RECRUITMENT FOR WATCHMAN

Advertisement No. FCI-RAJASTHAN/01/2017

REGISTERED APPLICATION FORM
Application Form for the Post of : Watchmen
Registration Number : 3173264971
22. Photo
1. Candidate's Name : SARDARA RAM SAINI
(Name as recorded in the School /
Matriculation / Birth Certificate etc.)
2. (a) Father's Name : GANGA RAM SAINI
(b) Mother's Name : LALI DEVI
3. Gender : MALE
4. Date of Birth : 17-Apr-1995
(As recorded in the School /
Matriculation / Birth Certificate etc.) 23. Signature
5. Age (as on 01.07.2017) : 22 Year(s) 02 Month(s) 14 Day(s)
6. Category : OBC
7. Whether Domiciled in the State of : NO
Jammu and Kashmir during the period
01-01-1980 to 31-12-1989
8. Whether Ex-Servicemen : NO
9. Whether Person with Disabilities (PWD) : NO
/ Physically Handicapped (PH)
10. Whether Departmental (FCI) Employee : NO
11. Minority Community : Not Applicable
12. Nationality : INDIAN
13. Exam City (in order of Preference) : ALWAR, JAIPUR, AJMER
14. Language of Written Test : Hindi
15. Post Applied For : Watchmen
16. Educational Qualification
(a) Name of Qualification (which makes : 8th Standard Pass
you eligible)
(b) Date of Issue / Acquiring Qualification : 13-Apr-2007
(c) Name of the School / Authority / : SARSHWATI SR SEC SCHOOL GHARI MAMOR
Board
(d) Whether Govt. Recognized : YES
17. Higher Qualification
(a) Have you completed Matriculation (10th : YES
Std.) ?

Sl.No. Name of Examination School/College Name Year of Passing % of Marks

Passed
1. Matriculation sarswati sr sec school 2009 67.17
ghari mamor
Note: In case of CGPA / OGPA or Grade, mention equivalent percentage of marks as per University /
Institute norms. Percentage of marks not to be rounded off.
(b) Details of Higher Qualification (if applicable)

Sl.N Name of Stream of the School/College Name Year of Passing % of Marks

o. Examination Examination
Passed
1. Intermediate/10+2 science sarswati mordan sr sec 2011 52.92
school bansur
Note: In case of CGPA / OGPA or Grade, mention equivalent percentage of marks as per University /
Institute norms. Percentage of marks not to be rounded off.
18. Email Id : SARDARASAINI@GMAIL.COM
19. Mobile Number : 9810537087
20. Address Details
Address Line 1 : GHARI MAMOR
Address Line 2 : POST GHARI MAMOR TEH THANAGAZI
District : ALWAR
City : ALWAR
Pin Code : 301024
State : Rajasthan
22. Whether FEE Paid : YES - SBI Collect Reference Number : du3264971,
Deposit Date : 07-Aug-2017

21. Declaration
1. I have not submitted any other application for this examination. I am aware that if I contravene this rule, my
application will be rejected summarily by FCI.
2. I have read the provisions in the Advertisement carefully and hereby undertake to abide by them.
3. I further declare that I fulfill all the conditions of eligibility regarding age limits, educational qualifications etc.
prescribed for the post applied for.
4. I also declare that I do not stand debarred by FCI as on date and have never been convicted by any court of law.
I also declare that no charge sheet is pending against me in any court of law. Further declare that I have never
been dismissed or compulsorily retired from the service of the Corporation or from a Department of a State or the
Central Government or from any Public Sector Undertaking or my service been terminated during probation.
5. For Candidate belonging to OBC -
I declare that I belong to the community, which is recognized as backward class by the Govt. of India for the
purpose of reservation in services as per order contained in Deptt. of Personnel and Training Office
Memorandum No. 36012/ 22/ 93-Estt.(SCT) dated 8.9.1993. I also declare that I do not belong to the person /
sections (creamy layer) mentioned in column 3 of the schedule of the OM mentioned above and modified vide
Govt. of India DOPT OMs mentioned in the Advertisement. I further declare that I am in possession of OBC
Certificate in the prescribed format given in the Advertisement.
6. I hereby declare that there is no Vigilance / Disciplinary case pending against me. I am in possession of No
Objection Certificate from my employer which shall be required to be sent along with other essential enclosures
in case of my shortlisting on the basis of the Written Test at the designated Address which shall be informed /
notified through the designated website (www.fciregionaljobs.com)
7. I hereby declare that self-certified copies of relevant certificates / documents are in my possession. In case, self-
certified copies of the relevant certificates / documents are not provided by me along with the Registered Online
Application Form Printout, if called for, my candidature will be cancelled without any notice.
I hereby declare that all the information given/ statements made by me in the application are true, complete and
correct to the best of my knowledge and belief and nothing has been concealed or suppressed. In the event of any
information being found false or incorrect or is not in conformity with the eligibility criteria mentioned in the
advertisement at any point of time my candidature / appointment may be cancelled / terminated without any notice
and / or I shall be liable for any other action under the extant rules.

Date: 07-Aug-2017 Signature of Candidate: _______________

Place: ____________ Candidate's Name (in Capital Letters): _______________