HARYANA STAFF SELECTION COMMISSION
One Time Registration Details CET-'C'-01/2025
Acknowledgement
CET-'C' ID 2025
20250203523
Full name as per matriculation DEEPAK
Father's name RAM MEHAR
Mother's name SUMAN
Date of birth as per matriculation 02-12-2005
Gender MALE
Marital status UNMARRIED
Email ID maniskumar8501@[Link]
Mobile No. 9060906490
Aadhaar number 624494120450
Identification marks 1 TIL ON BODY
Identification marks 2
Have you participated in the CET 01/2022 NO
Form filled by candidate
Have you filled the form by yourself? YES
Address Information
Correspondence Address Permanent Address
NEAR BUS STAND VPO NEAR BUS STAND VPO
Address Address
CHANDANA CHANDANA
Village/City/Sector CHANDANA Village/City/Sector CHANDANA
Post office CHANDANA Post office CHANDANA
State HARYANA State HARYANA
District KAITHAL District KAITHAL
Pin code 136027 Pin code 136027
Category Information
Are you a Domicile/ Bonafide resident of Haryana ? YES
Domicile certificate number HR20219458
Domicile certificate issue date 2021-08-04
Domicile certificate issuing authority name TEHSILDAR
Signature of the Candidate
HARYANA STAFF SELECTION COMMISSION
One Time Registration Details CET-'C'-01/2025
Category GEN
Have you worked or presently working on
adhoc/contract/workcharged/ daily wages basis in any
Department/ Board Corporation of Haryana Government NO
including Government-aided lnstitutions under Haryana
Government ?
Are you an Ex-Serviceman/Family Member of Ex-
NO
Serviceman?
Are you a dependent of freedom fighter (DFF)? NO
Are you a PWD (Person with Benchmark Disability)
NO
Candidate
Are you an eligible sports person (ESP)? NO
Do you have any criminal case against you? NO
Education Qualification
% of
Examination Course Board/university Year of
Duration Stream Rollno Marks/
Passed Type Name passing
CGPA
BOARD OF
10TH
SCHOOL
10TH - - WITH 2021 1021347874 91
EDUCATION
HINDI
HARYANA
BOARD OF
12TH SCHOOL
- - ARTS 2023 3023191787 75
COMPLETED EDUCATION
HARYANA
Payment Details
Transaction ID Paid Amount Date & Time
133519110 500 06/06/2025 [Link]
Uploaded Documents
• Photo Uploaded
• Signature Uploaded
• Aadhaar Uploaded
• Undertaking as per annexure -VII Uploaded
• Domicile Certificate Uploaded
• 10th or Matriculation certificate Uploaded
• 12th completed Uploaded
Declaration
Signature of the Candidate
HARYANA STAFF SELECTION COMMISSION
One Time Registration Details CET-'C'-01/2025
I declare that all the information and particulars filled in this application are true, complete, and correct to the
best of my knowledge and belief. I understand that any misrepresentation, omission or concealment of facts
may lead to the cancellation of my candidature at any stage of the recruitment process or termination of my
employment, if appointed
Uploaded Signature Acknowledgement Generated Date & Time
06-06-2025 [Link]
Signature of the Candidate
