ID Number: ---------
Passport Number: ---------
Ration Card Number: ---------

EDUCATION PARTICULARS

Details of 12th Science

Subjects Total Marks Obtained Marks

Physics 100 88

Chemistry 100 90

Maths 100 84

Total Marks: 300 Marksheet Serial Number: 0995149


Obtained Marks: 262 State Conduct: UTTAR PRADESH
Percentage: 87.33 Board Conduct: Uttar Pradesh Madhyamik Shiksha Parishad

Details of 10th

Total Marks: 600 Marksheet Serial Number: 1512035


Obtained Marks: 509 State Conduct: UTTAR PRADESH
Percentage: 84.83 Board Conduct: Uttar Pradesh Madhyamik Shiksha Parishad

MILITARY RECORD
Have you ever been enrolled in
NO
Armed Forces before?:
Have you been
discharged from
NO
Armed forces
before?:

COMMUNICATION PARTICULARS

Details of Permanent Address

Address 1: TIRWA ROAD SAURIKH KANNAUJ Address 2: NEAR ALIPUR MODE


State: UTTAR PRADESH District: KANNAUJ Pincode: 209728
Domicile: UTTAR PRADESH Phone No.: 6386226318 Mobile No.: 6386226318
kaditya16071994@g
Email id: himanshusurya255@[Link] Alternate Email id:
[Link]

Details of Correspondence Address

Same as Permanent Address


Alternate Mobile Number: 9565547496

A. I hereby declare that I am unmarried, governed by nationality condition as laid down by the Government of India and
have never been debarred from appearing at any examination. I have never been arrested/ prosecuted and convicted by a
criminal court or involved in any other case registered by the Police.
B. I hereby, solemnly declare that all the statements made in the above application are true and correct to the best of my
knowledge and belief.
C. I fully understand that in the event of my information being found false or incorrect, appropriate action can be taken
against me.
D. Eligibility criteria will be verified on reporting at the selection centres. If found ineligible, I understand that criminal
proceedings can be initiated against me for fraudulent entry and falsification of Government of India documents. I also
accept that no TA/ DA will be admissible to me in such cases.

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