Haryana Staff Selection Commn, Government of Haryana

7/24/2019 Haryana Staff Selection Commn, Government of Haryana

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22/11/2015 Har yana Staff Selection Commission, Gover nment of Har yana

http://adv3.hryssc.in/AppForm/Printform.aspx?FrmNo=CS1EXXAMelgdAwlDATY3mA==&PGID=Ar2bxpmIeBQ= 1/2

Haryana Staff SelectionCommission Version No. : 2.2

Form No.

: 300322190

Name / NITIN

Father/Husband's Name / /

MUKESH

Mother's Name/ NIRMALA

Gender/ Male Date of Birth/ :25/07/1995 Marital Status/

UnMarried

Nationality/ :Indian

Religion: Hindu

Area/ :Rural Adhar Number/:786093320091

Visible Identity Mark OnBody:

Black mole on the neck

:: Applied Post

S.N. Post Name Payment Status Post Application Id

1. Advt. No. 7/2015-Cat. No. 10-Sub Inspector Not Paid 2759332

Correspondence Address & Contact Details/

Vill- Dhani ramjilal, Khera khurampur, Tehsil- FarrukhnagarCity: Farrukhnagar, Tehsil: Farrukhnagar, Dist: Gurgaon, Pin: 122506State: Haryana, Mobile/Phone- 8395947701,

:: Reservation/

Category /:BCB; Certificate No. TEH/FNG/OBC/638; Issuing Authority: GOVT. OF HARYANA; Date Of Issue: 15/06/2012

Physically Handicapped / :None

Social Reservation / : None

Sports Type Details / : None

Are you a domicile of Haryana state/ ?: Yes

Knowledge of Hindi/Sanskrit upto Matric Standard?: Yes

Whether passed NCC Certificate?:No

:: Other Essential Details

Did you apply previously for the advertisement ?: No

:: Qualifying Examination/

Education University/

Board NamePassing

Year & MonthMarks

ObtainedTotal

Marks Percentage

Class 10th (Mandatory)-

Class 10th CENTRAL BOARD OF SECONDARY EDUCATION May 2010 8.80 10 83.60

12th/10+2-

12th/10+2 (Science-PCM) CENT RAL BOARD OF SE CONDARY EDU CATION M ay 2012 399.00 500 79.80

Printed on: 22/11/2015, 6:05 PM

7/24/2019 Haryana Staff Selection Commn, Government of Haryana

2/2

22/11/2015 Har yana Staff Selection Commission, Gover nment of Har yana

http://adv3.hryssc.in/AppForm/Printform.aspx?FrmNo=CS1EXXAMelgdAwlDATY3mA==&PGID=Ar2bxpmIeBQ= 2/2

:: Required Documents

S.N. Document Name Uploaded

Status

1. Class 10th Mark Sheet showing date of birth duly self-certified by affixing right hand thumb impression

for female and left hand thumb impression for Male Yes

2. Class 12th Mark Sheet (if applicable) Yes

3. Scanned copy of Haryana Domicile certificate Yes

4. Graduate Mark sheet (if applicable) No

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Place : Date : Signature of the Candidate :

Printed on: 22/11/2015, 6:05 PM