HARYANA STAFF SELECTION COMMISSION

One Time Registration Details CET-'C'-01/2025

Acknowledgement

CET-'C' ID 2025
993829

Full name as per matriculation NANCY

Father's name BIJENDER SHARMA

Mother's name POOJA

Date of birth as per matriculation 19-11-2001

Gender FEMALE

Marital status UNMARRIED

Email ID [email protected]
Mobile No. 9671535029
Aadhaar number 768261101699
Identification marks 1 NA
Identification marks 2
Have you participated in the CET 01/2022 YES
Previous CET 01/2022 Details
Registration No. as per previous CET 01/2022 993829
DOB as per previous CET 01/2022 2001-11-19
CET marks as per previous CET 01/2022 51.3995923
Category as per previous CET 01/2022 GEN
Form filled by candidate
Have you filled the form by yourself? YES
Address Information

Correspondence Address Permanent Address

HOUSE NO 802 NEAR SHIV HOUSE NO 802 NEAR SHIV
Address Address
MANDIR VILLAGE KUTANI MANDIR VILLAGE KUTANI
Village/City/Sector KOTANI Village/City/Sector KOTANI
Post office RAJAKHERI Post office RAJAKHERI
State HARYANA State HARYANA
District PANIPAT District PANIPAT
Pin code 132103 Pin code 132103

Category Information

Signature of the Candidate

 HARYANA STAFF SELECTION COMMISSION
One Time Registration Details CET-'C'-01/2025

Are you a Domicile/ Bonafide resident of Haryana ? YES

Domicile certificate number HR/2019/3714
Domicile certificate issue date 2019-05-27
Domicile certificate issuing authority name NAIB TEHSILDAR PANIPAT
Category GEN
Have you worked or presently working on
adhoc/contract/workcharged/ daily wages basis in any
Department/ Board Corporation of Haryana NO
Government 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 2018 2018336744 85.8
EDUCATION
SANSKRIT
HARYANA
BOARD OF
12TH SCHOOL
- - ARTS 2020 3020327861 86.6
COMPLETED EDUCATION
HARYANA
Payment Details
Transaction ID Paid Amount Date & Time
133697550 250 07/06/2025 18:57:16

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

Signature of the Candidate

 HARYANA STAFF SELECTION COMMISSION
One Time Registration Details CET-'C'-01/2025

Declaration
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

07-06-2025 19:00:54

Signature of the Candidate