Registration No.
Registration Date
Post applied for
Name of the Candidate
Father's Name
Mother's Name
Date of Birth-dd/mm/yyyy
Gender
Marital Status
Email ID
Mobile Number
Spouse Name
Category
Whether seeking age relaxation by virtue of your category and/or disability
Have you ever changed your name
Name Changed
Are you OH(Orthopedically Handicapped with at least 40% disability)?
Disability(in percentage)
Are you a government employee?:-
Type of Employment
Designation :-
Date of Joining :-
Pay Level/Scale :-
Identity Proof
Identity Proof No.
Nationality
Do you know cycling ?
life skill
Do you have a valid driving licence ?
Driving Licence No.
Date of Issue
Preference of examination centres
Choice-1:
Choice-2:
Choice-3:
Communication Address
Permanent Address
Visible mark of Identification of Candidate
Are you Domicile of Bihar?
Whether any Criminal case(s) has ever been registered against you?
Whether any FIR/Complaint Case/P.S. Case has ever been registered against you?
Whether serving in Patna High Court or courts subordinate to this Court?
Have you been awarded with “B” certificate of NCC?
Qualification
Name of the Degree/Course
Name of School/College/Institute
Name of Board/University
Subjects/Stream
Passing Year
Marks Obtained
Maximum Marks
%
Division
CGPA-Grade
CGPA-%
I undertake that if, at any stage, it is found that I possess any higher qualification, including a diploma course, other than the one prescribed in this advertisement, i.e., Intermediate (12th Pass) from a recognized Board/Institution, I shall not only be terminated forthwith but shall also be subject to criminal prosecution.
Identity Proof (
) :-
All the information & details furnished and documents uploaded hereinabove are correct and true to the best of my knowledge. If at any stage during recruitment or even after selection or appointment, it is found that the above furnished information is wrong then my candidature/ selection may be cancelled and I shall be liable for suitable action as decided by Hon’ble Patna High Court.
I have verfied all the details appearing at the preview page and found them correct. I understand that after making payment. no change or alteration can be made in the same.
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(Signature of Applicant)