Page No.

1/12

UNION PUBLIC SERVICE COMMISSION

DETAILED APPLICATION FORM [DAF]
INDIAN FOREST SERVICE EXAMINATION, 2025

RID. : 12513078858
Name : SHANU KUMAR PATHAK
Have you ever changed your name? : NO
Email : [email protected]
Mobile : 9315354866

1. (a) Date of Birth | 28-08-1995

(b) Age Relaxation claimed | NO

2. (a) Address for correspondence to which | 66 BLOCK-F,KHANPUR EXTENSION

Communication is to be sent |
Post Office: | SANGAM VIHAR
City: | NEW DELHI
District: | SOUTH DELHI
State : | DELHI
Pin Code : | 110080
(b) Telephone No. (with STD Code) | -
(c) Mobile No. | 9315354866
(c.1) Alternate Mobile No. | 9717033707
(d) Fax No. |
(e) E-mail address | [email protected]
(f) Permanent Postal Address | VILLAGE KEHUNIA
|
Post Office: | KEHUNIA
City: | PRANPUR PRAKHAND
District: | KATIHAR
State : | BIHAR
Pin Code : | 854116

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 | KEHUNIA

Rid :- 12513078858 |
 Page No. 2/12
City/Town/Village | KEHUNIA, PRANPUR PRAKHAND
District | KATIHAR
State | BIHAR
Pincode | 854116

8. (a) Community | EWS (5)

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
Rules of CSE, 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 in prescribed 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. | EWSCO/2025/74757

(c) Date of issue | 2025-01-29
(d) Designation of issuing authority | TEHSILDAR
(e) Full address of issuing authority | ANCHAL KARYALAYA PRANPUR, KATIHAR
BIHAR

(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 |

8.1.(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 |

Rid :- 12513078858 |
 Page No. 3/12
(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 | -NA-

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.

Rid :- 12513078858 |
 Page No. 4/12
(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 | NOT APPLICABLE
larger font size?

Note: Larger font is only for PwBD Candidates suffering from Blindness/ Low Vision.
8. 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, 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 |

9. (a) Name of Father | SHAMBHU NATH PATHAK

(a.1) Status | ALIVE
(b) Name of Mother | PUNAM PATHAK
(b.1) Status | ALIVE
(c) Nationality of Father | INDIAN
(d) Nationality of Mother | INDIAN
(e) Father's Profession: | PRIEST
(f) Mother's Profession: | HOMEMAKER
(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.180000
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 | KATIHAR

Rid :- 12513078858 |
 Page No. 5/12
belongs
(m) State to which your Mother originally | BIHAR
belongs
(n) District to which your Mother originally| KATIHAR
belongs
(o) Father's present postal Address | VILLAGE KEHUNIA
(If deceased give last address) |
Post Office: | KEHUNIA
City: | PRANPUR PRAKHAND
District: | KATIHAR
State : | BIHAR
Pin Code : | 854116
(p) Mother's present postal Address | 66 BLOCK-F,KHANPUR EXTENSION
(If deceased give last address) |
Post Office: | SANGAM VIHAR
City: | NEW DELHI
District: | SOUTH DELHI
State : | DELHI
Pin Code : | 110080

(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.
10.1(a) Do you possess the prescribed Educational
Qualification (Vide rule-7 of the rules of the Examination)?
Please upload a scanned copy of the Certificate
if the answer is "YES" | NO
(b) Certificate No./Enrolment No./Roll No. | ROLL NO 14019284114
(c) Date of issue | 2021-02-27
(d) Designation of issuing authority | VICE CHANCELLOR UNIVERSITY OF DELHI
(e) Full address of issuing authority | REGISTRAR UNIVERSITY OF DELHI

Note : If you do not possess the prescribed educational qualification as mentioned in rule-7 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
INDIAN FOREST SERVICE(MAIN) EXAMINATION, 2025.

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

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

10.2 Educational Qualifications : Commencing with Matriculation or equivalent examination till Graduation:-
(Please upload scanned copy of all Certificates/Degree)

Rid :- 12513078858 |
 Page No. 6/12
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 1ST 07.60 10.00 2010 MATHS SCIENCE ST JOSEPH PUBLIC CENTRAL BOARD
SOCIAL SCIENCE SCHOOL MSV OF SECONDARY
ENGLISH NAGAR EDUCATION
SANSKRIT SAMASTIPUR
12th or Equivalent 1ST 71.4 2012 ENGLISH MATHS JILA SCHOOL NATIONAL
PHYSICS PURNIA SCHOOL OF
CHEMISTRY OPEN
HINDI SCHOOLING
Stream at Graduation Level :-- SCIENCE
B.SC. 2ND 56.67 2020 INDUSTRIAL DESHBANDHU UNIVERSITY OF
CHEMISTRY COLLEGE DELHI, DELHI

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

11.(ii) Have you been self-employed?: | YES

If yes, please give details.

Nature of employment Monthly Income Period Place of employment Remarks
From To (Address)

12. Have you ever been debarred by

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

13. 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 2021-10 5802606 YES NO
(PRELIMINARY)
EXAMINATION

14(a). How many times have you appeared

at the Indian Forest Service
Examination:- | 0

14(b). Details of IFS Examination in which you have appeared

Year Roll No.

Rid :- 12513078858 |
 Page No. 7/12

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

(a)Prizes, Medals, Scholarships etc. | NATIONAL TALENT SEARCH EXAMINATION.

(b) Sports/N.C.C. etc. | NO ANY
(c) Position(s) of distinction Leadership held in | SOLO SONG SCHOOL LEVEL, DISTRICT
School/College TALENT SEARCH EXAMINATION
CERTIFICATE
(d) Other extracurricular activities and interests (Such | TEACHING CHILDRENS,SINGING, PLAYING
as hobbies etc.) CRICKET,WATCHING NATIONAL LEVEL
CRICKET MATCHES MALE,READING AND
SINGING RAM CHARIT MANAS.

16. Photo-ID Proof | AADHAR CARD (XXXXXXXX4849)

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

--> Matriculation Certification / School Leaving Certificate as proof of date of birth or any other
certificate/document as prescribed in the rules for the exam.
--> Certificate in support of claim to belong to SC / ST / OBC (Non Creamy Layer)/ EWS .
--> Certificate of 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.
--> 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.)

Rid :- 12513078858 |
 Page No. 8/12

EWS ANNEXURE

1. Name of the Candidate | SHANU KUMAR PATHAK

2. Rid | 12513078858

3. Income Details
Relations Name of Date of PAN No. Profession Name and Annual income of the Whether
hip with Candidate and Birth Address of candidate and his family the
the his/her Family Employer members for the financial candidate
candidate members year 2022-2023 from all and their
sources i.e. salary, family
agriculture, business, members,
profession, other sources etc. whose
names
are
(ii) mentione
d in Col.
3(ii) file
ITRs
(iii) (iv) (v) (viii)
(i)
(vi) (vii)
SELF SHANU KUMAR 1995-08- CIQPP67 SELF EM MAHADEV SALARY :0 NO
PATHAK 28 73B PLOYED CLASSES AGRICULTURE : 0
BUSINESS :0
PROFESSION : 140000
OTHER SOURCE : 160000
TOTAL INCOME : 300000
TOTAL FAMILY INCOME : 300000

4(A) Whether the family# of the candidate owns | NO

or possesses agricultural land
# family for this purpose will include the person
who seek benefits of reservation, his/her
parents, and siblings below the age of 18 years
as also his/her spouse and children below the
age of 18 years.

(B) If yes,

(i) Whether the agricultural land held by the |

family of the candidate is equal to or more than 5
acres

(ii) Area of the agricultural (irrigated as well |

as un-irrigated) land owned family of the candidate
Note:- If answer to 4(B)(i) is ‘Yes’: The
candidate must mention clearly how many acres
of land are held by him and his family members
separately and also the total area of the

Rid :- 12513078858 |
 Page No. 9/12
agricultural land.. Eg. Father – 3 acres, Mother-
2 Acres, Brother [Name]-1 Acre, Total – 6 acres
etc.

(iii) Address of agricultural (irrigated as well |

as un-irrigated) land owned by family of the
candidate
# Note:- Complete Address including
location[village, Block, Tehsil, District, State
etc.] of all agricultural (irrigated as well as un-
irrigated) land owned by family of the candidate
must be mentioned separately.

5(A) Whether the family# of the candidate own | NO

residential flat(s) of 1000 Sq. ft. and above
# family for this purpose will include the person
who seek benefits of reservation, his/her
parents, and siblings below the age of 18 years
as also his/her spouse and children below the
age of 18 years.

(B) Area of the residential flat(s)# owned by the |

family of the candidate
# Note:- If answer to 5(A) is yes:- The candidate
must mention the area of all flats owned by the
family of the candidate separately. For eg. Flat 1:
1200 Sq. ft., Flat 2:- 800 Sq. ft. etc.

(C) Address of residential flat(s)# owned by the |

family of the candidate
# Note:- Complete Address[village, Block, Tehsil,
District, State etc.] of all flat(s) owned by the
family of the candidate must be mentioned
separately. For eg. Flat 1:- ABC Colony, XYZ
State; Flat 2: PQR Colony, STU State etc.

6(A) Whether the family# of the candidate own | NO

residential plot(s) of 100 Sq. yards and above in
notified municipalities
# family for this purpose will include the person
who seek benefits of reservation, his/her parents,
and siblings below the age of 18 years as also
his/her spouse and children below the age of 18
years.

(B) Area of the residential plot(s)# owned by the |

family of the candidate
# Note:- If answer to 6A is ‘Yes’: The candidate
must mention the area of all residential plot(s)
owned by the family of the candidate separately.
For eg. Plot 1: 150 Sq. yards., Plot 2:- 80 Sq.
Yards. etc.

Rid :- 12513078858 |
 Page No. 10/12
(C) Address of residential plot(s)# owned by the |
family of the candidate
# Note:- Complete Address[village, Block, Tehsil,
District, State etc.] of all plot(s) owned by the
family of the candidate must be mentioned
separately. For eg. Plot 1:- ABC Colony, XYZ
State; Plot 2: PQR Colony, STU State etc.

7(A) Whether the family# of the candidate own | NO

residential plot(s) of 200 Sq. yards and above in
areas other than notified municipalities
# family for this purpose will include the person
who seek benefits of reservation, his/her parents,
and siblings below the age of 18 years as also
his/her spouse and children below the age of 18
years.

(B) Area of the residential plot(s)# owned by the |

family of the candidate in areas other than notified
municipalities
# Note:- If answer to para 7A is ‘Yes’: The
candidate must mention the area of all
residential plot(s) owned by the family of the
candidate in areas other than notified
municipalities separately. For eg. Plot 1: 150 Sq.
yards., Plot 2:- 80 Sq. Yards. etc.

(C) Address of residential plot(s)# owned by the |

family of the candidate in areas other than notified
municipalities
# Note:- Complete Address[village, Block, Tehsil,
District, State etc.] of all plot(s) owned by the
family of the candidate in areas other than
notified municipalities should be mentioned
separately. For eg. Plot 1:- ABC Colony, XYZ
State; Plot 2: PQR Colony, STU State etc.

8. Any other relevant information the candidate |

wish to submit relating to his/her EWS status

Rid :- 12513078858 |
 Page No. 11/12

UNDERTAKING

I SHANU KUMAR PATHAK son/daughter of Shri SHAMBHU NATH PATHAK Resident of

village/town/city VILLAGE KEHUNIA district KATIHAR state BIHAR Pin Code 854116 hereby
declare that I belong to Economically Weaker Section(EWS) Category . It is also declared that I have read
and understood the instructions mentioned in the Ministry of Social Justice & Empowerment’s O.M.
No.20013/01/2018-BC-II dated 17.01.2019, Department of Personnel & Training’s O.M.s
No.36039/1/2019-Estt.(Res.) dated 19.01.2019 and 31.01.2019 and I have reason to declare that I fall under
Economic Weaker Section(s) and eligible in all respects for getting reservation under EWS quota in direct
recruitment in civil posts and services in the Government of India.

DECLARATION OF EWS ANNEXURE

Information furnished above is true to the best of my knowledge and I have not concealed any relevant information. The
same information was submitted before the ‘Income and Asset Certificate’ issuing authority for getting this certificate and
availing myself of this benefit of reservation under EWS category. I swear that if it is found at any stage the information
furnished by me is false or that I have concealed some relevant information, I will forfeit the claim for appointment to any
service on the basis of Civil Services Examination 2024 and also be liable for all or any civil or criminal proceedings under
the law of the land.

Place: (Signature of the Candidate)

Date: Name of Candiate: SHANU KUMAR PATHAK

Rid. : 12513078858
 Page No. 12/12
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- I.

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

[Note: Online submission of the DAF-I by the candidate within prescribed time period is
construed as his/her signed application]

Powered by TCPDF (www.tcpdf.org)