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UNION PUBLIC SERVICE COMMISSION

DETAILED APPLICATION FORM
CIVIL SERVICES EXAMINATION, 2025

RID. : 12510474807
Name : KANHAIYA KUMAR KUSHWAHA
Have you ever changed your name? : NO
Email : [email protected]
Mobile : 9650035778

1. (a) Date of Birth | 24-03-1994

(b) Age Relaxation claimed | NO

2. (a) Address for correspondence to which | H NO-620, KH NO-2315, GALI NO-8, C-BLOCK,
SURENDER COLONY, PART-1
Communication is to be sent |
Post Office: | BURARI
City: | DELHI
District: | NORTH DELHI
State : | DELHI
Pin Code : | 110084
(b) Telephone No. (with STD Code) | -
(c) Mobile No. | 9650035778
(c.1) Alternate Mobile No. |
(d) Fax No. |
(e) E-mail address | [email protected]
(f) Permanent Postal Address | H NO-620, KH NO-2315, GALI NO-8, C-BLOCK,
SURENDER COLONY, PART-1
|
Post Office: | BURARI
City: | DELHI
District: | NORTH DELHI
State : | DELHI
Pin Code : | 110084

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 :

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If born in India: | YES
Post Office | PACHRUKHI
City/Town/Village | MALLUPUR
District | SIWAN
State | BIHAR
Pincode | 841241

8. (a) Community | UNRESERVED (4)

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, 2025.
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, 2025.
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 2023-24 (i.e. for the period from 1st April, 2023
to 31st March, 2024) 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 01.04.2024 (after the completion
of FY 2023-24) but not later than the closing date of the application for Civil Services (Preliminary)
Examination-2025. 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 inprescribed format based on the income for the Financial Years (FYs) 2023-24, 2022-23
and 2021-22.The Certificate must be issued on/after 01.04.2024 (after the completion of FY 2023-24) but
not later than the closing date of the application for Civil Services (Preliminary) Examination-2025

(b) Certificate No. |

(c) Date of issue |
(d) Designation of issuing authority |
(e) Full address of issuing authority |

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

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

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(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, 2025 dated 22nd January,
2025)

(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, 2025 dated,
22nd January, 2025.
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-2025 dated 22nd January, 2025 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
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, 2025
dated 22nd January, 2025.
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-2025 dated 22nd January, 2025.
Facility of Compensatory time to eligible candidates will be provided, if desired by them.

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(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
CSE, 2025?
(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 | DELHI

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
(iii)Indian Language for Paper A | HINDI
(b) Optional Subject for paper VI & VII | PUBLIC ADMINISTRATION

12. (a)Language Medium for Examination

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

(b) Language Medium for Examination

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

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(c) In case of Sindhi and Santhali,
type of script should be indicated
by the candidate |

(d)Language Medium for Interview

Test | HINDI

13. (a) Name of Father | JAWAHAR LAL PRASAD KUSHWAHA

(a.1) Status | ALIVE
(b) Name of Mother | JULI DEVI
(b.1) Status | ALIVE
(c) Nationality of Father | INDIAN
(d) Nationality of Mother | INDIAN
(e) Father's Profession: | AGRICULTURE
(f) Mother's Profession: | HOUSEWIFE
(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.100000
financial year 2023-2024
(j) Annual income of your Mother for | Rs.0
financial year 2023-2024
(k) State to which your Father originally | BIHAR
belongs
(l) District to which your Father originally | SIWAN
belongs
(m) State to which your Mother originally | BIHAR
belongs
(n) District to which your Mother originally| SIWAN
belongs
(o) Father's present postal Address | VILLAGE MALLUPUR, ACNCHA THANA-
PACHRUKHI
(If deceased give last address) |
Post Office: | PACHRUKHI
City: | SIWAN
District: | SIWAN
State : | BIHAR
Pin Code : | 841241
(p) Mother's present postal Address | VILLAGE MALLUPUR, ACNCHA THANA-
PACHRUKHI
(If deceased give last address) |
Post Office: | PACHRUKHI
City: | SIWAN
District: | SIWAN
State : | BIHAR

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Pin Code : | 841241

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. | 2822484
(c) Date of issue | 2019-10-14
(d) Designation of issuing authority | ASSISTANT REGISTRAR
(e) Full address of issuing authority | CAMPUS OF OPEN LEARNING DELHI 110007

(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 I 67 2009 ALL GENERAL GSVMHS BSEB PATNA
SUBJECTS PACHRUKHI
12th or Equivalent III 44.8 2016 ARTS PATRACHAR CBSE
VIDYALAYA
Stream at Graduation Level :-- HUMANITY
B.A. II 50 2019 HISTORY AND SOL UNIVERSITY OF
EDUCATION DELHI,
DELHI-110007.

14.3 Higher Educational Qualifications : Commencing with Post Graduation or equivalent examination :-
Examination Class/ Year of Date of Likely date CGPA Percentag Subject(s) College/Institution Board/
Passed/ Division Passing Joining of Score Out of e University
Appeared/ /Grade Completion of
Appearing Marks(%)

15.(i) Have you ever been employed? : | NO

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

16. Have you ever been debarred by

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

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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 Qualified Whether Whether Whether Whether
year of appeared at for Mains appeared at you were re you havejoi continuing
Examination the Examin the commended ned/appoint till date or re
/Advt. ation Interview for appoint ed signed(with
No./Item No. ment date)
for
Recruitment
Civil Services (Preliminary) 2020-05 0000000 YES NO
Examination
Civil Services (Preliminary) 2022-05 0000000 YES NO
Examination

18(a). How many times have you appeared

at the Civil Services(Pre) Examination | 2

18(b). Details of Examination in which you have appeared including CS(P) Exam
Year 2020 2022
Roll No. 0000000 0000000

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. Please give Particulars at the University/State/National Level in respect of:-

(a)Prizes, Medals, Scholarships etc. |

(b) Sports/N.C.C. etc. |

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(c) Position(s) of distinction Leadership held in |
School/College
(d) Other extracurricular activities and interests (Such |
as hobbies etc.)

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21. Your order of preference against the Services/Posts given below , for which you would like to be
considered for appointment.
Note 1 : It is clarified that the below order of services does not reflect their relative importance in the eyes of the
Government and the candidates are advised to use their own discretion while indicating preference for various
services.
Note 2: A candidate shall be required to mandatorily indicate order of preferences only for those services
participating in the Civil Services Examination for the year, for which he is interested to be allocated to. No
change in preferences for Services once submitted by a candidate would be permitted . In case preference for
none of the Services is indicated, the candidate will not be considered for Service Allocation [as per Rules
of CSE, 2025].
Note 3: The services which are not required to be opted have been shown as 'NOT OPTED.'
Note 4: A candidate who is appointed to the Indian Police Service on the basis of the results of an earlier
examination and continues to be a member of that service shall not be eligible to opt for the Indian Police
Service in Civil Services Examination, 2025.

S.N. Name of Services/Post Order of Preference

1. Indian Administrative Service 1
2. Indian Foreign Service 2
3. Indian Police Service 3
4. Indian Audit and Accounts Service, Group "A" 4
5. Indian Civil Accounts Service ,Group "A" 5
6. Indian Corporate Law Service ,Group "A" 6
7. Indian Defence Accounts Service ,Group "A" 7
8. Indian Defence Estates Service, Group "A" 8
9. Indian Information Service, Group "A" 9
10. Indian Postal Service,Group "A" 10
11. Indian Post & Telecommunication Accounts and Finance Service, Group "A" 11
12. Indian Railway Management Service (Traffic), Group "A" 12
13. Indian Railway Management Service (Personnel), Group "A" 13
14. Indian Railway Management Service (Accounts), Group "A" 14
15. Indian Railway Protection Force Service, Group "A" 15
16. Indian Revenue Service (Customs & Indirect Taxes) Group "A" 16
17. Indian Revenue Service, (Income Tax) Group "A" 17
18. Indian Trade Service, Group "A" (Gr. III) 18
19. Armed Forces Headquarters Civil Service , Group 'B'(Section Officer's Grade) 19
20. Delhi , Andaman and Nicobar Islands, Lakshadweep, Daman & Diu and Dadra & 20
Nagar Haveli Civil Service (DANICS), Group "B"
21. Delhi , Andaman and Nicobar Islands, Lakshadweep, Daman & Diu and Dadra & 21
Nagar Haveli Police Service (DANIPS), Group "B"
22. Pondicherry Civil Service (PONDICS), Group "B" 22
23. Pondicherry Police Service (PONDIPS), Group "B" 23

22. Photo-ID Proof | AADHAAR CARD (XXXXXXXX0870)

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

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--> Matriculation Certification / School Leaving Certificate as proof of date of birth or any other
certificate/document as prescribed in the rules for the exam.
--> The certificate of graduation or equivalent educational qualifications (including a copy of recognition
letter / equivalence certificate from AIU/UGC, if applicable)
--> 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.)

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DECLARATION BY THE CANDIDATE

I, hereby declare that all statements and entries made in all the columns of this application are true,
complete and correct to the best of my knowledge and belief.

2. That I have read Rules of the Civil Services Examination, 2025 published in Part I –
Section 1 of the Gazette of India Extraordinary dated 22nd January, 2025 and understand that in the
event of any information being found false or incorrect or ineligibility being detected before or
after the examination, or flouting of any instructions given by the Commission along with e-Admit
card/ Question – cum – Answer Booklets/ e-Summon letter etc.action can be taken against me by
the Commission.

3. That I further declare that I fulfil all the eligibility conditions regarding age limits, educational
qualifications etc. prescribed for admission to the Examination. I have not exhausted the number of
attempts admissible to me under the Rules of the Examination, 2025.

4. That I have not withheld any information required as per this Detailed Application Form.

5. I have thoroughly scrutinised the list of scanned documents as enumerated and uploaded scanned
copies of all the documents relevant for me.

6. That I have read the Rules of Examination and the instructions carefully and I hereby undertake to abide
by them.

7. That I have informed my Head of the Office/Department in writing that I have applied for this
examination.

Signature of the Candidate

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