J&K SERVICES SELECTION BOARD
GOVERNMENT OF JAMMU & KASHMIR
APPLICATION FORM FOR DIVISION/DISTRICT CADRE POSTS
NAME OF POST - Veterinary Pharmacist
Application ID - 1195666
Date - 06-09-2021 10:40:21
ADVERTISEMENT NUMBER - 4 OF 2021
Post Department Sub Department Cadre/Item No.
Veterinary Pharmacist Animal/Sheep husbandary Directorate,Animal Div.Jammu (Item No. 610)
and Fisheries Department Husbandary Department Doda (Item No. 616)
Jammu
PERSONAL DETAILS
Full Name Father's Name
Mr. RAHUL SINGH SHAN RAM SINGH
Mother's Name Gender
KAMLESHA DEVI Male
Date Of Birth Age as on 01.01.2021
07-February-1997 23
Mobile Number Email Whether Married
7889988324 [email protected] No
Division District
jammu Doda
Domicile Certificate Detail
NOTE :- Domicile Certificate needs to be produced at the time of Document Verification.
Certificate Number Certificate Issuing Authority
DOM/0810/30Jul2020/004047786 TEHSILDAR MOHALLA
Permanent Address
House No./ Room No. Locality/ Mohalla/ Ward Number Village/ Town/ City
Village Assisi Tehsil Mohalla BPO Prem Nagar Assisi
Division District Tehsil
jammu Doda Mohalla
Block Panchayat Pincode
Gundana Pershulla A 182201
Correspondence Address
House No./ Room No. Locality/ Mohalla/ Ward Number Village/ Town/ City
Village Assisi Tehsil Mohalla BPO Prem Nagar Assisi
Division District Tehsil
jammu Doda Mohalla
Block Panchayat Pincode
Gundana Pershulla A 182201
Category of Applicant
Category
RBA
Date of Issue of Certificate Issuing Authority
04-05-2021 TEHSILDAR MOHALLA
Are you Specially Abled Person (PH)?
No
Are you an employee of J&K Government?
No
Are you an Ex-Servicemen?
No
Have you ever been selected for any other Government Job under ESM Category?
No
Criminal Proceedings
Whether any FIR has been lodged/registered against you?
No
Whether any prosecution is pending in any Court of Law against you?
No
Whether any Chargesheet has been filed against you?
No
Whether you have been convicted by any court of competent jurisdiction in any offence?
No
Was any Court Case been filed against you?
No
Whether any disciplinary action has been initiated by Government/Semi-Government Organizations against you?
No
Qualification Details
10th Board 10th Percentage 10th Result Date
Jammu & Kashmir Board Of School Education 82.8 03/02/2012
10th Obtain Marks 10th Maximum Marks
414 500
Other Details
Do you possess the prescribed educational qualifications as per the advertisement / notification? Choice of Examination Center at
Yes Jammu Division
Declaration
I hereby declare that I have carefully read the Advertisement Notification for this post and all the terms and conditions indicated therein and undertake to
abide by the terms and conditions of the advertisement / notification for participating in the selection process. I fulfill all the terms and conditions
mentioned in the advertisement notification and the information provided by me herein is true and correct to the best of my knowledge. I also undertake
that in case of failure to possess the qualification prescribed in the advertisement notification, the board will be fully competent to debar me from the
selection process. I further stipulate that I have carefully read the Government notification and assure that I am not barred by the provisions of the said
notification. I further undertake that I shall not claim any benefit of any qualification/category that have not specifically indicated in this online application
form. Further, I am aware that I will be liable for appropriate penal action, disqualification from the selection process or loss of the job in the event of
selection having been made, if the information provided by me is proved to be incorrect at any stage. The charges for filling up the form are Rs. 350 and
are non-refundable. I am aware that I shall not have claim over the charges, once successfully paid to JAMMU AND KASHMIR Services Selection Board,
JAMMU AND KASHMIR. All the disputes related to refund of excess payment, if any, are subject matter of the JAMMU AND KASHMIR Service Selection
Board. Candidates are advised to apply for refund of excess payment, if any, through official portal www.ssbjk.org.in only. No chargeback request shall be
entertained. Do you agree? *
ONLY FOR INSERVICE CANDIDATES
SIGNATURE WITH
CERTIFIED THAT S/O W/O D/O
STAMP OF HEAD OF
IS WORKING AS______________________________________________________________________
DEPARTMENT
IN
From
To _________________________
ON BASIS
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