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BSF - Preview Registration Form

The document is an application form for the post of Constable (Washermen) in the Border Security Force, submitted by Brajesh Kumar. It includes personal details, identity information, qualifications, and a declaration confirming the accuracy of the provided information. The application has been submitted with a payment status of 'Paid' and includes various certificates and documents as attachments.

Uploaded by

MAYANK TIWARI
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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0% found this document useful (0 votes)
58 views3 pages

BSF - Preview Registration Form

The document is an application form for the post of Constable (Washermen) in the Border Security Force, submitted by Brajesh Kumar. It includes personal details, identity information, qualifications, and a declaration confirming the accuracy of the provided information. The application has been submitted with a payment status of 'Paid' and includes various certificates and documents as attachments.

Uploaded by

MAYANK TIWARI
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

Border Security Force

Application Form

Post Details

Applied Post / ए�ाइड पो� : Constable(Washermen)

Application No / : CT/2025/02/539570 Application Status / : Submitted Payment Status / : Paid


आवेदन सं�ा आवेदन की ��थित भुगतान की ��थित

Personal Information

Candidate's Name / ��ाशी का : BRAJESH KUMAR Mobile No. / मोबाइल सं�ा : 87******71
नाम

Email Id / इ-मेल आई. डी : bk34****[at]gmail[dot]com

Identity Details

Aadhar : xxxxxxxx9136

Aadhar No / आधार सं�ा : xxxxxxxx9136

Additional Information

Date of Birth / : 01-07-1999 Age / आयु : 26 Years, 1 Months, 23 Days Nationality / रा��ीयता : INDIAN
ज�ितिथ

Father Name / िपता : CHHTE LAL Mother's Name / माता : SARALA DEVI Permanent : na
का नाम का नाम Identification Mark on
Body / शरीर पर �थायी
पहचान िच�

Gender / िलंग : MALE Marital Status / : UNMARRIED Do you have domicile : Yes
वैवािहक ��थित certificate?

Domcile issuing state : UTTAR PRADESH Domicile certificate : 170321318192


number

Category Reservation

Religion / धम� : Hindu Category / �ेणी : SC

Certificate Number / : 170341301723 Certificate Issuing : UTTAR PRADESH Certificate Issuing : Etah
�माण प� सं�ा State / �माणप� जारी District / �माणप� जारी
करने वाले रा� का नाम करने वाले िजला का नाम

Certificate Issuing : Tehsildar Certificate Issuing Date / �माणप� जारी करने : 25-08-2013
Authority / �माणप� की ितिथ
िकसके �ारा जारी िकया
गया

Mode of Recruitment / भत� का तरीका : Direct entry(DE)

Subcategory

Are You Ex- : NO


Servicemen? / �ा
आप भूतपूव� सैिनक ह� ?

Departmental / : No
िवभागीय

Permanent Address Details

Permanent : VILL RAYA POST NAGLA PINCODE / िपन कोड : 207247 State/UT / रा� / : UTTAR PRADESH
Address / �थायी पता GAJPATI TEH ALIGANJ DISTT क��ीय शािसत �दे श
ETAH
District / िजला : Etah Village/City / गां व / शहर : ALIGANJ

Police Station / पुिलस : JAITHRA Post Office / डाक-घर : NAGLA GAJPATI Tehsil / तहसील : ALIGANJ
�े शन

Correspondence Address Details

Correspondence : VILL RAYA POST NAGLA PINCODE / िपन कोड : 207247 State/UT / रा� / : UTTAR PRADESH
Address / प�ाचार पता GAJPATI TEH ALIGANJ DISTT क��ीय शािसत �दे श
ETAH

District / िजला : Etah Village/City / गां व / शहर : ALIGANJ

Police Station / पुिलस : JAITHRA Post Office / डाक-घर : NAGLA GAJPATI Tehsil / तहसील : ALIGANJ
�े शन

Other Details

Do you have(NCC)? / �ा आपके : NO


पास एन. सी. सी �माण प� है ?

Is there any criminal case : No


pending against you.?

Is Communal/Gujarat Riots? : No

Is Candidate who had ordinarily : No


been domiciled in the State of
Jammu & Kashmir from
01.01.1980 to 31.12.1989?

Do you have(Sport Achievement)? / �ा आपके पास खेल उपल�� �माण : No


प� है ?

Physical Standards

Height / ऊंचाई (in cms) : 170.00 Chest (Male only) / छाती (केवल : 80
पु�ष) (in cms)

Weight / वजन (in Kgs) : 55

Qualifications Details

Qualification Type / : SSC/Matric/High School Certificate No. / : H0404171 Year / वष� : 2015
यो�ता �कार �माण प� सं�ा

State / रा� : UTTAR PRADESH Board/University / : State Board


बोड� / िव�िव�ालय

Qualification Type / : Intermediate(10+2) Certificate No. / : 04002807 Year / वष� : 2017


यो�ता �कार �माण प� सं�ा

State / रा� : UTTAR PRADESH Board/University / : State Board


बोड� / िव�िव�ालय

Work Experience

Are you employed? / �ा आप सेवारत है ? : No

Qualification / Experience

Matriculation Or equivalent From a recognised board. : Yes

Must be proficient in respective Trade. : Yes

Must qualify trade test in the respective trade conducted by : Yes


recruitment board.

Physical Standard

Physical Category / �ेणी : General

Certificate & Document


Photo Signature SSC/Matric/High School Certificate

Intermediate(10+2) Certificate Caste Certificate Domicile Document

Transaction Details

Date : 20-08-2025 [Link] Gateway : HDFC Transaction Id : cb18831ead9151d8e080

Gateway Transaction : 113904002959 Amount : 59.00 Status : PAID


Id

Centre Preference

Date : 20-08-2025 Place : ALIGANJ Centre Preference : Delhi

Declaration
1. I hereby declare and confirm that all the entries made in this application form as above are true and correct to the best of my knowledge and belief. In the event of
any information being found false or incorrect or ineligibility being detected before or after medical examination my candidatature will stand cancelled and all my claims for the
recruitment forfeited. I also understand that if at any stage I have violated any of the rules/Regulation governing the conduct of selection process, my candidature may be cancelled
or declared to have failed by the selection board at its sole discretion.
2.I also declare that I do not stand debarred by SSC/UPSC as on date and have never been convicted by any court of law. I also declared that no criminal case is pending against
me. Further declare that I have never been dismissed or removed from Govt Service or my service been terminated during probation.
3.I do Hereby also opt/opt out of the disclosure scheme for making available above information filled in the application and total marks with ranking in the merit if I stand in the final
of this examination for publication in the web page of the department.

Candidate Signature

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