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UNION PUBLIC SERVICE COMMISSION

DETAILED APPLICATION FORM [DAF]-I
CIVIL SERVICES (MAIN) EXAMINATION, 2024

RID. : 12409544256
Roll No. : 0856391
Name : JITENDRA DHAKAD
Have you ever changed your name? : NO
Email : [email protected]
Mobile : 7470880278

1. (a) Date of Birth | 08-04-97

(b) Age Relaxation claimed | NO

2. (a) Address for correspondence to which | S110, NIVEDITA KUNJ

Communication is to be sent | SECTOR 10, RK PURAM
Post Office: |
City: | NEW DELHI
District: | NEW DELHI
State : | DELHI
Pin Code : | 110022
(b) Telephone No. (with STD Code) | -
(c) Mobile No. | 7470880278
(c.1) Alternate Mobile No. |
(d) Fax No. |
(e) E-mail address | [email protected]
(f) Permanent Postal Address | VILLAGE SINGHARPUR, POST KILAWANI
| TEHSIL KOLARAS
Post Office: |
City: | SHIVPURI
District: | SHIVPURI
State : | MADHYA PRADESH
Pin Code : | 473774

3. Gender : | MALE

4. Marital Status : | UNMARRIED

(If Married, Nationality of spouse) |
5. (a) Citizenship : | A CITIZEN OF INDIA.(1)
(b) Nationality : | INDIAN

6. Mother tongue : | HINDI

7. Place of Birth :
If born in India: | YES
Post Office | KILAWANI

Roll No. :- 0856391 | This is "PREVIEW OF THE FORM".This will not be accepted by
Commission.Only FINALLY SUBMITTED FORM will be accepted.
 Page No. 2/9
City/Town/Village | SINGHARPUR
District | SHIVPURI
State | MADHYA PRADESH
Pincode | 473774

8. (a) Community | OBC (3)

8. (a.1) Do you want to change your | NO
category from SC/ST/OBC/EWS
to Unreserved
I UNDERSTAND THAT MY RESERVED CATEGORY STATUS WILL BE DECIDED IN THE LIGHT OF
RULES/NOTICE OF CSE-2024 AND ON THE BASIS OF SUPPORTING DOCUMENTS/ CERTIFICATES
UPLOADED ONLINE ONLY WITH DAF-I. NO CERTIFICATE/ DOCUMENT SUBMITTED BY ANY
OTHER MODE AND/OR AFTER THE CLOSING OF DAF-I WILL BE CONSIDERED. I ALSO
UNDERSTAND THAT ANY REQUEST FOR CATEGORY CHANGE SUBMITTED BY ANY OTHER
MODE AND/OR AFTER THE CLOSING OF DAF-I WILL NOT BE CONSIDERED.

Note 1: No change in the community status already indicated by candidate in his / her application form for
this examination will be allowed by the Commission except in the circumstances mentioned in the
Rule 26 of CSE Rules, 2024.
Note 2: In case you are a SC or ST category candidate, upload a scanned copy of certificate in prescribed format
in support of your claim. The certificate must be issued latest by the date of closure of online application
form for Civil Services (Preliminary) Examination, 2024 (i.e. 06.03.2024).
Note 3: In case you are EWS Category candidate, upload a scanned copy of ‘Income and Asset Certificate’ in
prescribed format based on the income for Financial Year 2022-23 (i.e. for the period from 1st April, 2022
to 31st March, 2023) in support of your claim. Certificate based on the income of any other Financial Year
shall not be treated as valid. The Certificate must be issued on/after 01.04.2023 (after the completion of
FY 2022-23) but not later than the closing date of the application for Civil Services (Preliminary)
Examination-2024 i.e.06.03.2024.Such candidates must meet the Income and Asset criteria issued by the
Central Government.
Note 4: In case you are an OBC Category candidate, upload a scanned copy of OBC (Non-Creamy Layer) certificate
in prescribed format based on the income for the Financial Years (FYs) 2022-23, 2021-22 and 2020-21.The
Certificate must be issued on/after 01.04.2023 (after the completion of FY 2022-23) but not later than
the closing date of the application for Civil Services (Preliminary) Examination-2024 i.e.06.03.2024.

(b) Certificate No. | 562/B121/202324

(c) Date of issue | 2024-02-15
(d) Designation of issuing authority | SUB-DIVISIONAL MAGISTRATE
(e) Full address of issuing authority | TEHSIL - KOLARAS, DISTRICT - SHIVPURI,
MADHYA PRADESH - 473774

(f) Name of the Caste as mentioned in | DHAKAD (20)

the Community Certificate and | MADHYA PRADESH
Name of the issuing State.
[For SC/ST/OBC Candidates]
(g) State Creamy or Non Creamy Layer | Non Creamy Layer
(h) If you belong to any of the minority
Communities notified by the Government
(Muslim/Christians/Sikhs/Buddhists/
Zoroastrians[Parsi]/Jains) | NO
(i) If yes, Name of the Minority

Roll No. :- 0856391 | This is "PREVIEW OF THE FORM".This will not be accepted by
Commission.Only FINALLY SUBMITTED FORM will be accepted.
 Page No. 3/9
community |

9.1.(a) Whether you are a PwBD/PwD | NO

candidate
(b)(1) Category |

(b).2 Indicate Form Type of the Certificate |

of Disability
(c) Percentage of disability as indicated in |
the Certificate of Disability
(d) Certificate No. |
(e) Date of Issue |
(f) Designation of issuing authority |
(g) Full address of issuing authority |

(h) Are you a PwBD/PwD candidate [as |

per column 9.1.(a)] having physical
limitation to write?(If Yes, upload
scanned copy of the requisite certificate
as per Appendix-V (for PwBD) /
Appendix-VII (for PwD)of the Notice
of CSE, 2024 dated 14th February,
2024)

(i) Do you want to avail Compensatory |

Time
(j) Would you require scribe in the |
Examination
Note 1: The Persons with Benchmark Disabilities(PwBD)in the categories of blindness, locomotor disability (both
arm affected – BA) and cerebral palsy will be eligible for the facility of scribe. In case of other
category of Persons with Benchmark Disabilities as defined under section 2(r) of the RPWD Act, 2016,
such candidates will be eligible for the facility of scribe on production of a certificate to the
effect that the person concerned has physical limitation to write, and scribe is essential to write
examination on behalf, from the Chief Medical Officer/ Civil Surgeon/ Medical Superintendent of a
Government Health Care institution as per proforma at Appendix-V of the Notice of CSE, 2024 dated,
14th February, 2024.
Further, for persons with specified disabilities (PwD) covered under the definition of Section 2(s) of the
RPwD Act, 2016 but not covered under the definition of Section 2(r) of the said Act, i.e. persons having
less than 40% disability and having difficulty in writing will be eligible for the facility of scribe
subject to production of a certificate from the competent medical authority of a Government healthcare
institution as per proforma at Appendix-VII of the Notice of CSE-2024 dated 14th February, 2024 to
the effect that person concerned has limitation to write and that scribe is essential to write examination
on his/her behalf.
Facility of Scribe to eligible candidates will be provided, if desired by them.
Note 2: The candidates have discretion of opting for their own scribe or request the Commission for the same.
Note 3: The qualification of the Commission’s scribe as well as own scribe will not be more than the minimum
qualification criteria of the examination. However, the qualification of the scribe should always be
matriculate or above.
Note 4: The Persons with Benchmark Disabilities (PwBD) in the category of blindness, locomotor disability (both arm
affected – BA) and cerebral palsy will be eligible for Compensatory Time of twenty minutes per hour
of the examination. In case of other categories of Persons with Benchmark Disabilities, such candidates
will be eligible for this facility on production of a certificate to the effect that the person concerned

Roll No. :- 0856391 | This is "PREVIEW OF THE FORM".This will not be accepted by
Commission.Only FINALLY SUBMITTED FORM will be accepted.
 Page No. 4/9
has physical limitation to write from the Chief Medical Officer/ Civil Surgeon/ Medical Superintendent
of a Government Health Care institution as per proforma at Appendix – V of the Notice of CSE, 2024
dated 14th February, 2024.
Further, for persons with specified disabilities (PwD) covered under the definition of Section 2(s) of the RPwD
Act, 2016 but not covered under the definition of Section 2(r) of the said Act, i.e. persons having less
than 40% disability and having difficulty in writing will be eligible for compensatory time subject
to production of a certificate to the effect that person concerned has limitation to write from the
competent medical authority of a Government healthcare institution as per proforma at Appendix-VII of
the Notice of CSE-2024 dated 14th February, 2024.
Facility of Compensatory time to eligible candidates will be provided, if desired by them.
(j)(i) If yes, "Commission's Scribe" or "Own |
Scribe"
(k) Would you require any assistive |
device(s)
(l) Would you require question paper in |
larger font size?

Note: Larger font is only for PwBD Candidates suffering from Blindness/ Low Vision.
9. 2. (a) Have you ever been recommended as a | NO
PwBD candidate in the examinations
conducted by the UPSC in the past?

(b). If yes, mention name and year of the examination(s) with Roll No.
Name of the Examination Year of the Roll No.
Examination

(c) Whether such recommendation was on | NO

the basis of the Certificate of Disability
NOW UPLOADED by you for the
CS(M) Exam, 2024?
(d) After any such recommendation by the | NO
UPSC were you ever found UNFIT/
NOT RECOMMENDED by the Central
Standing Medical Board or any other
Medical Board constituted by the
Government with regard to your
physical disability?
(e) If yes, provide details thereof |

10. Choice of Centre for Examination | AHMEDABAD

11.
(a)(i) Do you hail from Arunachal Pradesh/
Manipur/Meghalaya/Mizoram/Nagaland/
Sikkim and are claiming exemption
from appearing in INDIAN LANGUAGE
FOR PAPER A? | NO

(ii) Are you a PwBD candidate falling

under Deaf/Hard of Hearing category
and seeking exemption from appearing
in INDIAN LANGUAGE FOR PAPER A? | NO

Roll No. :- 0856391 | This is "PREVIEW OF THE FORM".This will not be accepted by
Commission.Only FINALLY SUBMITTED FORM will be accepted.
 Page No. 5/9
(iii)Indian Language for Paper A | HINDI
(b) Optional Subject for paper VI & VII | ELECTRICAL ENGINEERING

12. (a)Language Medium for Examination

for Paper I to Paper V
(Essay and General Studies) | ENGLISH

(b) Language Medium for Examination

for Paper VI to Paper VII (Optional
Subject as at (b) of Col. 11 above) | ENGLISH

(c) In case of Sindhi and Santhali,

type of script should be indicated
by the candidate |

(d)Language Medium for Interview

Test(refer para 27 of the Instructions)
to the Candidates) | ENGLISH

13. (a) Name of Father | SRINIVASH DHAKAD

(a.1) Status | ALIVE
(b) Name of Mother | KAMLESH DHAKAD
(b.1) Status | ALIVE
(c) Nationality of Father | INDIAN
(d) Nationality of Mother | INDIAN
(e) Father's Profession: | AGRICULTURE
(f) Mother's Profession: | AGRICULTURE
(g) If Father is in service, post held by him | NOT APPLICABLE
(g)(i) if retired indicate the post held
by him at the time of his retirement,
otherwise fill 'NOT APPLICABLE' | NOT APPLICABLE
(h) If Mother is in service, post held by her | NOT APPLICABLE
(h)(i) if retired indicate the post held
by her at the time of her retirement,
otherwise fill 'NOT APPLICABLE' | NOT APPLICABLE
(i) Annual income of your Father for | Rs.40000
financial year 2022-2023
(j) Annual income of your Mother for | Rs.0
financial year 2022-2023
(k) State to which your Father originally | MADHYA PRADESH
belongs
(l) District to which your Father originally | SHIVPURI
belongs
(m) State to which your Mother originally | MADHYA PRADESH
belongs
(n) District to which your Mother originally| SHIVPURI
belongs
(o) Father's present postal Address | VILL- SINGHARPUR, TEH- KOLARAS
(If deceased give last address) | DIST- SHIVPURI
Post Office: |
City: | SHIVPURI

Roll No. :- 0856391 | This is "PREVIEW OF THE FORM".This will not be accepted by
Commission.Only FINALLY SUBMITTED FORM will be accepted.
 Page No. 6/9
District: | SHIVPURI
State : | MADHYA PRADESH
Pin Code : | 473774
(p) Mother's present postal Address | VILL- SINGHARPUR, TEH- KOLARAS
(If deceased give last address) | DIST- SHIVPURI
Post Office: |
City: | SHIVPURI
District: | SHIVPURI
State : | MADHYA PRADESH
Pin Code : | 473774

(q) Whether your family owns or

possesses any of the following assets. | NO
i. 5 acres of agricultural land and above;
ii. Residential flat of 1000 sq ft. and above;
iii. Residential plot of 100 sq. yards and
above in notified municipalities;
iv. Residential, plot of 200 sq. yards and
above in areas other than the notified
municipalities.
14.1(a) Do you possess the prescribed Educational
Qualification (Vide rule-6 of the rules of the Examination)?
Please upload a scanned copy of the Certificate
if the answer is "YES" | YES
(b) Certificate No./Enrolment No./Roll No. | 892825067522621358
(c) Date of issue | 07-08-2021
(d) Designation of issuing authority | CHAIRPERSON, BOARD OF GOVERNERS
(e) Full address of issuing authority | IIT BOMBAY, POWAI, MUMBAI-76

Note : If you do not possess the prescribed educational qualification as mentioned in rule-6 of the
examination your candidature is liable to be cancelled. The proof of passing the requisite qualifying
examination should have been issued latest by the closing date of Detailed Application Form-I of the
Civil Services (Main) Examination, 2024.

(f)(i) Do you have any basic Educational

Qualification or higher qualification
obtained from a foreign institution? | NO

14.2 Educational Qualifications : Commencing with Matriculation or equivalent examination till Graduation:-
(Please upload scanned copy of all Certificates/Degree)
Examination Class/ Percentage CGPA Year of Subject(s) Name of Name of
Passed Division of Score Out of School/College Board/University
/Grade Marks(%) Passing /Institution
10th or Equivalent first 10 10 2013 Mathematics, Jawahar Navodaya CBSE
Science, Social Vidyalaya
Science, Hindi,
English
12th or Equivalent first 93.6 2015 Physics, chemistry, Jawahar Navodaya CBSE
Mathematics, Hindi, Vidyalaya
English

Roll No. :- 0856391 | This is "PREVIEW OF THE FORM".This will not be accepted by
Commission.Only FINALLY SUBMITTED FORM will be accepted.
 Page No. 7/9
Stream at Graduation Level :-- ENGINEERING
B. TECH. NA 8.02 10 2021 Electrical IIT Bombay INDIAN
Engineering INSTITUTE OF
TECHNOLOGY
BOMBAY,
MUMBAI,
MAHARASHTRA

15.(i) Have you ever been employed? : | YES

If yes, Are you in

Government/Public Enterprise | YES

If yes, Date of intimation in writing

to your Head of Office/Department
regarding appearing in Civil Services
Examination 2024 | 15-02-2024

Note: The candidates employed in Government/Public Sector Enterprise/Government Autonomous Bodies

must ensure that they have intimated their parent Department before applying for this Examination with
proof of receipt by the Department. If it is found, that the candidates have not done the same, their
candidature is liable to be rejected forthwith without any further notice.

Details of your employments (in chronological order till date)

Designation/Posi Monthly Whether Perman Period Name of Place of Employment
tion remuneration ent/Temporary/ From To employer/ (Address)
(Total) in Rupee Ad-hoc dd-mm- dd-mm- Organisation/
yyyy yyyy Firm/Individual
ASSISTANT 80000 PERMANENT 29-03-2023 Present CENTRAL NEW DELHI
DIRECTOR I ELECTRICITY
AUTHORITY

15.(ii) Have you been self-employed?: | NO

16. Have you ever been debarred by

the UPSC from any of its
Examinations/Selections? | NO

17. Whether you have ever applied for

U.P.S.C. Examination /Recruitment
(Excluding Current Examination): - | YES
Details of other application for Examination/Recruitment held/to be held by UPSC :-
Name of Examination/Post Month and Roll. No. Whether Whether Whether you Whether you Whether
year of appeared at appeared at were recomm have joined/a continuing
Examination the the Interview ended for ppointed till date or re
/Advt. Examination appointment signed(with
No./Item No. date)
for

Roll No. :- 0856391 | This is "PREVIEW OF THE FORM".This will not be accepted by
Commission.Only FINALLY SUBMITTED FORM will be accepted.
 Page No. 8/9
Recruitment
ENGINEERING SERVICES JULY 2021 0405428 YES YES YES YES CONTINUI
NG

18(a). How many times have you appeared

at the Civil Services(Pre) Examination
so far, including the current
Examination held in June, 2024 |2

18(b). Details of Examination in which you have appeared including CS(P) Exam, 2024
Year 2023 2024
Roll No. 5801595 0856391

Note: The candidates who are not in possession of their Roll Nos. for previous year
examination are advised to fill 0000000 in place of their Roll Nos.
19. Have you ever accepted allocation
to a Service/Post on the basis
of Civil Services Examination
held in earlier years? | NO
(a). Year of the Civil Services
Examination on the basis of which
you had been last allocated to
service/post |
(b). Name of service/post to which
allocated |
(c). Your Roll No. for the examination |
(d). Whether you were appointed/joined
Service? |

(e). Whether you are continuing in that

Service/Post? |

(f). If you have resigned from such post/service

Mention date of acceptance of the resignation
by the Competent authority |

20. Fee Payment Details (Subject to Verification) :-

Application No. | 20240856391
Transaction-Id | CPADYSMKU7
Paid (in Rs.) | 200
Agency Name | State Bank of India
Mode of Payment | UPI

Details of Fee paid:Candidates (except Female/SC/ST/PwBD candidates who are exempted from
payment of fee) applying for Civil Services (Main) Examination are required to pay fee of Rs.200/- (Rupees
Two Hundred only) either by remitting the money in any Branch of State Bank of India by Cash or by using
Visa/Master/Rupay Credit/Debit Card/ UPI Payment/ SBI MoPS or by using Internet Banking facility of any Bank.

Roll No. :- 0856391 | This is "PREVIEW OF THE FORM".This will not be accepted by
Commission.Only FINALLY SUBMITTED FORM will be accepted.
 Page No. 9/9
21. Photo-ID Proof | AADHAAR CARD (XXXXXXXX4296)

22. List of Scanned documents uploaded by the candidate:-

Note1: The documents/certificates uploaded with DAF-I only will be accepted.
Note2: The documents/certificates submitted through any other mode or after closing date of DAF-I will
NOT be accepted under any circumstances.
--> Scanned Copy of Matriculation Certification / School Leaving Certificate as proof of date of birth or
any other certificate/document as prescribed in Rule 5(3)of the rules for the exam. [Col. 1(a) of this form]
--> Scanned Copy of Certificate in support of claim to belong to SC / ST / OBC (Non Creamy Layer)/ EWS
(details of which have been indicated in Col.8), and UNDERTAKING FOR OBC/EWS CANDIDATES, as
applicable in a single file.The original physical copy of UNDERTAKING must be submitted at the time of
Personality Test.
--> Scanned Copy of the certificate of graduation or equivalent educational qualifications (including a copy
of recognition letter / equivalence certificate from AIC/UGC, if applicable)[Col. 14 of this form]
--> Copy of the selected Photo ID Proof (viz. Aadhaar Card, Voter Card, PAN Card, Passport, Driving
Licence or any other Photo ID Proof issued by the Central/State Government.)
--> Undertaking “A” for Government employees in the prescribed format annexed with Instructions to
Candidates. [Ref. Col. 15(i) of this form and Para 13 of the Instructions to the candidate]. The original
physical copy must be submitted at the time of Personality Test.

Roll No. :- 0856391 | This is "PREVIEW OF THE FORM".This will not be accepted by
Commission.Only FINALLY SUBMITTED FORM will be accepted.
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