FCI Registration Slip ANUP

2 pages

Please download to get full document.

View again

of 2
All materials on our website are shared by users. If you have any questions about copyright issues, please report us to resolve them. We are always happy to assist you.
  ~ Home  ~ भारतीय    खाय    नगम  FOOD CORPORATION OF INDIA  ZONE-WISE RECRUITMENT for Junior Engineer (JE) (Civil Engineering / Electrical Engineering / Mechanical Engineering),Assistant Grade-II (Hindi), Typist (Hindi) and Assistant Grade-III (General / Accounts / Technical / Depot) Registered Application Form  Application Form for the Post of : Assistant Grade III (Depot) ( I )   EAST   ZONE Registration Number : 39260798534 1 . Candidate's Name : ANUP KUMAR SAHOO  (Name as recorded in the Matriculation / Secondary Examination Certificate) 22.Photo2 . (a) Father's Name : LATE AKSHAYA KUMAR SAHOO  (b) Mother's Name : TILOTTAMA SAHOO3 . Gender : MALE4 . Date of Birth : (As recorded in the Matriculation / Secondary Examination Certificate.)  04/08/1993 5 . Age : 21 Year(s), 4 Month(s), 28 Day(s)  as on (01.01.2015) 6 . Category : OBC 23.Signature7 . Whether Domiciled in the Kashmir Division in the State of Jammu andKashmir during the period 01-01-1980 to 31-12-1989: NO8 . Whether Ex-Servicemen / Availed the benefits of Ex-Servicemen:  NO9 . Whether Person with Disabilities(PWD)/ Physically Handicapped(PH): NO10 . Whether Departmental (FCI) Employee: NO11 . Whether belonging to Minority Community: NO12 . Nationality : INDIAN13 . Zone Applied For : EAST14 . Name of the Written Test Center: Bhubaneshwar 15 . Post Applied For : Assistant Grade III (Depot) ( I )16.Educational Qualification(a)  Name of Academic/Professional Degree/ Diploma(which makes you eligible) :   Graduate degree in any discipline from a recognized University Do you have : Proficiency in use of Computers  YES(b)  Name of the University /Board:  RAVENSHAW UNIVERSITY  (Whether Recognized University/ an Institution approved by AICTE or Board) :  YES   (c)  Year of Passing 2014  (Year) (d)  Duration of Course /Programme :  36  (in Months) (e)  Percentage of Marks : 59.85  %(Marks up to 2 decimal points in aggregate of all years/ semesters (In case of CGPA / OGPA / Letter Grades, it isequivalent percentage(%).  (f)  Remarks if any : 17 . Whether completed :  YES18 (a) . Email Id : anup93.2012@gmail.com   (b) . Confirm Email id: anup93.2012@gmail.com19 . Mobile Number : 876376411720 . Experience : NO21 . Communication Address :   (a) . Address Line 1 :   AT/PO-BALARAMPUR   (6) . Address Line 2 :   VIA-ATHGARH   (c) . City :   CUTTACK   (d) . District :   CUTTACK   (e) . Pin Code :   754295     ADVERTISEMENT NO. 3/ 2015 FCI CATEGORY - III    (Please Print the form for Further Reference)   (f) . State :   Orissa24 . Whether FEE Paid :    YES - Bank Reference Number : IK72825869 , Deposit Date : 12 Mar 2015   Amount {Excluding bank charges but including service tax of Rs. 39/-. Service Tax Code (Registration Number) –AAACF0365NST099} : 350.00 (in Rs.)25 . Declaration : i. I have not submitted any other application for this examination. I am aware that if I contravene this rule, my application will be rejected summarily byFCI.ii. I have read the provisions in the Advertisement carefully and hereby undertake to abide by them.iii. I further declare that I fulfill all the conditions of eligibility regarding age limits, educational qualifications, experience etc. prescribed for the postapplied for.iv. I also declare that I do not stand debarred by FCI as on date and have never been convicted by any court of law. I also declare that no charge sheet ispending against me in any court of law. Further declare that I have never been dismissed or compulsorily retired from the service of the Corporation or from a Department of a State or the Central Government or from any Public Sector Undertaking or my service been terminated during probation.v. For Candidate belonging to OBC -I declare that I belong to the community, which is recognized as backward class by the Govt. of India for the purpose of reservation in services as per order contained in Deptt. of Personnel and Training Office Memorandum No. 36012/ 22/ 93-Estt.(SCT) dated 8.9.1993. I also declare that I do notbelong to the person / sections (creamy layer) mentioned in column 3 of the schedule of the OM mentioned above and modified vide Govt. of IndiaDOPT OMs mentioned in the Notice. I further declare that I am in possession of OBC Certificate in the prescribed format given in the Notice of the Advertisement.vi. I hereby declare that there is no Vigilance / Disciplinary case pending against me. I am in possession of ‘No Objection Certificate’ from my employer which shall be required to be sent along with other essential enclosures in case of my shortlisting on the basis of the Written Test / Skill test at thedesignated Address which shall be informed / notified through the designated website (www.fcijobsportal.com)vii. I hereby declare that self-certified copies of relevant certificates / documents are in my possession. In case, self-certified copies of the relevantcertificates / documents are not provided by me along with the Registered Online Application Form Printout, if called for, my candidature will becancelled without any notice. I hereby declare that all the information given/ statements made by me in the application are true, complete and correct to the best of myknowledge and belief and nothing has been concealed or suppressed. In the event of any information being found false or incorrect or is not inconformity with the eligibility criteria mentioned in the advertisement at any point of time my candidature / appointment may be cancelled / terminatedwithout any notice and / or I shall be liable for any other action under the extant rules. Date: 12 Mar 2015 Signature:Place:   Candidate's Name (in Capital letters) :
Related Search
We Need Your Support
Thank you for visiting our website and your interest in our free products and services. We are nonprofit website to share and download documents. To the running of this website, we need your help to support us.

Thanks to everyone for your continued support.

No, Thanks