FGFHG

efJe%eeheve mebKee : S-4/F&-1/2013
efoveebke : 19/08/2013
(Submit)
cSd
a esa 'kqYd tek djus dh vfUre frfFk rd vH;fFkZ;ksa }kjk 'kqYd tek djus dh
n'kk esa mudk vkosnu Lohdkj gksxkA ;fn fu/kkZfjr vfUre frfFk ds ckn fdlh cSd
a esa 'kqYd tek fd;k
tkrk gS rks vH;FkhZ dk vkosnu Lohdkj ugha gksxk] mls fujLr ekuk tk;sxkA tek 'kqYd fdlh n'kk esa
fdlh vH;FkhZ dks okil ugha gksxkA fu/kkZfjr vfUre frfFk rd 'kqYd cSd
a esa tek djuk rFkk fu/kkZfjr
vfUre frfFk rd vkosnu 'Submit' djus dk nkf;Ro vH;FkhZ dk gSA**
;g foKkiu vk;ksx dh Website http://uppsc.up.nic.in ij Hkh miyC/k gSA bl foKkiu esa
vkosnu djus gsrq *vku&ykbu* vkosnu i)fr ON-LINE APPLICATION SYSTEM) ykxw gSA vU; fdlh
ek/;e ls izfs "kr vkosnu&i= Lohdkj ugha fd;k tk;sxkA vH;FkhZ vku&ykbu vkosnu gh djsAa
**vku ykbu vkosnu** djus ds lEcU/k esa vH;fFkZ;ksa dks lwfpr fd;k tkrk gS fd fuEufyf[kr funs'Z kksa dks
HkyhHkkfr le> ysa vkSj rnuqlkj vkosnu djsAa
vk;ksx dh Website http://uppsc.up.nic.in ij ALL NOTIFICATION/ADVERTISEMENT DETAILS
vH;FkhZ }kjk Click djus ij ON-LINE ADVERTISEMENT Lor% iznf'kZr gksxk] ftlesa fuEufyf[kr
rhu Hkkx gS&
a
1. User Instruction
2. View Advertisement
3. Apply
mu leLr foKkiuksa dh lwph iznf'kZr gksxh ftuesa vku&ykbu vkosnu i)fr ykxw gSA User
esa vH;fFkZ;ksa dks vku&ykbu QkeZ Hkjus ls lEcfU/kr fn'kk&funs'Z k fn;s x;s gSAa vH;FkhZ blesa
ls ftl foKkiu dks ns[kuk pkgsa mlds lkeus View Advertisement dks Click djsAa ,slk djus ij
iwjk foKkiu iznf'kZr gksxkA vku&ykbu vkosnu gsrq Apply ij Click djsAa
^^vku&ykbu vkosnu** djus dk dk;Z fuEukafdr rhu Lrjksa ij fd;k tk;sxk%&
Apply click djus ij ifjf'k"V&1 esa ijh{kk ds lkis{k Candidate Registration fDyd
djus ij vH;FkhZ dk Basic Registration form ifjf'k"V&2 iznf'kZr gksxk ftlesa p;u ds rhu izdkj
& (Select Type of Recruitment) - lkekU;] fo'ks"k ,oa lkekU;@fo'ks"k nksuksa iznf'kZr gksxasA fo'ks"k p;u
o nksuksa p;u lkekU;@fo'ks"k gsrq dsoy mRrj izn's k ds fodykax vkaf'kd :i ls n`f"V ckfkr
vFkkZr~ ih-ch- rFkk vkaf'kd :i ls Jo.k okf/kr vFkkZr ih-Mh- vH;FkhZ gh ik= gksx
a As QkeZ Hkjus ds
Ik'pkr~ Submit cVu ij Click djus ls izFke pj.k dk iathdj.k iw.kZ gks tk;sxkA rRi'pkr~
'Candidate Registration's Acknowledgement' ifjf'k"V&3 iznf'kZr gksxk ftls Print ij click
djds eqfnzr fd;k tk ldsxkA
ijh{kk 'kqYd Hkqxrku gsrq nks fodYi izkIr gksxas tks E-Challan rFkk I-Collect ds :i esa
gksx
a As ftldks LVsV cSd
a vkWQ bf.M;k vFkok iatkc us'kuy cSd
a esa tek fd;k tk ldrk gSAa ftu
vH;fFkZ;ksa ds ikl nksuksa esa ls fdlh cSd
a esa Net Banking dh lqfo/kk miyC/k gks] os I-Collect ds ek/;e
ls ijh{kk 'kqYd tek dj ldrs gSaA E-Challan vFkok I-Collect dk fodYi pquus ij Examination
fees payment details ifjf'k"V&4 iznf'kZr gksxkA E-Challan }kjk ijh{kk 'kqYd tek djus gsrq cSd
a
dk p;u djus ij lEcfU/kr cSd
a dk E-Challan SBI ifjf'k"V&5 PNB ifjf'k"V&6 ftlesa
Candidate Registration No., Name, Date of Birth rFkk Fee Amount eqfnzr gksxkA
bZ&pkyku ds lkFk pkyku esa ftl cSd
a dk uke eqfnzr gS vkSj ftldk p;u vH;FkhZ }kjk Lo;a
izLrj&1 esa fd;k x;k gS mDr cSd
a dh fdlh ftys dh fdlh 'kk[kk esa tkdj fu/kkZfjr /kujkf'k bZ&pkyku
esa eqfnzr gksxh tek djds bZ&pkyku dh ,d izfr cSd
a ls izkIr djuk gksxk rFkk bls vH;FkhZ vius ikl
lqjf{kr j[ksaxAs cSd }kjk vH;FkhZ dks okil dh x;h bZ&pkyku dh izfr esa cSd
a }kjk "Transaction ID/
Journal No." vkSj fnukad vafdr fd;k tk;sxk] ftldk mi;ksx r`rh; Lrj ij vkosnu&i= Hkjrs le;
vH;FkhZ dks djuk gksxkA
cSd
a esa 'kqYd tek djus ds fnukad ds ckn nks fnu NksM+ dj vxzrs j dk;Z fnol
esa vijkUg 2-00 cts ds i'pkr~ vH;FkhZ dks vk;ksx dh osclkbV ij iznf'kZr "Submit Application Form"
dks Click djus ij iznf'kZr QkesVZ esa vku&ykbu lwpuk;sa Hkjuh gksxh rFkk QksVks vkSj gLrk{kj LdSu djds
viyksM djuk gksxk] ftldk uewuk
ij gSA vH;FkhZ viuh QksVks o gLrk{kj fu/kkZfjr lkbt
lkbt dk mYys[k vku&ykbu vkosnu esa fu/kkZfjr LFkku ij gksxk esa gh LdSu djsAa ;g Hkh /;ku j[ksa
fd QksVks uohure vkSj vko{k (Chest) rd gksuh pkfg;sA ;fn QksVks o gLrk{kj fu/kkZfjr vkdkj esa LdSu
djds upload ugha fd;k tkrk rks vkosnu i= dks vku&ykbu flLVe Lohdkj ugha djsxkA QksVks o
gLrk{kj LdSu djds viyksM djus dh izf;k
esa nh xbZ gSA vkosnu izk:i ij lHkh
izfof"V;k vafdr djus ds ckn "View application form" dks click djds vH;FkhZ vius }kjk Hkjh xbZ
lwpukvksa dks ns[k ysa fd lHkh lwpuk;sa lgh&lgh Hkjh xbZ gSa vkSj iwjh rjg lUrq"V gksus ds ckn vku&ykbu
vkosnu vk;ksx dks izfs "kr djus gsrq "Submit" cVu dks Click djsAa vH;FkhZ }kjk leLr lwpuk;sa lgh&lgh
funs'Z kkuqlkj vku&ykbu QkesVZ esa Hkjdj vkosnu tek djus dh fu/kkZfjr vfUre frfFk rd "Submit" cVu
dks Click djuk vko';d gS] ;fn vH;FkhZ }kjk "Submit" cVu dks Click ugha fd;k tk;sxk rks vkosnu
vk;ksx dk;kZy; dks izkIr ugha gksxk ftldk nkf;Ro vH;FkhZ dk gksxkA "Submit" cVu dks Click djus
ds i'pkr~ vkosnu dk fizUV vkmV
ysdj vH;FkhZ bls vius ikl lqjf{kr j[ksAa fdlh
folaxfr dh n'kk esa mDr fizUV vkmV vk;ksx dk;kZy; esa vH;FkhZ dks izLrqr djuk gksxk vU;Fkk vH;FkhZ
dk vuqjks/k Lohdkj ugha fd;k tk;sxkA
,d ckj vkosnu "Submit" djus ds i'pkr~ mlesa dksbZ la'kks/ku ugha fd;k tk ldsxkA
vku&ykbu vkosnu ds 'Candidate Registration' dk izk:i Hkjus ij bZ&pkyku
dk fizUV vkmV vH;FkhZ izkIr djsxa ]s ftlesa nks izfr;k gksaxhA mDr bZ&pkyku ds ek/;e ls gh vH;FkhZ
Hkkjrh; LVsV cSd
a vFkok iatkc us'kuy cSd
a ] ftldk bZ&pkyku vH;FkhZ us fizUV fd;k gS] dh fdlh 'kk[kk
esa viuh Js.kh ds vuqlkj 'kqYd tek djsx
a As E-CHALLAN/I-COLLECT ds vfrfjDr vU; fdlh ek;e
ls tek 'kqYd Lohdkj ugha gksxkA izkjfEHkd ijh{kk gsrq Js.khokj fu/kkZfjr 'kqYd fuEukuqlkj gS%a &
Instruction
5& fodykax Js.kh

6&
ds vkfJr
7& HkwriwoZ lSfud
8& efgyk
&ijh{kk 'kqYd NIL + vku&ykbu f;k 'kqYd ` 15@& ;ksx

&ekad 1 ls 4 rd mfYyf[kr viuh ewy Js.kh ds vuqlkj
& ekad 1 ls 4 rd mfYyf[kr viuh ewy Js.kh ds vuqlkj
&ekad 1 ls 4 rd mfYyf[kr viuh ewy Js.kh ds vuqlkj
= `
15@&
vH;FkhZ }kjk vkosnu esa fd;k x;k nkok lR; ugha ik;s tkus ij vH;FkhZ dks vk;ksx dh iz'uxr
ijh{kk rFkk vU; leLr p;uksa@ijh{kkvksa ls fMckj djus dh dk;Zokgh rFkk vU; n.MkRed dk;Zokgh
dh tk ldrh gSA
lcfeV fd;s x;s vkosnu esa ;fn vH;FkhZ dksbZ la'kks/ku djuk pkgrs gSa rks fu/kkZfjr vfUre frfFk rd
os nwljk vkosnu la'kksf/kr lwpuk ds lkFk vku&ykbu izfs "kr dj ldrs gSAa igys vkosnu esa tek fd;k
x;k 'kqYd fdlh n'kk esa okil ugha fd;k tk;sxk vkSj mldk lek;kstu vU; vkosnu esa Hkh ugha gksxkA
vH;FkhZ }kjk ,d ls vf/kd vkosnu 'Submit' djus dh n'kk esa vfUre vkosnu gh Lohdkj gksxk] 'ks"k
lHkh vkosnu fujLr ekus tk;sx
a As
m0iz0 yksd lsok vk;ksx mi;qDZ r lkekU;@fodykax fo'ks"k p;u ds vUrxZr lfEefyr inksa dh eq[;
ijh{kk&2013 esa izo's k ds fy, mi;qDr vH;fFkZ;ksa dk p;u djus gsrq bl foKkiu ds
esa mfYyf[kr ftyksa ds fofHkUu ijh{kk dsUnzkas ij ,d izkjfEHkd ijh{kk dk vk;kstu djsaxAs vk;ksx
}kjk vH;fFkZ;ksa dks ijh{kk frfFk rFkk vkoafVr ijh{kk dsUnz dh lwpuk izo's k i= ds ek/;e ls nh
tk;sxhA vfUre :i ls izkIr vkosnu i=ksa dh la[;k ds vuqlkj ftyk dsUnzkas dh la[;k
?kVkbZ@c<+kbZ tk ldrh gSA
d lkekU; p;u gsrq fjfDr;ksa dh vuqekfur la[;k&1200 gSA [k
fodykaxtu cSdykx@fo'ks"k p;u gsrq dsoy lgk;d pdcUnh vf/kdkjh@lgk;d vk;rhdj.k
vf/kdkjh in gsrq dqy 10 fjfDr;k gSa ftuesa ls 05 fjfDr n`f"Vckfkr ih-oh- rFkk 05 fjfDr Jo.k
ckfkr ih-Mh- vH;fFkZ;ksa ds fy, vkjf{kr gSAa
'kklukns'k la[;k & 15@42@198&dk&4&2003 fnukad 28 twu 2003 ds izkfo/kkukuqlkj
:0 5500@& iqjkuk osrueku ls uhps ds inksa dks iz'uxr ijh{kk esa fofufnZ"V fd;s tkus dh
O;oLFkk ds n`f"Vxr lfEefyr fd;s tkus okys laHkkfor inksa dk fooj.k bl izd kj gS%&
;k=hdj@ekydj vkh{kd] lkaf[;dh lgk;d m|ksx foHkkx] Je izorZu vfkdkjh] T;s"B xUuk
fodkl fujh{kd] vkcdkjh fujh{kd] {ks=h; ;qok dY;k.k ,oa izknsf'kd fodklny vf/kdkjh]
midkjkiky] lgk;d fu;a=d Js.kh&2 ckV rFkk eki] vfk'kklh vfkdkjh uxj iapk;r] cky
fodkl ifj;kstuk vfkdkjh] fofk lgk;d ifjogu foHkkx] fofk lgk;d vkokl ,oa 'kgjh
fu;kstu] vfk'kklh vfkdkjh Js.kh&2 m00 ikfydk dsUnzhf;r lsok] lgk;d pdcUnh
vfkdkjh@lgk;d vk;rhdj.k vfkdkjh] vkeksn ,oa i.kdj fujh{kd xzM
s &2] iwfrZ fujh{kd] gkV
fujh{kd] vij ftyk cpr vf/kdkjh] lax.kd@dfu"B lkaf[;dh fujh{kd@{ks= vUos"kd f"k
lkaf[;dh ,oa Qly chek] vUos"kd de lax.kd lgdkjh lfefr;k] xUuk fodkl fujh{kd]
lgdkjh fujh{kd oxZ&2@lgk;d fodkl vfkdkjh] ys[kk ijh{kd Je foHkkx] [kk.Mlkjh
fujh{kd] vfk'kklh vfkdkjh Js.kh&3 m0 0 ikfydk dsUnzhf;r lsok lEiz{s kd efgyk ,oa
ckyfodkl foHkkx] lEiz{s kd jk"Vh; Nk=lsuk ny funs'kky;] lgk;d izHkkjh lewg&2 m|ku
,oa [kk| izlaLdj.k] ys[kk ijh{kd [kk| ,oa jln foHkkx] ys[kk ijh{kd lgdkjh lfefr;k]
ys[kk ijh{kd LFkkuh; fufk ys[kk foHkkx] dfu"B ys[kk fujh{kd f'k{kk foHkkx] lgk;d ys[kk
ijh{kd m0 0 ikfydk dsUnzhf;r vkfMV] lgk;d lEifRr vkh{kd vkokl ,oa 'kgjh
fu;kstu] ys[kk ijh{kd uxj fodkl foHkkx] dfu"B 'kksk lgk;d oxZ&2 m|ku] ys[kkdkj
Js.kh&1 uxj fodkl foHkkx] lgk;d ys[kk ijh{kd] vfk'kklh vfkdkjh Js.kh&4 uxj fodkl
foHkkx] m|ku v/kh{kd LFkkuh; fudk;] dfu"B ys[kk ijh{kd jk"Vh; cpr] dj vfkdkjh
iapk;r jkt] vUos"kd de lax.kd ifjokj dY;k.k] m|ku fujh{kd oxZ&2] dfu"B ikSk j{kk
lgk;d oxZ&2 m|ku] eRL; fujh{kd] iz/kku fyfid Js.kh&3 m0iz0 ikfydk fyfid oxhZ; lsok
rFkk ys[kk ijh{kd QElZ lkslk;Vht ,oa fpV~lA
mi;qDZ r esa ls lkekU; p;u ds vUrxZr ys[kk ijh{kd LFkkuh; fufk ys[kk ijh{kk foHkkx]
m|ku fujh{kd oxZ&2] Je izorZu vfkdkjh] vkeksn ,oa i.kdj fujh{kd] iwfrZ fujh{kd] vfk'kklh
vfkdkjh uxj iapk;r] vfk'kklh vfkdkjh Js.kh&3 LFkkuh; fudk;] T;s"B xUuk fodkl
fujh{kd] vkcdkjh fujh{kd] lgk;d ys[kk ijh{kd LFkkuh; fudk;] ys[kk ijh{kd LFkkuh;
fudk;] vij ftyk cpr vfkdkjh] gkV fujh{kd] lax.kd@dfu"B lkaf[;dh fujh{kd@{ks=
vUos"kd f"k lka0 ,oa Qly chek] lgdkjh fujh{kd oxZ&2@lgk;d fodkl vfkdkjh lg0]
[kk.Mlkjh fujh{kd] lgk;d pdcUnh vfkdkjh@lgk;d vk;rhdj.k vfkdkjh] eRL; fujh{kd
rFkk ys[kk ijh{kd QElZ lkslk;Vht+ ,oa fpV~l ds inksa ds vfk;kpu izkIr gq, gSaA 'ks"k ftu inksa
ds vfk;kpu izkjfEHkd ijh{kk ds ifj.kke vkus rd ;fn izkIr gks tk;sx
a ]s bl ijh{kk esa lfEefyr
fd;s tk ldrs gSAa vr% fjfDr;ksa dh la[;k ?kV&c<+ ldrh gSA
m0iz0 ds vuqlfw pr tkfr;ks@
a m0iz0 ds vuqlfw pr tu tkfr;ks@
a m0iz0 ds vU; fiNM+s
oxksZ ds fy, vkj{k.k fo|eku 'kkldh; fu;eksa ds vuqlkj fn;k tk;sxkA blh izdkj {kSfrt vkj{k.k
ds vUrxZr vkus okyh Jsf.k;ksa ;Fkk&m0iz0 ds Lora=rk laxkz e lsukfu;ksa ds vkfJr@HkwriwoZ lSfud rFkk
m0iz0 dh efgyk vH;fFkZ;ksa dks Hkh fo|eku v|ru 'kklukns'kksa ds vuqlkj fjfDr;kW cuus ij vkj{k.k
vuqeU; gksxkA m0iz0 ds lekt ds fodykax vH;fFkZ;ksa ds fy, 'kklu }kjk vf/klwfpr fpfUgr fd;s
x;s inksa ij gh vkj{k.k vuqeU; gksxkA
1 vkj{k.k@vk;q esa NwV dk ykHk pkgus okys vH;FkhZ lacfa /kr vkjf{kr Js.kh ds leFkZu esa bl
foLr`r foKkiu ds ifjf'k"V 8, esa eqfnzr rFkk osclkbV ij miyC/k fu/kkZfjr izk:i ij l{ke vf/kdkjh
}kjk tkjh izek.k i= izkIr dj ysa ,oa tc muls vis{kk dh tk; rc os mls vk;ksx dks izLrqr djsAa
2 m0iz0 ds vkjf{kr Js.kh ds lHkh vH;FkhZ vkosnu esa viuh Js.kh vo'; vafdr djsAa 3 ,d ls
vf/kd vkjf{kr Js.kh dk nkok djus okys vH;fFkZ;ksa dks dsoy ,d NwV] tks vf/kd ykHkdkjh gksxh]
nh tk;sxhA 4 vuqlfw pr tkfr] vuqlfw pr tutkfr] vU; fiNM+k oxZ] Lora=rk laxzke lsukuh ds
vkfJr@HkwriwoZ lSfud rFkk efgyk vH;fFkZ;ksa dks] tks mRrj izn's k jkT; ds ewy fuoklh ugha gS]a mUgsa
vkj{k.k dk ykHk vuqeU; ugha gS] ,sls vH;FkhZ lkekU; Js.kh ds vH;FkhZ ekus tk;sx
a As efgyk vH;fFkZ;ksa
ds ekeys esa firk i{k ls fuxZr izek.k i= gh ekU; gksx
a As
dsoy
vk;q esa NwV gsrq vkikr deh'ku izkIr@vYidkfyd deh'ku izkIr vf/kdkjh] tks lsuk ls voeqDr ugha
gq;s gSa fdUrq ftudh lSU; lsok esa iquokZl ds fy, o`f) dh xbZ gS] Hkh bl ijh{kk ds fy, 'kklukns'k
la[;k&22@10@1976 &dkfeZd&2&85] fnukad 30 tuojh] 1985 ds vuqlkj fuEufyf[kr 'krksZ ij
vkosnu dj ldrs gSa %&1 ,sls vkosndksa dks Fky lsuk@ukS lsuk@ok;q lsuk ds l{ke vf/kdkjh }kjk
tkjh bl vk'k; dk izek.k i= izkIr djuk gksxk fd mudh lsok esa o`f) iquokZl ds fy;s dh x;h gS
vkSj muds fo:) dksbZ vuq'kklukRed dk;Zokgh yfEcr ugha gSA 2 ,sls vkosndksa dks ;Fkk le; ;g
fyf[kr v.MjVsfdax izLrqr djuh gksxh fd vkosfnr in ds fy;s pqu fy;s tkus ij os vius dks lSU;
lsok ls rRdky voeqDr djk ysx
a As vkikr@vYidkfyd deh'ku izkIr vf/kdkjh dks ;g lqfo/kk vuqeU;
ugha gksxh] ;fn d mls lsuk esa LFkk;h deh'ku izkIr gks x;k gksA [k og R;kx i= nsdj lsuk ls
voeqDr gqvk gksA x og lsuk ls dnkpkj vFkok 'kkjhfjd v{kerk ds dkj.k voeqDr gqvk gksA
,sls fookfgr iq:"k vH;FkhZ] ftudh ,d ls vf/kd thfor iRuh gks rFkk
efgyk vH;FkhZ ftUgksua s fdlh ,sls O;fDr ls fookg fd;k gks ftldh igys ls gh ,d iRuh gks] ik= ugha
gksx
a ]s tc rd fd egkefge jkT;iky us mDr 'krZ ls NwV iznku u dj nh gksA
vkosnu i= Lohdkj fd;s tkus dh vfUre frfFk rd vH;fFkZ;ksa dks fdlh ekU;rk
izkIr fo'ofo|ky; dh Lukrd fMxzh ;k led{k vgZrk vo'; /kkfjr djuh pkfg,A bldk mYys[k
vH;FkhZ vius vkosnu i= ds fu/kkZfjr LrEHk esa djsAa fdUrq dfri; inksa gsrq fof'k"V vgZrk;sa Hkh gS]a ftudk
fooj.k fuEuor~ gSa %&
Page No. 1
1- fofk lgk;d vkokl ,oa 'kgjh fu;kstu

fofk Lukrd
2- lgk;d lEifRr vkh{kd vkokl ,oa 'kgjh fu;kstu
3- cky fodkl ifj;kstuk vfkdkjh
lekt dk;Z ;k lekt 'kkL= ;k x`g foKku
esa Lukrd mikf/k
4- ys[kk ijh{kd LFkkuh; fufk ys[kk
okf.kT; Lukrd rFkk nsoukxjh fyfi esa
fyf[kr fgUnh dk dk;Zdkjh KkuA
5- dfu"B ys[kk ijh{kd jk"Vh; cpr funs'kky;
ys[kk ijh{kk vkSj ys[kk deZ fo"k; ds lkFk
okf.kT; esa Lukrd
6- lgk;d fu;a=d fofkd eki foKku xzM
s &AA
,d fo"k; ds :i esa HkkSfrdh ;k ;kaf=d
vfHk;a=.k lfgr foKku esa mikf/kA
7- vUos"kd de lax.kd lgdkjh lfefr;k
xf.kr@lkaf[;dh fo"k; ds lkFk Lukrd
8- lax.kd@dfu"B lkaf[;dh fujh{kd@{ks= vUos"kd xf.kr@lkaf[;dh@xf.krh; lkaf[;dh ds lkFk
f"k lkaf[;dh ,oa Qlychek
Lukrd
9- dfu"B 'kksk lgk;d oxZ&2@m|ku fujh{kd
ch-,l-lh-f"k ;k ch-,l-lh- tho foKku
oxZ&2@m|ku fujh{kd
lewg vf/kekuh% ,e-,l-lh- f"k ;k
,e-,l-lh- ouLifr 'kkL= ;k dhV foKku
fofr foKku esa ,e-,l-lh- f"k
10- T;s"B xUuk fodkl fujh{kd]
1& f"k esa Lukrd
xUuk fodkl fujh{kd
2& ,sls vH;FkhZ tks f"k foKku esa LukrdksRrj
mikfk j[krs gks]a dks vU; ckrksa ds leku gksus ij
lewg ^,d* vkSj lewg ^nks* ds inksa ij lhkh
HkrhZ ds ekeys esa vfkeku fn;k tk;sxkA
11- vUos"kd de lax.kd ifjokj dY;k.k
xf.kr ;k lkaf[;dh esa LukrdksRrj mikf/k
12- lgdkjh fujh{kd oxZ&2@lgk;d fodkl
1& dyk vFkZ'kkL= esa Lukrd ;k okf.kT;
vf/kdkjh lgdkjh lfefr;ka
;k ch0,llh0 f"k esa Lukrd
2& ,sls vH;fFkZ;ksa dks vfkeku fn;k tk;sxk]
tks ,e0,llh0f"k] ,e0,llh0] ,e0dke0
;k vFkZ'kkL= esa ,e0,0 gks ftlesa lgdkfjrk
,oa lEc) fo"k; jgs gks]a ftlds ikl ,d
oSdfYid fo"k; lgdkfjrk ds lkFk okf.kT;
vkSj vFkZ'kkL= esa mikfk gks vkSj ch0,u0
esgrk bULVhV~;Vw vkQ dksvkijsfVo eSut
s esUV]
iwuk esa lgdkfjrk esa LukrdksRrj fMIyksek gksA
13- ys[kk ijh{kd LFkkuh; fudk;
okf.kT; esa fMxzh ;k pkVZMZ ,dkm.Vsl
a h esa
14- lgk;d ys[kk ijh{kd LFkkuh; fudk;
b.VjehfM,V ;k dyk ;k foKku ;k f"k
esa fMxzh
15- eRL; fujh{kd
1& Hkkjr esa fofk }kjk LFkkfir fdlh
fo'ofo|ky; ls eRL; foKku esa Lukrd
mikfk ;k tUrq foKku] ouLifr foKku vkSj
jlk;u 'kkL= fo"k;ksa ds lkFk Lukrd mikfk
;k ljdkj }kjk mlds led{k ekU;rk
izkIr dksbZ mikfkA
vfkekuh vgZrk& lsUVy buySMa fQ'kjht
fjlpZ bULVhV~;Vw ] cSjdiqj ls buySM
a fQ'kjht
Vfs uax dkslZ dk izek.k i= ;k lsUVy bULVhV~;Vw
vkQ fQ'kjht ,twds'ku] cEcbZ ls fMIyksekA
16- ys[kk ijh{kd
1& Hkkjr esa fof/k }kjk LFkkfir fdlh
QElZ lkslk;Vht ,oa fpV~l
fo'ofo|ky; ls okf.kT; esa Lukrd dh
mikfk ;k ljdkj }kjk mlds led{k
ekU;rk izkIr fdlh fo'ofo|ky; ;k laLFkku
ls ys[kk dk;Z esa LukrdksRrj fMIyksekA
2& ljdkj }kjk ekU;rk izkIr fdlh laLFkku ls
dEI;wVj izpkyu esa ^vks* Lrjh; izek.k i=A
1 vH;fFkZ;ksa dks 01 tqykbZ] 2013 dks 21 o"kZ dh vk;q vo'; iwjh djuh pkfg,
vksSj mUgsa 40 o"kZ ls vf/kd vk;q dk ugha gksuk pkfg, vFkkZr~ mudk tUe 02 tqykbZ] 1973 ls iwoZ rFkk
01 tqykbZ] 1992 ds ckn dk ugha gksuk pkfg,A m0iz0 ds vuqlfw pr tkfr] vuqlfw pr tutkfr] vU;
fiNM+s oxZ] Lora= rk laxzke lsukuh ds vkfJrksa rFkk dq'ky f[kykfM+;ksa ds fy, vfkdre vk;q lhek
esa ikp o"kZ dh NwV vuqeU; gksxh vFkkZr~ mudk tUe 2 tqykbZ 1968 ds iwoZ dk ugha gksuk pkfg,A
blh izdkj m0iz0 ds fodykaxtu gsrq vf/kdre vk;q lhek 55 o"kZ gS vFkkZr~ vH;FkhZ dk tUe 2 tqykbZ]
1958 ds iwoZ ugha gksuk pkfg,A dq'ky f[kykM+h 'kklukns'k la[;k&22@21@1983&dk&2] fnukad
28&11&1985 esa fofgr kfo/kkuksa ds vuq:i vius izek.k i= l{ke vf/kdkjh ls kIr dj ysa vkSj
eq[; ijh{kk ds vkosnu i= ds lkFk vo'; layXu djsAa
2 m0iz0 ds vkikr deh'ku izkIr vfkdkfj;ks@
a vYideh'ku izkIr vfkdkfj;ks@
a HkwriwoZ lSfudksa ds fy;s
lewg *x* ds vjktif=r inksa ds fy, lsuk esa dh x;h lsok dh lEiw.kZ vof/k ds vfrfjDr vk;q
lhek rhu o"kZ vkSj vf/kd gksxhA
vf/k'kklh vf/kdkjh Js.kh&2] 3 ,oa 4 LFkkuh; fudk; gsrq&fdlh ,sls O;fDr dh n'kk esa
ftlus fdlh Hkh dsfUnzf;r lsok vFkok ikfydk esa ,d o"kZ ;k vf/kd dh lsok dj yh gks] vfkdre
vk;q fujUrj lsok vFkok 7 o"kZ dh vofk blesa tks Hkh de gks] dh lhek rd vfkd gksxhA
1 izkjfEHkd ijh{kk esa lQy
gksus okys vH;FkhZ gh eq[; fyf[kr ijh{kk esa lfEefyr fd, tk;sxa ]s ftlds fy, vk;ksx ds funs'Z kkuqlkj
lQy vH;fFkZ;ksa dks iqu% vkosnu djuk gksxk ,oa lkekU; vH;fFkZ;ks]a m0iz0 ds vU; fiNMs+ oxZ ds
vH;fFkZ;ksa rFkk vU; jkT;ksa ds vH;fFkZ;ksa ds fy, ijh{kk 'kqYd :0 200@& ,oa vku&ykbu izf;k
'kqYd :0 15@&] ;ksx :0 215@& rFkk m0iz0 ds vuqlfw pr tkfr@m0iz0 ds vuqlfw pr tutkfr
ds vH;fFkZ;ksa gsrq ijh{kk 'kqYd :0 80@& ,oa vku&ykbu izf;k 'kqYd :0 15@& ;ksx :0 95@&
fu/kkZfjr gSA {kSfrt vkj{k.k ds vUrxZr vkus okys m0iz0 ds fodykax vH;fFkZ;ksa dks eq[; ijh{kk gsrq dksbZ
'kqYd ns; ugha gS ijUrq vku&ykbu izf;k 'kqYd :0 15@& ek= ns; gksxkA m0iz0 ds LorU=rk laxzke
lsukuh ds vkfJr rFkk m0iz0 ds lsuk ds HkwriwoZ lSfud rFkk efgyk vH;FkhZ ftl eq[; Js.kh ls lEcfU/
kr gkaxs s mUgsa mlh oxZ@Js.kh gsrq 'kqYd tek djuk gksxkA 2 vH;FkhZ lko/kkuh iwod
Z uksV dj ysa fd
eq[; ijh{kk esa os mlh vuqdez kad ij ijh{kk esa cSBx
as s tks mUgsa izkjfEHkd ijh{kk ds fy, vkoafVr fd;k
x;k gSA 3 eq[; ijh{kk gsrq frfFk;kW rFkk ijh{kk dsUnz ckn esa vk;ksx }kjk fu/kkZfjr fd, tk;sx
a As 4
dsoy ogh vH;FkhZ lk{kkRdkj ds fy, vkgwr fd;s tk;sx
a s tks eq[; ijh{kk fyf[kr ijh{kk ds vkkkj ij
lQy ?kksf"kr gksx
a As 5 vH;fFkZ;ksa dks lk{kkRdkj ds iwoZ fu/kkZfjr vkosnu i=kfn Hkjuk gksxkA 6 fofHkUu
inksa ds fy, vf/kekU;rk,a lk{kkRdkj ds le; ekxh tk;saxh tks vfUre gksx
a h vkSj rRi'pkr~ muesa dksbZ
ifjorZu vuqeU; ugha gksxkA 7 ewy izek.k i=ksa dh tkWp lk{kkRdkj ds le; gksxh ml le; vH;fFkZ;ksa
dks nks QksVksxkz Q vius foHkkxk/;{k vFkok ml laLFkk ds iz/kku }kjk] tgk mUgksua s vfUre f'k{kk ik;h gks
vFkok fdlh jktif=r vf/kdkjh }kjk izekf.kr rFkk nks vizekf.kr QksVksxkz Q Hkh izLrqr djus gksx
a As
8 dsUnz vFkok jkT; ljdkj ds v/khu dk;Zjr vH;fFkZ;ksa dks lk{kkRdkj ds le; vius lsok;kstd dk
vukifRr izek.k i= izLrqr djuk gksxkA 9 ftu inksa dh p;u izf;k ds vUrxZr mudh lsok fu;ekofy;ksa
esa fyf[kr ijh{kk rFkk lk{kkRdkj nksuksa dk mYys[k gS mu inksa ds fy, eq[; ijh{kk ds vk/kkj ij lk{kkRdkj
ds fy, lQy ?kksf"kr vH;fFkZ;ksa dks lk{kkRdkj esa mifLFkr gksuk vfuok;Z gSA
vH;fFkZ;ksa dks eq[; ijh{kk fyf[kr ijh{kk ds vkosnu i=ksa esa fd;s tkus okys leLr nkoksa dh
iqf"V esa izek.k i= layXu djuk vfuok;Z gSA ;fn os leLr nkoksa dh iqf"V esa izek.k i= layXu ugha djrs
gS]a rks mudk vH;FkZu fujLr dj fn;k tk;sxkA
1 m0iz0 yksd lsok vk;ksx ds fu.kZ; ds vuqlkj fdlh
Hkh vH;FkhZ dks vius vkosnu i= esa xyr rF;ksa dks] ftudh izek.k i= ds vk/kkj ij iqf"V ugha dh tk
ldrh gS] nsus ij vk;ksx dh iz'uxr ijh{kk rFkk vU; leLr ijh{kkvksa ,oa p;uksa ls ikp o"kksaZ rd
ds fy;s izfrokfjr fd;k tk ldrk gSA 2 vk;ksx dk;kZy; esa vkosnu i= izkIr gks tkus ds i'pkr~
vH;fFkZ;ksa dh Js.kh] miJs.kh] tUefrfFk vkfn esa ifjorZu vuqeU; ugha gSA 3 gkbZLdwy vFkok led{k
mRrh.kZ ijh{kk ds izek.k i= esa vafdr tUefrfFk gh ekU; gksxhA vH;FkhZ dks eq[;ijh{kk ds vkosnu i=
ds lkFk gkbZLdwy vFkok led{k ijh{kk dk izek.k i= layXu djuk gksxkA tUefrfFk gsrq mDr izek.k
i= ds vfrfjDr vU; dksbZ vfHkys[k ekU; ugha gksxk rFkk mDr izek.k i= layXu u djus ij vkosnu
i= fujLr dj fn;k tk;sxkA 4 eq[; ijh{kk ds vkosnu i= ds lkFk vH;FkhZ dks 'kSf{kd ;ksX;rkvksa
ds lEcU/k esa fd;s x;s nkoksa dh iqf"V esa vadi=] izek.k i= ,oa mikf/k dh vfHkizekf.kr izfr tks fdlh
jktif=r vf/kdkjh vFkok vfUre 'kSf{kd laLFkk ds iz/kku }kjk vfHkizekf.kr gks layXu djuk gksxkA nkoksa
dh iqf"V esa izek.k i=@vfHkys[k layXu u djus ij vkosnu i= vLohd`r dj fn;k tk;sxkA 5 lekt
ds fodykax vH;fFkZ;ksa dks m0iz0 yksd lsok 'kkjhfjd :i ls fodykax] Lora=rk laxkz e lsukfu;ksa ds
vkfJr vkSj HkwriwoZ lSfudksa ds fy, vkj{k.k la'kks/ku vf/kfu;e] 1997 dh /kkjk&2 esa mfYyf[kr
fodykaxrk ls xzLr gksus lEcU/kh izek.k i= ;Fkk la'kksf/kr lifBr 'kklukns'k fnukad 03 Qjojh] 2008
tks fu/kkZfjr izk:i ij fodykaxrk izek.k i= nsus gsrq l{ke fpfdRlkf/kdkjh@fo'ks"kK }kjk fuxZr ,oa eq[;
fpfdRlkf/kdkjh }kjk izfr gLrk{kfjr gks]a izLrqr djus ij 'kklu }kjk fpfUgr fd, x;s inksa ij gh vkj{k.k
dk ykHk vuqeU; gksxkA vkosnu i= tek djus dh vafre frfFk rd HkwriwoZ lSfudksa dks lSU; lsok
ls voeqDr gksuk vko';d gSA 6 ijh{kk dh frfFk] le; rFkk dsUnzkas vkfn ds lEcU/k esa vuqdez kad lfgr
izo's k i=ksa ds ek/;e ls lwpuk nh tk;sxhA vH;fFkZ;ksa dks vkoafVr dsUnz ij gh ijh{kk nsuh gksxhA ijh{kk
dsUnz ifjorZu vuqeU; ugha gksxkA 7 tks vH;FkhZ dkykUrj esa vgZ ugha ik;s tk;sxa s mudk vH;FkZu fujLr
dj fn;k tk;sxk vkSj eq[; ijh{kk esa izo's k gsrq mudk dksbZ nkok ekU; ugha gksxkA vH;fFkZ;ksa ds vH;FkZu
ds lEcU/k esa vk;ksx dk fu.kZ; vfUre gksxkA 8 vkosnu i= esa tUe frfFk dk mYys[k u djus ij
=
+ fq Viw.kZ tUefrfFk vafdr djus ij] vf/ko;Ld ;k vYio;Ld gksus ij] U;wure 'kSf{kd vgZrk /kkfjr u
djus ij] vkosnu i= izkIr fd, tkus gsrq fu/kkZfjr vfUre frfFk ds ckn vkosnu i= izkIr gksus ij] vkosnu
i= ds ?kks"k.kk i= ds uhps gLrk{kj u djus ij] vkosnui=@vH;FkZu fujLr dj fn;k tk;sxkA 9
vk;ksx vkosnu i= dh ljljh tkp ij vH;fFkZ;ksa dks vkSicfU/kd izo's k ns ldrs gS]a fdUrq ckn esa fdlh
Hkh Lrj ij ;g ik;s tkus ij fd vH;FkhZ vgZ ugha Fkk] vFkok vkosnu i= izkjfEHkdLrj ij gh Lohdkj
djus ;ksX; ugha Fkk] mldk vH;FkZu fujLr dj fn;k tk;sxk vksjS ;fn fu;qfDr gsrq laLrqr Hkh dj fn;k
x;k gks rks vk;ksx dh laLrqfr okil ys yh tk;sxhA 10 dnk'k; vFkkZr ijh{kk Hkou esa udy djus]
vuq'kklughurk] nqO;Zogkj rFkk vU; vokaNuh; dk;Z djus ij vH;FkhZ dk vH;FkZu fujLr dj fn;k
tk;sxkA bu vuqn's kksa dh vogsyuk djus ij vH;FkhZ dks bl ijh{kk rFkk Hkfo"; esa gksus okyh ijh{kkvksa
ls izfrokfjr fd;k tk ldrk gSA 11 vk;ksx ls lHkh i=kpkj esa ijh{kk dk uke] foKkiu la[;k]
jftLV'ku ua-] vH;FkhZ dh tUefrfFk] firk@ifr dk uke rFkk vuqekad ;fn fn;k x;k gks dk mYys[k
vo'; gksuk pkfg,A 12 fu;qfDr gsrq p;fur vH;fFkZ;ksa dks fu;eksa esa visf{kr LokLF; ijh{k.k djkuk
gksxkA 13 bl ijh{kk ds vk/kkj ij eq[; ijh{kk esa izo's k gsrq fjfDr;ksa dk 18 xquk rd vH;FkhZ lQy
?kksf"kr fd;s tk;sx
a s rFkk eq[; ijh{kk ds ifj.kke ds vk/kkj ij lk{kkRdkj gsrq 3 xquk rd vH;FkhZ cqyk;s
tk;sx
a As lk{kkRdkj esa mifLFkr gksuk vfuok;Z gSA 14 ,sls vH;FkhZ tks Lukrd ijh{kk esa lfEefyr gks
jgs gS]a os bl ijh{kk esa vkosnu u djs]a D;ksfa d os ik= ugha gSAa 15 vH;FkhZ mRrj i=d dks Hkjus esa dsoy
dkys cky IokbaV isu dk iz;ksx djsAa isfa ly ;k fdlh vU; isu dk iz;ksx dnkfi u djsAa 16 mRrj
i=d esa vH;FkhZ }kjk lgh lgh lwpuk,a dkys cky IokbUV isu ls Hkjh tk;sAa mRrj i=d esa Hkjh x;h
lwpuk dks OgkbVuj] CysM vFkok jcj vkfn ls feVk;k ugha tk;sA
'kkjhfjd ekin.M okys in tSls vkcdkjh fujh{kd] midkjkiky vkfn miyCk
gksus dh n'kk esa lEcfU/kr lsok fu;ekoyh@vf/k;kpu ds vuqlkj mu ij 'kkjhfjd ekin.M ykxw jgsxkA
1& vfUre fu;r frfFk o le; ds Ik'pkr~ vkosnu fdlh Hkh n'kk esa Lohdkj ugha fd;s tk;sx
a As visf{kr
lwpukvksa ls jfgr rFkk ,sls vkosnu ftl ij vH;FkhZ ds QksVks vFkok gLrk{kj ugha gksx
a ]s le; ls izkIr
gksus ij Hkh ljljh rkSj ij fujLr dj fn;s tk;sx
a As
2& lHkh izdkj ds iw.kZ vkosnu tek djus dh vfUre frfFk o le; rd vH;FkhZ }kjk 'ON LINE
APPLICATION' izf;k esa SUBMIT cVu dks CLICK djuk vfuok;Z gSA vH;FkhZ vius }kjk Hkjh x;h
lwpukvksa dk fizUV vkmV izkIr dj ysa vkSj mls lqjf{kr j[ksAa fdlh folaxfr dh n'kk esa vH;FkhZ dks fizUV
vkmV vk;ksx dk;kZy; dks izLrqr djuk gksxk vU;Fkk vH;FkhZ dk vuqjks/k Lohdkj ugha fd;k tk;sxkA
3& vkj{k.k dk ykHk pkgus okys vH;FkhZ lacfa /kr vkjf{kr Js.kh ds leFkZu esa bl foLr`r foKkiu esa eqfnzr
fu/kkZfjr izk:i ifjf'k"V&8, ij l{ke vf/kdkjh }kjk tkjh izek.k i= izkIr dj ysa ,oa tc muls vis{kk
dh tk;s rc os mls vk;ksx dks izLrqr djsAa ,d ls vf/kd vkjf{kr Js.kh dk nkok djus okys vH;fFkZ;ksa
dks dsoy ,d NwV] tks vf/kd ykHkdkjh gksxh] nh tk;sxhA
vuqlfw pr tkfr] vuqlfw pr tu tkfr] vU; fiNM+k oxZ] Lora=rk laxkz e lsukuh ds vkfJr] fodykaxrk
ls xzLr] HkwriwoZ lSfud rFkk efgyk vH;fFkZ;ksa dks] tks m0iz0 jkT; dh ewy fuoklh ugha gS]a mUgsa vkj{k.k
dk ykHk vuqeU; ugha gSA ,sls vH;FkhZ lkekU; Js.kh ds ekus tk;saxAs efgyk vH;fFkZ;ksa ds ekeys esa firk
i{k ls fuxZr izek.k i= gh ekU; gksxkA
4& vk;ksx vH;fFkZ;ksa dks mudh ik=rk ds lEcU/k esa dksbZ ijke'kZ ugha nsrs gS]a blfy, mUgsa foKkiu dk
lko/kkuhiwod
Z v/;;u djuk pkfg;s vkSj os rHkh vkosnu djsa tc os lUrq"V gks tk;sa fd os foKkiu dh
'krksZ ds vuqlkj vgZ gSAa
5& Lora=rk laxkz e lsukfu;ksa ds vkfJrksa dh Js.kh esa dsoy iq=] iq=h rFkk ikS= iq= dk iq= ,oa ikSf=;k
gh vkrs gSAa Lora=rk laxkz e lsukuh ls dsoy mi;qDZ r lEcU/k gh i;kZIr ugha gS vfirq vH;FkhZ dks Lora=rk
laxzke lsukuh ij okLro esa vkfJr Hkh gksuk pkfg,A vH;fFkZ;ksa dk /;ku 'kklukns'k fnukad 22-1-1982]
08-03-1983 rFkk 'kklukns'k la[;k 3014&dkfeZd&2&1982 fnukad 18-10-1982 lifBr 'kklukns'k
la[;k&6@1972 dkfeZd&2&1982 fnukad 15-1-1983 dh vksj vk"V djrs gq, lwfpr fd;k tkrk gS
fd vc mDr Js.kh ds vH;FkhZ vkj{k.k fo"k;d izek.k&i= 'kklukns'k la[;k&4@3@82&dk&2&97
fnukad 26-12-97 }kjk fu/kkZfjr izk:i ij ftykf/kdkjh ls izkIr dj izLrqr djsAa
6& fdlh vukpkj] fdlh egRoiw.kZ lwpuk dks fNikus] vfHk;kstu@vkijkf/kd okn yfEcr gksu]s nks"k fl)
gksu]s ,d ls vf/kd thfor ifr ;k iRuh ds gksu]s rF;ksa dks xyr izLrqr djus rFkk vH;FkZu@p;u ds
lEcUk esa flQkfj'k djus vkfn R;ksa esa fyIr ik;s tkus ij vH;FkZu fujLr djus rFkk vk;ksx dh
ijh{kkvksa ,oa p;uksa ls izfrokfjr (Debar) djus dk vf/kdkj vk;ksx dks gksxkA
7& ;fn vH;fFkZ;ksa dks vku&ykbu vkosnu esa dksbZ dfBukbZ gks jgh gS rks nwjHkk"k }kjk vFkok Website
ij "Contact us" ls viuh dfBukbZ@leL;k dk gy izkIr dj ldrs gSaA
Page No. 2
8&izkjfEHkd ijh{kk gsrq ftyksa dh lwph ifjf'k"V 8 ij miyC/k gS rFkk vkj{k.k lEcUkh izek.k i=ksa ds
izk:i ifjf'k"V&8, ij miyCk gSA blh izdkj ijh{kk dh ;kstuk] ifjf'k"V&9 ij] izkjfEHkd ijh{kk
gsrq ikB~;e ifjf'k"V&10 ij rFkk eq[; ijh{kk gsrq ikB~;e ifjf'k"V&11 ij miyC/k gSA
ifjf'k"V 1 ls 7ch esa fn;s x;s uewus vH;fFkZ;ksa dks izf;k ls Hkyh&HkkWf r voxr djkus ds mn~n's ;
ls fn;s tk jgs gSAa fofHkUu lEcfU/kr ijh{kk inksa dh vko';drk ds vuqlkj bu uewuksa esa vUrj gks ldrk gSA
p Candidate Registration Acknowledgement p

Candidate Home Page>Notifications/Advertisements>Registration Successfully
Print Registration Slip
Uttar Pradesh Public Service Commission

Registration Slip
Applied for
Detailed Application Form:

At the top of the page there is a Declaration for the candidates are advised to go through the
Lower Sub.-Pre 2013/Lower Sub.- Prelim. 2013.
contents of the Declaration carefully. Candidate has the option to either agree or disagree with the
You have been registered successfully.
contents of Declaration by clicking on 'I agree or 'I do not agree' buttons. In case the candidate opts
Please note down your Registration Number for future Reference.
to disagree, the application will be dropped, and the procedure will be terminated. Accepting to agree
Candidate Registration No. : 10120000084
only will submit the candidates On-line Application.
Advertisement/Notification No. : A-4/E-1/2013
Notification Details:
Candidate Name : SANDEEP JAISWAL
This section shows information relevant to notification i.e. Notification number, selection
Father's / Husband's Name : P. JAISWAL
Date of Birth : 01/01/1980
type, directorate/department name and post name.
Are you domicile of UP? : Yes
Personal Details:
Category :
This section shows information about candidate personnel details i.e. Registration Number.
Gender :
Candidate name, Father/Husband name, Gender, DOB, UP domicile, Category, Marital status, email
Fee (in INR) : NIL
and contact number.
Note :Other Details of Candidate
Other details of candidate shows the information details about UP Freedom Fighter, Ex (1) Please Note Down Candidate Registration No. 10120000084 for Future communication with UPPSC.
(2) Your Application will be treated as incomplete unless accomplished by application form fee and uploading of
Army, service duration and your physical deformity.
photograph with signature & the detailed application form submission.
Education & Experience Details
(3) Submission of detailed application form will be allowed on next working day from 2:00 PM onwards after the
It shows your educational and experience details.
deposition of fee through E-Challan in the prescribed bank.
Candidate Address, Photo & Signature details
(4) E-Challan generation from the website will be valid for fee deposition in the prescribed bank upto the last date
Here you will see your complete communication address and photo with your signature. to fee deposition given in the advertisement only in banking hours.
(5) Detailed application form submission will be stopped after 23:59 hrs of the last date of form submission given
Declaration Segment
At the bottom of the page there is a 'Declaration' for the candidates. Candidates are advised in the advertisement.
(6) Candidates whose fee amount is NIL in registration slip can submit the detailed application form at the same time
to go through the contents of the Declaration carefully.
without generating E-challan.
After filling all above particulars there is provision for preview your detail before final submission *Please do submission at an early date to avoid delay/problem in submission due to heavy network traffic on the last date.
of application form on clicking on "Preview" button.
[Date : 05/02/2013, Time : 12:02:47]
Preview page will display all facts/particulars that you have mentioned on entry time if
you are sure with filled details then click on "Submit" button to finally push data into server with
Print
successfully submission report that you can print.
No need to deposit the fee. You can directly submit detailed application form.
Otherwise using "Back" button option you can modify your details.
(CANDIDATES ARE ADVISED TO TAKE A PRINT OF THIS PAGE BY CLICKING
Submit Application Form
ON THE "PRINT" OPTION AVAILABLE)
Other Information regarding Application :
Print
1- On clicking "View Application status" option in candidate Segment page you can see current
Select any one of the Payment Mode for Fee Deposition
status of candidate.
E-Challan { I-Collect
2- On clicking "Result" option in candidate Segment page candidate can see result status of
periodically.
Select any one Bank Name
Please Select... d
3- "Interview/Exam Schedule" option in candidate Segment page candidate can see interview
Click here to Generate E-Challan
and examination schedule details periodically.
4- On clicking "Key Answer Sheet" candidate can download key answer sheet.
5- On clicking "Admit Card/Hall Ticket" candidate can download their Admit Card using with
some basic credential of candidate.
Candidate Home Page>Fee Payment
6- On clicking "List of Rejected Candidate" candidate can view rejected candidate list.
* All pink fields are compulsory
7- On clicking "Syllabus" candidate can view syllabus of particular examination.
10120000109
(Candidates applying On-line need NOT send hard copy of the On-line Application filled Candidate Registration No.:
Date
of
Birth
(DD/MM/YYYY)
:
DAY / MONTH / YEAR
by them On-line or any other document/certificate/testimonial to the Uttar Pradesh Public Service Commission. However they are advised to take printout of the On-line Application and retain
Select any one of the Payment Mode for Fee Deposition
it for further communication with the UPPSC.)(The Candidates applying for the examination
should ensure that they fulfill all eligibility conditions for admission to examination. Their admis E-Challan { I-Collect
sion at all the stages of the examination will be purely provisional subject to satisfying the
prescribed eligibility conditions.) UPPSC takes up verification of eligibility conditions with reference to original documents at subsequent stages of examination process.
Select any one Bank Name
State Bank of India
LAST DATE FOR RECEIPT OF APPLICATIONS: On-line Application process must be completed (including filling up of Part-I, Part-II and Part-III of the Form) before last date of form
Pgk5h
Enter
Verification
Code
:
submission according to advertisement, after which the Web. Link will be disabled.
Pgk5h
pAll
Notifications/AdvertisementsDetails
Details p
pAll Notifications/Advertisements
Click here to Generate E-Challan
Candidate Home Page>Notifications/Advertisements
Online Advertisement | Offline Advertisement
Advertisement Applicable for online Submission Only

Name
Selection
Type
lfEefyr voj v/khuLFk lsok k0 ijh{kk
3&lkekU;&fo'ks"k nksuks A
a -4/E-1/2013,19/08/2013
Advt. Number, Date
Fee Deposition
Last Date
Start Date
Form Submission
Last Date
19/08/2013 16/09/2013
Close
* After taking the Print out of this generated e-Challan, approach to nearest branch of the selected Bank &
deposit the fee in cash only. Please ensure that the concerned bank person has written Bank Transaction Id/
Journal number and the Transaction Date in the appropriate Place in candidate copy of the e-challan. After
depositing the required fee in the Bank.
Candidate will be able to Submit the Detailed Application For on the Next working Day after 2:00 PM.
Apply
21/09/2013
pBank
E-Challan p
p
'A-4/E-1/2013-2014'
Print
E-Challan (
01/07/2013
Directorate/Department Name Post/Vacancy Name, Deptt. No.
Nature
Pay Scale
Lower
Age
Upper
Age
Total
No. of Post
Quali
fication
Opt Optionp
Lower Sub.-Pre-2013
00000-00000
21
40
1200
view
Candidate Registration
Lower Sub.Prelim.2013,
State Bank of India
Fee Deposition Last Date :
30/03/2013
Cash Only
BACK
Public Service Commission, Uttar Pradesh
Check Digit
"9"
Bank Copy
Fee Details
Cash can be deposited AT PAR in any branch of State Bank of India
Candidate Home Page>Notifications/Advertisements>Candidate Basic Registration
Combined Lower Subordinate Services Preliminary Examination - A-4/E-1/2013/Lower Sub.-Pre 2013/Lower Sub.- Prelim. 2013
Advertisements No. :
Directorate/Department :
Post Name :
Date for Calculating Age :
Account Number : 31340979155

Deposit only through : Fee Collection-> UPPSC (Scree No.7125)
Refer Lucknow Circle e-Circular no. 95 dated 01.09.2010
AND Corporate Centre e-Circular no. 551 dated 06.10.2010
A-4/E-1/2013
Lower Sub.-Pre.2013
Lower Sub.-Prelim. 2013
01/07/2013
Select Type of Recruitment : {
Candidate Registration/Challan No.
10120000199
Name of Candidate
SANDEEP KUMAR
Date of Birth (dd/mm/yyyy)
01/01/1980
Fee Amount in figure (`

`)
115/-
Amount In Word
One Hundred Fifteen Only
Bank Transaction ID/Journal No.*
Personnel Information
1. Candidate Name :
2. Father/Husband Name :
Candidate Signature : p
*
.................................................................................
(Do not enter Mr./Mrs./Dr./Er. etc. in Prefix of your Father's/Husband's Name)
3. a. Are you Domicile of UP? :
Please Select...
d
*
d
Please Select...
DAY d / MONTH d / YEAR d *
6. Gender :
7. Are you Married?
Please Select...
Please Select...
8. Contact Number:
+91
30/03/2013
Cash Only
*
*
Aquired (Y/N)
No
hfCaW
Enter Verification Code :
Is Grade
System
No
Marks
Obtained
Total
Mark
Percentage
10120000199
Name of Candidate
SANDEEP KUMAR
01/01/1980

`)
115/-
Amount In Word

Transaction Date *
2 0
D D M M Y Y Y Y
Bank Officer Signature & Stamp *p

p
* Mandatory to be filled by bank staff
Submit
Cancel
Check Digit
"9"
Candidate Copy
Cash can be deposited AT PAR in any branch of State Bank of India
Essential Qualification Details
Hkkjr esa fof/k }kjk LFkkfir fdlh fo'ofo|ky; ls Lukrd dh mikf/k ;k

Hkkjr ljdkj }kjk blds led{k ekU;rk izkIr dksbZ vgZrkA

Fee Details
9. Email ID :
Name
State Bank of India
4. Category :
5. Date of Birth (DD/MM/YYYY) :
1.
2 0
D D M M Y Y Y Y

p
*
(Do not enter Mr./Mrs./Dr./Er. etc. in Prefix of your Name)
Sr.
No.
Transaction Date *
Close
http://uppsc.up.nic.in/challan preview.asox 14/02/2013 15:21:33
Print Challan
Page No. 3
pBank
E-Challan p
p
p Submit Application Form for Combined Lower Subordinate Services Preliminary Exam p
Print
Punjab National Bank
Check Digit
"9"
Bank Copy
30/03/2013
Cash Only
BACK
E-Challan

Fee Details
Cash can be deposited AT PAR in any branch of Punjab National Bank

Entry in Finacle through PAYFEE menu only,
Institute ID : UPPSC
10120000199
Name of Candidate
SANDEEP KUMAR
01/01/1980
`)
115/Amount In Word
Transaction Date *
2 0
D D M M Y Y Y Y
p
........................................................................................
Punjab National Bank
Check Digit
"9"
Candidate Copy
30/03/2013
Cash Only

Fee Details
Cash can be deposited AT PAR in any branch of Punjab National Bank

10120000199
Name of Candidate
SANDEEP KUMAR
01/01/1980
`)
115/Amount In Word
Transaction Date *
2 0
D D M M Y Y Y Y
p
Candidate Home Page>Submit Application Form>Application Full details

I declare that I have read the user instructions & detailed advertisement
Notification Details
Notification No.
A-4/E-1/2013
Selection Type :
Directorate/Department :
Lower Sub.- Pre 2013
Post Name :
Lower Sub.- Prelim. 2013

Candidate Personnel Details
1. Application Registration No.
101200000084
2. Candidate Name :
SANDEEP JAISWAL
3. Father/Husband Name :
P. JAISWAL
4. Gender :
Male
5. Date of Birth
01/01/1980
6. Are you Domicile of UP?
Yeas
7. Category :
General
8. Are you Married ?
No.
9. Contact No.
10. Email-ID
Transaction Details
11. Bank Name :
12. Transaction ID :
13. Transaction Date :
//0
Other Details of Candidate
14. Are you Dependent of UP Freedom Fighter?
No
15. Are you UP Ex Army ?
No
15.1. Service Duration (Day-Month-Year) 0
15.2. Retirement Date (Date/Month/Year) / /
Yes
16.1. Are you Blind Or Have Vision problem?: No
16.2. Are you Deat or Have hearing problem ?: No
16.3. Have you any physical Problem?: Yes
16. Are You Handicap of UP?
* Mandatory to be filled by bank staff

http://uppsc.up.nic.in/challan preview.asox 14/02/2013 15:21:33
Print Challan
Sr.No.
16.3.1.
16.3.2.
16.3.3.
16.3.4.
p Submit detailed application form & scanned photo with signature p

Candidate Home Page > Submit Application Form
16.3.5.
Detailed Application Form Submission will be allowed only after 2:00 PM on the next
working Day since from the Fee deposition date in the Bank.
Candidate Registration No.
16.3.6.
16.3.7.
1012000084
Selected PH Category
BL
BA
BLA
OL
5OA
One Arm affected (right or left) [OA]
Impaired Reach Weakness of grip |Ataxic
Siff Back and Hps (Cannot sit or stoop) [BH]
BH
Muscular Weakness and limited physical endurance [MW] MW
17.
Are You Skilled Player Of UP?:
17.1. Essential Qualifications & Marks According to Advertisement:Sr.

No.
contact us for problem related

to Trans ID/Journal No. Date
1.
Transaction ID/Journal No.

Transaction Date
** Click
here for
guidelines
for
uploading
photo with
sign **
DAY d / MONTH d / YEAR d
Proceed
Please enter personel information and upload scanned file.

01 d / Jan
Gender
heg<e
d
Are you Domicile of UP ?
Yes
Category
meeceeve d
Browse...
QPAGw
150.00
Yes
You are Selected these Subjects :
Please Select the Subject Name
5 vFkZ'kkL=
lekt'kkL=@lekt foKku
f"k
1. vFkZ'kkL=
Yes
If Yes, Please Select Subject Name->
Cancel
123.00
1. vFkZ'kkL=
2. okf.kT;
3. xf.kr
20. Other Essential Qualification
Please enter personel information and upload scanned file.
Submit
82.00
No
** Click here for guideLines for uploading photo with signature **
Enter Verification Code
Percentage
Yes
19. Are You Post Graduate ?
C:Users Administrator D
Aquired Is Grade Obtained Total

System Marks
Marks
Yes

5 vFkZ'kkL=
lekt'kkL=@lekt foKku
f"k
d / 1980 d
Upload Scanned Photo with Signature File

Select Scanned File
Qualification
Hkkjr esa fof/k }kjk LFkkfir fdlh fo'ofo|ky; ls Lukrd dh mikf/k ;k ljdkj }kjk
blds led{k ekU;rk izkIr dksbZ vgZrkA
18. Are You Graduate ?

Imag e
Preview
Personnel Information
Date Of Birth
No
Essential Qualification Details
Bank Transaction Details

Please Select...
-0
PH Category [LOCOMOTOR or CEREBRAL PLASY]

Both Legs affected out not arms [BL]
Both Arms affected [BA]
Both Legs and Both Arms affected [BLA]
One Leg affected (right or left) [OA]
{ Fee Deposition through E-Challan Fee amount is NIL
Bank Name
-0
Precautions while entering Transaction ID/Journal Number
ch,llh ;k ch,llh Ag ds jktdh; Qy ifjj{k.k ,oa fMCck cUn
SBI :- Please remove characters like 'O'. J' in the prefix of Transaction ID/Journal Number
(if found) Provided by SBI Branch then enter only remaining digits.
ie. 019951077 or 0019951077 or J19951077 or J019951077 pl. enter only. 19951077
laLFkku y[ku ;k led{k ls 15 ekg dk LukrdksRrj fMIyksek ikB~;e

vFkok fdlh ekU;rk izkIr laLFkku ls gksVy feysa izcU/k vkSj Hkkstu izcU/k esa
rhu o"khZ; fMIyksekA
1- lekt 'kkL= vFkok lekt foKku esa Lukrd rFkk iksLV xzt
s ,q V
fMIyksek bu gsYFk ,twd's ku
d
21. Are You Know Hindi in Devnagari Lipi?

Yes
Candidate's Address, Photo Signature Details
PNB:- Please remove character lime '-' from the TRANSACTION ID/JOURNAL NUMBER (if found)
Provided by PNB Branch then enter only remaining characters and digits.
ie. M- 416965 pl. enter only M416965
Appendix-7A The Procedure relating to upload Photo & Signature.

Guide Lines for Scanning Photograph with Signature
1. Paste the Photo on any white paper as per the above required dimensions. Sign in the Signature
Space provided. Ensure that the signature is within the box.
2. Scan the above required size containing photograph and signature. Please do not scan the
complete page.
3. The entire image (of size 3.5 cm by 6.0 cm) consisting of the photo along with the signature is
required to be scanned, and stored in *.jpg, .jpeg, .gif, .tif, .png format on local machine.
4. Ensure that the size of the scanned image is not more than 50 KB.
5. If the size of the file is more than 50 KB, then adjust the settings of the scanner such as the DPI
resolution, no. colours etc., during the process of scanning.
6. The applicant has to sign in full in the box provided. Since the signature is proof of identity, it
must be genuine . and in full; initials are not sufficient. Signature in CAPITAL LETTERS is not
permitted.
7. The signature must be signed only by the applicant and not by any other person.
8. The signature will be used to put on the Hall Ticket and wherever necessary. If the Applicant's
signature on answer signature on the Hall Ticket, the applicant will be disqualified.
22. Address.
22.1 House no/Village :
22.2 Street No/PO :
22.3 City Name :
22.4 State Name :
22.5 District Name :
22.6 PIN :
lucknow
123
1
thakurganj
24. Photo & Signature
mRrj izn's k
y[ku
354365
I accept the following declaration : Yes
Declaration Segment
1. I here by declare that read all term & condition accroding advertisement and I accept it.
2. I here by declare that all the entires/statements made in this application are true, complete and correct to the best of my
knowledge and belief.
3. In the event of any information being found or incorrect or ineligibility being detect before or after selection, the commission
can take action against me as per rule incase it is detected that I have misled UPPSC on any issue then I will solely responsible for
all penel consequences thereof.
SC2gT
Type Verification Code as displayed in Image:Cancel
Close
Back
Submit
p Successfull Confirmation of Application Form p

Candidate Home Page>Submit Application Form>Successfull Confirmation of Application Submission
Print Application ID Slip

Your Application has been Submitted Successfully.
Please note down your Application ID for further Reference.
Sample Image & Signature:-
A-4/E-1/2013 : Lower Sub.-Pre 2013/Lower Sub. - Prelim.2013
mo
Application ID : 200047101000001
Registration Number : 10120000084
Candidate Name : SANDEEP JAISWAL
Date of Birth : 01/01/1980
Note:Filled in Application Form has been received in the Commission's office but its Acceptance is subject to the
verification process pertaining to the Candidates Age eligibility as per the post/objections related to photo
uploading related to photo uploading/Rejected/Accepted etc., So Please Visit the website again to view the
application status after the last date of form submission on the website under the uption View Application
Status for ensuring the Acceptance of Application Form.
[Date : 05/02/2013, Time : 12:06:42]
Page No. 4
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heefjefMe -8
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efpeve veiejeW ceW eejefcYeke hejer#ee Deeeesefpele keer peeesieer Jes efvecve ekeej nQ :
Deeieje, Fueeneyeeo, Deepeceie{, yejsueer, ieesjKehegj, yemleer, FeJee, Hewpeeyeeo, ieeefpeeeyeeo, peewvehegj, PeeBmeer, keevehegj veiej, ueKeveT, cesj", mLeeve ....................
nmlee#ej ............................
efcepee&hegj, cegjeoeyeeo, jeeyejsueer, menejvehegj, meerleehegj, MeenpeneBhegj, JeejeCemeer, cewvehegjer, ceLegje SJeb cegpehehejveiej~
efoveebke ....................
veece ................................
heo.................................
heefjefMe - 8S
mebmLee kee veece ......................
G. e. keer Devegmetef ele peeefle leLee Devegmetef ele peve peeefle kes efuees peeefle eceeCe-he$e
helee.................................
eceeefCele efkeee peelee nw efke eer/eerceleer/kegceejer ....................megheg$e/megheg$eer eer....................... efveJeemeer eece.....................
cegn j ................................
lenmeerue.................. veiej .................... efpeuee ....................Gej eosMe jepe keer .................... peeefle kes
vees :- en eceeCe-he$e eosMeere Kesue-keto mebIe kes meefeJe eje Jeefkeeiele he mes efkees iees nmlee#ej nesves hej ner ceeve nesiee~
Jeefkee nw efpemes mebeJf eOeeve (Devegmetef ele peeefle) DeeosMe, 1950 (pewmee efke mecee-mecee hej mebMeeseOf ele ngDee) /mebeJf eOeeve (Devegmetef ele pevepeeefle, Gej eosMe)
ehe - 3
DeeosMe, 1967 kes Devegmeej Devegmetef ele peeefle/ Devegmetef ele pevepeeefle kes he ceW ceevelee oer ieF& nw~
(ceevelee eehle eer[e/Kesue ceW Deheves efJeMJeefJeeeuee keer Deesj mes DevleefJe&MJeefJeeeuee eefleeeseif elee ces
eer/eerceleer/kegceejer........................... leLee DeLeJee Gvekee heefjJeej Gej eosMe kes .................... eece ....................lenmeerue
Yeeie uesves Jeeues efKeuee[er kes efuees)
....................veiej ....................efpeuee ................... ceW meeceeveleee jnlee nw~
efJeMJeefJeeeuee kee veece ................. jepe mlej keer mesJeeDeeW/heoeW hej efveegefkee kes efuees kegMeue efKeueeef[ eeW kes efuees eceeCe-he$e
mLeeve ....................
nmlee#ej ............................
eceeefCele efkeee peelee nw efke eer/eerceleer/kegceejer......................Deelcepe/helveer/Deelcepee eer..........................
efoveebke ....................
hetje veece ............................
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cegnj ....................
heo kee veece .........................
efpeueeeqOekeejer/Deefleefjkee efpeueeefOekeejer/efmeer ceefpems^ /hejievee ceefpems^ /lenmeerueoej/ efoveebke ...................... leke ...................... (mLeeve kee veece) ceW Deeeesepf ele DevleefJe&MJeefJeeeuee ......................
Deve Jesleve Yeesieer ceefpems^ eefo keesF& nes/ efpeuee meceepe keueeCe DeefOekeejer~ (eer[e/Kesue-keto kee veece) eefleeesefielee/tvee&cesv ceW ......................efJeMJeefJeeeuee keer Deesj mes Yeeie efueee~ Gvekes erce kes eje Gkee
eefleeesefielee/tvee&cesv ceW ................... mLeeve eehle efkeee ieee~ en eceeCe-he$e [erve DeeHe mhees&md e DeLeJee Fbeepe& Kesue-keto
Gej eosMe kes Deve efhe[s Jeie& kes efueS peeefle eceeCe-he$e
............................. efJeMJeefJeeeuee ceW GheueyOe efjkee[& kes DeeOeej hej efoee ieee nw~
ehe-1
mLeeve ....................
nmlee#ej ............................
veece ................................
eceeefCele efkeee peelee nw efke eer/eerceleer/kegceejer ....................megheg$e/megheg$eer eer....................... efveJeemeer eece.................... efoveebke ....................
heo.................................
lenmeerue.................. veiej .................... efpeuee ....................Gej eosMe jepe keer .............eqhe[er peeefle kes
Jeefkee nQ~ en peeefle Gej eosMe ueeske mesJee (Devegmetef ele peeefleeeW, Devegmetef ele peve peeefleeeW leLee Deve efhe[s JeieeX kes efuees Deej#eCe) DeefOeefveece, 1994
mebmLee kee veece .......................
(eLeemebMeeseOf ele) keer Devegmeteer-Ske kes Devleie&le ceevelee eehle nw~
cegnj .................................
en Yeer eceeefCele efkeee peelee nw efke eer/eerceleer/kegceejer..........................hetJeexkee DeefOeefveece, 1994 (eLeemebMeeseOf ele) keer Devegmeteer-oes (pewmee vees :- en eceeCe-he$e eqJeMJeefJeeeuee kes [erve DeeHe mheesm&d e ee Fbeepe& Kesue-keto eje Jeefkeeiele he mes efkees iees nmlee#ej nesves hej ner ceeve nesiee~
ehe - 4
efke Gej eosMe ueeske mesJee) (Devegmetef ele peeefleeeW, Devegmetef ele peve peeefleeeW Deewj Deve efhe[s JeieeX kes efuees Deej#eCe) (mebMeesOeve) DeefOeefveece, 2001 eje
(ceevelee eehle eer[e/Kesue ceW Deheves mketue keer Deesj mes jeêr e Kesue-keto ces Yeeie uesves Jeeues efKeuee[er kes efuees)
eeflemLeeefhele efkeee ieee nw SJeb pees Gej eosMe ueeske mesJee (Devegmetef ele peeefleeeW, Devegmetef ele peve peeefleeeW Deewj Deve efhe[s JeieeX kes efuees Deej#eCe) (mebMeesOeve)
[eFjskes^ DeeHe heefyueke Fvm^keMevme/efveosMeke,efMe#ee, Gej eosMe ................. jepe mlej keer mesJeeDeeW/heoeW
DeefOeefveece, 2002 eje mebMeeseOf ele keer ieeer nw, mes Deeeefole veneR nw~ Fvekes ceelee-efhelee keer efvejblej leerve Je<e& keer DeJeefOe kes efuees mekeue Jeeef<e&ke Deee heeBe
hej efveegekf ee kes efuees kegMeue efKeueeef[eeW kes efuees eceeCe-he$e
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eer/eerceleer/kegceejer.......................... leLee/DeLeJee Gvekee heefjJeej Gej eosMe kes eece ................lenmeerue ....................veiej eceeefCele efkeee peelee nw efke eer/eerceleer/kegceejer......................Deelcepe/helveer/Deelcepee eer...................... efveJeemeer (hetje helee)
....................efpeuee .................... ceW meeceeveleee jnlee nw~
...................... ceW ....................mketue ceW ke#ee ....................kes efJeeeLeea ves efoveebke ......................mes
mLeeve ....................
nmlee#ej ............................
efoveebke ...................... leke .................... (mLeeve kee veece) ceW Deeeesepf ele mketueeW kes vesMeveue iescme keer ......................
efoveebke ....................
hetje veece ............................
(eer[e/Kesue-keto kee veece) eefleeesefielee/tvee&cesv ceW ......................mketue keer Deesj mes Yeeie efueee~ Gvekes erce kes eje Gkee eefleeesefielee/
cegn j ......................
heo kee veece .......................... tvee&cesv ceW ...................... mLeeve eehle efkeee ieee~
efpeueeeqOekeejer/Deefleefjkee efpeueeefOekeejer/efmeer ceefpems^ /hejievee ceefpems^ /lenmeerueoej~ en eceeCe-he$e [eFjske^s DeeHe heefyueke Fvm^keMevme/efMe#ee ceW GheueyOe efjkee[& kes DeeOeej hej efoee ieee nw~
mLeeve ....................
nmlee#ej ............................
G.e. kes efJekeueebieeW kes efuees eceeCe-he$e
efoveebke ....................
veece ................................
CERTIFICATE FOR PHYSICALLY HANDICAP OF U.P.
NAME & ADDRESS OF THE INSTITUTE/HOSPITAL
heo.................................
Certificate No..........
Date ........................
mebmLee kee veece .......................
DISABILITY CERTIFICATE
cegnj .................................
This is certified that Shri/Smt/Kum...............................................................................
vees :- en eceeCe-he$e eqveosMeke/ee Deefleefjkee/mebegkee ee GheefveosMeke [eFjskes^ Dee@]He heefyueke Fvm^keMevme/efMe#ee ................... eje
son/wife/daughter of Shri ....................................................................... age..............
Recent
sex................ identification mark(S)................................. is suffering from permanent
Jeefkeeiele he mes nmlee#ej nesves hej ceeve nesiee~
Photograph of the
disability of following category.
candidate
A. Locomotor or cerebral palsy :
showing the
(i) BL-Both legs affected but not arms.
disability duly
(ii) BA-Both arms affected
attested by the
(a) Impaired reach
(b) Weakness of grip
Chairperson of the
(iii) BLA-Both legs and both arms affected
Medical Board.
(iv) OL-One leg affected (right or left)
(a) Impaired reach
(c) Ataxic
(v) OA-One arm affected
(a) Impaired reach
(c) Ataxic
(vi) BH-Stiff back and hips (Cannot sit or stoop)
(vii) MW-Musculer weakness and limited physical endurance.
B. Blindness or Low Vision :
(i) B-Blind
(ii) PB-Partialy Blind
C. Hearing impairment :
(i) D-Deaf
(ii) PD-Partialy Deaf
(Delete tha category whichever is not applicable)
2. This condition is progressive/non-progressive/likely to improve/not likely to improve. Re-assessn of this case is
not recommended/is recommended after a period of ........ year...... months.
3. Percentage of disability in his/her case is ................... percent.
4. Sh./Smt./Kum........................................... meets the following physical requirements discharge of his/her
duties:
(i)F-can perform work by manipulating with fingers.
Yes/No
(ii) PP- can perform work by pulling and pushing.
Yes/No
(iii) L-can perform work by lifting.
Yes/No
(iv) KC- can perform work by kneeling and crouching.
Yes/No
(v) B-can perform work by bending.
Yes/No
(vi) S-can perform work by sitting.
Yes/No
(vii) ST- can perform work by standing.
Yes/No
(viii) W-can perform work by walking.
Yes/No
(ix) SE-can perform work by seeing.
Yes/No
(x) H-can perform work by hearing/speaking.
Yes/No
(xi) RW- can perform work by reading and writing.
Yes/No
(Dr......................)
(Dr......................)
(Dr......................)
Member
Member
Chairperson
Medical Board
Medical Board
Medical Board
Countersigned by the
Medical Superintendent/CMO/HQ
Hospital (with seal)
* Strike out which is not applicable.
heefjefMe - 9
hejer#ee keer eespevee : eefleeesefielee hejer#ee ceW eceJeej leerve mlej meefcceefuele nQ eLee : (1) eejefcYeke hejer#ee (Jemleghejke) (2) cegKe hejer#ee (Jemleghejke
SJeb hejchejeiele (3) mee#eelkeej~
eejefcYeke hejer#ee
eejefcYeke hejer#ee kesJeue Ske eMve he$e (meeceeve DeOeeve) keer nesieer~ hee"deece Fme efJe%eeheve kes heefjefMe-10 ceW GefuueefKele nw~ eMve he$e
300 Debke kee leLee oes Ievs (hetJee&vn 9.30 mes 11.30 yepes leke) DeJeefOe kee nesiee efpemeceW 150 eMve neWies~
cegKe hejer#ee
cegKe hejer#ee kesJeue oes DeefveJeee& eMve he$e (eLece eMve he$e- meeceeve DeOeeve (Jemleghejke), hetCee&ke 200, mecee 2 Ievs (hetJee&vn 9.30
yepes mes 11.30 yepes leke) SJe eMveeW keer mebKee 120 leLee efleere eMve he$e (hejchejeiele) meeceeve efnvoer SJeb efnvoer efveyevOe, hetCeeke 200
mecee 3 IeCs (Dehejevn 2.00 yepes mes meeeb 5.00 yepes leke) kes neWies~
Fme eMve he$e kes oes KeC[ (eLece KeC[ meeceeve efnvoer-100 Debke, efleere KeC[, oes efnvoer efveyevOe- 100 Debke) neWies~
cegKe hejer#ee kee hee"deece Fme efJe%eeheve kes heefjefMe-11 ceW GefuueefKele nw~
heefj efMe-10
meeceeve DeOeeve kee hee"deece (eejefcYeke hejer#ee)
DeefOekelece Debke - 300

mecee - 2 IeCs
eMveeW keer mebKee - 150
(1) Yeejle kee Fefleneme SJeb Yeejleere jeêr e Deevoesueve :- Yeejleere Fefleneme kes Devleie&le meeceeefpeke, DeeefLe&ke SJeb jepeveerefleke he#eeW keer
meeceeve peevekeejer hej cenlJe nesiee~ Yeejleere jeêre Deevoesueve hej DeYeefLe&eeW mes mJeleb$elee Deevoesueve, jeêr elee kee DeYegoe leLee mJeleb$elee
eeefhle kes mecyevOe ceW meejhejke peevekeejer Dehese#f ele nw~
(2) Yeejle SJeb efJeMJe kee Yetieesue, Yeejle SJeb efJeMJe kee Yeewelf eke, meeceeefpeke SJeb DeeefLe&ke Yetieesue :- Yeejle kes Yetieesue kes Devleie&le osMe
kes Yeewefleke, meeceeefpeke SJeb DeeefLe&ke Yetieesue mes mecyeefvOele eMve neWies~ efJeMJe Yetieesue ceW efJe<ee keer kesJeue meeceeve peevekeejer Dehese#f ele nesieer~
(3) Yeejleere jepeveerefle SJeb Meemeve, mebefJeOeeve, jepeveerefleke JeJemLee, hebeeeleer jepe, ueeskeveerefle SJeb DeefOekeeefjke cegodos Deeefo :Yeejleere jepeveerefle SJeb Meemeve kes Devleie&le osMe kes mebefJeOeeve, hebeeeleer jepe leLee meecegoeefeke efJekeeme meefnle jepeveerefleke eCeeueer kes %eeve mes
mecyeefvOele eMve neWies~
(4) Yeejleere DeLe&JeJemLee SJeb meeceeefpeke efJekeeme :- DeYeefLe&eeW kes pevemebKee, heee&JejCe leLee veiejerkejCe mes mecyeefvOele mecemeeDeeW SJeb
heejmheefjke mecyevOe, Yeejleere DeeefLe&ke veerefle SJeb Yeejleere mebmke=efle kes Jeeheke mJehe kes %eeve kee hejer#eCe efkeee peeesiee~
(5) jeêre SJeb Devleje&êre cenlJe keer meeceefeke IeveeeW :- FmeceW Kesueketo kes eMve Yeer meefcceefuele neWies~
(6) Yeejleere ke=ef<e :- Yeejle ceW ke=ef<e, ke=ef<e Glheeo SJeb Gmekes efJeheCeve kes mecyevOe ceW meeceeve peevekeejer keer Dehes#ee DeYeefLe&eeW mes nesieer~
(7) meeceeve efJe%eeve :- meeceeve efJe%eeve kes eMve owefveke DegveYeJe leLee es#eCe mes mecyeefvOele efJe<eeeW meefnle efJe%eeve kes meeceeve heefjyeesOe SJeb
peevekeejer hej DeeOeeefjle neWies, efpemekeer Ssmes efkemeer Yeer megefMeef#ele Jeefkele mes Dehes#ee keer pee mekeleer nw efpemeves Jew%eeefveke efJe<eeeW kee efJeMes<e DeOeeve
veneR efkeee nw~ FmeceW Yeejle kes efJekeeme ceW efJe%eeve SJeb eeweeseif ekeer keer Yetefcekee mes mecyeefvOele eMve Yeer neWies~
G.e. kes mJeleb$elee mebeece mesveeefveeeW kes Deeefeleesb kes efueS eceeCe-he$e
(8) eejefcYeke ieefCele neF&mketue mlej leke :- DebkeieefCele, yeerpeieefCele Je jsKeeieefCele~
eceeCe-he$e
DeYegekf ele :- DeYeefLe&eeW mes en Dehese#f ele nesiee efke Gej eosMe kes efJeMes<e heefjes#e ceW Gheeg&kele efJe<eeeW kee GvnW meeceeve heefjee nes~
eceeefCele efkeee peelee nw efke eer/eerceleer/kegceejer ...........................efveJeemeer....................... eece.....................
heefjefMe-11
lenmeerue.................. veiej .................... efpeuee ....................Gej eosMe ueeske mesJee (Meejerefjke he mes efJekeueebie,
meeceeve DeOeeve kee hee"deece (cegKe hejer#ee)
mJeleb$elee mebeece mesveeefveeeW kes Deeefele Deewj YetlehetJe& mewevf eke kes efueS Deej#eCe) DeefOeefveece 1993 kes Devegmeej mJeleb$elee mebeece mesveeveer nQ Deewj eer/eerceleer/kegceejer
eMve he$e - eLece
(Deeefele) ................... heg$e/heg$eer/heew$e/heew$eer Ghejebekf ele DeefOeefveece 1993 kes ner eeJeOeeveeW kes Devegmeej Gkee eer/eerceleer (mJeleb$elee mebeece mesveeveer) DeefOekelece Debke - 200
mecee - 2 IeCs
eMveeW keer mebKee - 120
................ kes Deeefele nQ~
nmlee#ej ...........................
(1) jeêre SJeb Devleje&êre cenlJe kes meeceefeke ceeceues :- FmeceW Kesueketo mes mecyeefvOele eMve Yeer meefcceefuele neWies~
mLeeve ....................
hetje veece ...........................
(2)
eg
e
k
f
e
l
emeb
i
ele
SJeb
Deeuees
eveelceke
leLee
ef
J
eMues
<
eCeelceke
ees
i
elee~
efoveebke ....................
cegn j ...............................
(3) meeceeve ceeveefmeke eesielee :- Ssmes eMve efpevemes DeYeLeea keer heefjCeece hejke DeefYe#ecelee keer hejKe nes mekes~
efpeueeeqOekeejer .........................
(4) meebeKf ekeere efJeMues<eCe - eehe Deewj [eeeece, efpevemes DeYeefLe&eeW keer meebefKekeere, eehekeer, [eeeece mecyevOeer emlegle metevee mes meeceeve
meeru e...............................
%eeve mecyevOeer heefjCeece, efve<ke<e& efvekeeueves keer #ecelee keer hejKe nes mekes~
kegMeue efKeueeef[ eeW kes efuees eceeCe-he$e pees G.e. kes cettue efveJeemeer nQ
(5) meeceeve peeiekelee Deewj Yeejleere mebefJeOeeve leLee hebeeeleer-jepe JeJemLee mecyevOeer %eeve~
MeemeveeosMe mebKee - 22/21/1983-keeefce&ke-2 efoveebke 28 veJecyej, 1985
(6)
kechetj %eeve - kechetj kee heefjee, ne[&Jesej SJeb meeheJesej, kechetj vesJeke&, Fvjves SJeb F&-cesue~
eceeCe-he$e kes Heece& - 1 mes 4 ehe - 1
(7) iee@Oeer efJeeejOeeje - jepeveerefleke, meeceeefpeke SJeb DeeefLe&ke #es$e~
(ceevelee eehle eer[e/Kesue ceW Deheves osMe keer Deesj mes Devleje&e^ r e eefleeeseif elee ceW Yeeie uesves Jeeues efKeuee[er kes efuees)
(8)
G.e. hej DeeOeeefjle efJeefMe eMve - efMe#ee, mebmke=efle, ke=ef<e, pevemebKee, Jeeheej SJeb JeeefCepe, meeceeefpeke eLeeeW, Geesie Deeefo~
mecyeefvOele Kesue keer jeêre Hes[jsMeve/jeêr e Smeesemf eSMeve kee veece ............................ jepe mejkeej keer mesJeeDeeW/heoeW hej efveegekf ee
(9) DevleJezeefkeleke #ecelee efpemeceW meces#eCe keewMeue, efveCe&e #ecelee SJeb mecemee meceeOeeve Yeer meceeefnle nesiee~
kes efuees kegMeue efKeueeef[ eeW kes efuees eceeCe-he$e
eceeefCele efkeee peelee nw efke eer/eerceleer/kegceejer ....................Deelcepe/helveer/Deelcepeeeer.......................... efveJeemeer..................... (10) meeceeve ceeveJe JeJenej - DevegMeemeve, vewelf ekelee, vesle=lJe, ceefnueeDeeW kee meMeefkelekejCe~
hetje helee ................. ves efoveebke ................mes efoveebke .................. leke................(mLeeve kee veece) ceW Deeeesepf ele (11) meeceeve efJe%eeve - meeceeve efJe%eeve kes eMve owefveke DevegYeJe leLee es#eCe mes mecyeefvOele efJe<eeeW meefnle efJe%eeve kes meeceeve heefjyeesOe SJeb
peevekeejer hej DeeOeeefjle neWies, efpemekeer Ssmes efkemeer Yeer megefMeef#ele Jeeqkele mes Dehes#ee keer pee mekeleer nw efpemeves Jew%eeefveke efJe<eeeW kee efJeMes<e DeOeeve
......................(eer[e/Kesue-keto kee veece) keer eefleeeseif elee/tvee&cesv ceW osMe keer Deesj mes Yeeie efueee~
veneR efkeee nw~ FmeceW Yeejle kes efJekeeme ceW efJe%eeve SJeb eeweesefiekeer keer Yetecf ekee mes mecyeefvOele eMve Yeer meefcceefuele neWies~
Gvekes erce kes eje Gkee eefleeeseif elee/tvee&cesv ceW ......................mLeeve eehle efkeee ieee~
eMve he$e - efleere
en eceeCe-he$e jeêr e Hes[jsMeve/jeêre Smeesemf eSMeve/(eneB mebmLee kee veece efoee peees) ......................ceW GheueyOe efjkee[& kes DeeOeej
meeceeve efnvoer SJeb efveyevOe
hej efoee ieee nw~
hetCeeke - 200
mecee - 3 IeCe
mLeeve ....................
nmlee#ej ...........................
eLece KeC[
meeceeve efnvoer
efveOee&efjle Debke 100
efoveebke ....................
veece ...............................
1. Deheef"le ieeebMe kee meb#esheCe, Gmemes mecyeefvOele eMve, jsKeebefkele DebMeeW keer JeeKee SJeb Gmekee Gheegkele Meer<e&ke~
heo................................
2. Meemekeere, De&Meemekeere, Jeweefeke leLee JeJemeeefeke mecemeeDeeW kes efvejekejCe nsleg mecyeefvOele kees mecyeesefOele he$e, keeee&uee DeeosMe,
mebmLee kee veece ......................
DeefOemetevee Deewj heefjhe$e mecyevOeer he$euesKeve/DeeuesKeve~
cegnj ..............................
3. DeveskeeLeea Meyo, efJeueesce Meyo, heee&eJeeeer Meyo, lelmece SJeb leodYeJe, #es$eere, efJeosMeer(Meyo YeC[ej), Jele&veer,DeLe&yeesOe, Meyo-he, mebeOf e,
vees:- en eceeCe-he$e vesMeveue Hes[jsMeve/vesMeveue Smeesemf eSMeve kes meefeJe eje Jeefkeeiele he mes efkees iees nmlee#ej nesves hej ner ceeve nesiee~
meceeme, efeeeeW, efnvoer JeCe&ceeuee, efJejece efevn, Meyo jevee, Jeekee jevee, DeLe&, cegneJejs SJeb ueeskeesef eee@, G.e. keer cegKe yeeseuf eee@ leLee efnvoer
ehe - 2
Yee<ee kes eeesie ceW nesves Jeeueer DeMegefeeb~
(ceevelee eehle eer[e/Kesue ceW Deheves eosMe keer Deesj mes jeêr e eefleeeseif elee ces Yeeie uesves Jeeues efKeuee[er kes efuees)
efleere KeC[
efnvoer efveyevOe
efveOee&ejf le Debke 100
(mecyeefvOele Kesue keer eosMeere Smeesemf eSMeve kee veece) ................................ jepe mejkeej keer mesJeeDeeW/heoeW
Fmekes Devleie&le oes GheKeC[ neWies~ eleske GheKeC[ mes Ske-Ske efveyevOe (kegue efceueekejoes efveyevOe) efueKeves neWies~ eleske efveyevOe keer efJemleej meercee
hej efveegekf ee kes efuees kegMeue efKeueeef[ eeW kes efuees eceeCe-he$e
eceeefCele efkeee peelee nw efke eer/eerceleer/kegceejer......................Deelcepe/helveer/Deelcepee eer...................... efveJeemeer (hetje helee) 700 Meyo nesieer~ efveyevOe nsleg efvecveJeled #es$e neWies :...................... ves efoveebke ......................mes efoveebke ...................... leke ...................... ceW (eer[e/ (De) (i) meeefnle, mebmke=efle (ii) jeêr e efJekeeme eespeveeSb/efeeevJeeve (iii) ke=ef<e, Geesie SJeb Jeeheej~
Kesue-keto kee veece) keer eefleeeseif elee (tvee&cesv mLeeve kee veece) ......................Deeeesefpele jeêr e ...................... ceW (eer[e/Kesue- (ye) (i) efJe%eeve, heee&JejCe (ii) eeke=efleke DeeheoeS@ SJeb Gvekes efveJeejCe (iii) jeêr e, Devleje&e^ r e, meeceefeke meeceeefpeke mecemeeS@/efveoeve~
keto kee veece) keer eefleeeseif elee/tvee&cesv ceW eosMe keer Deesj mes Yeeie efueee~
meefeJe
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efJe%eeheve mebKee : S-4/F&-1/2013

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