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C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS

C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS


WEST BENGAL POLICE RECRUITMENT BOARD
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
APPLICATION FORM FOR THE POST OF SI/LSI OF EXCISE 2018
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
943E409E13F628B5BBC35AE7E37D174E5FC9B29DE29471C7845E4934584A32E5
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS

C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS


40065435MC910317A
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Application C910317NRS
Sl. No. 40065435

C910317NRS
To C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
The Chairman
C910317NRS
West BengalC910317NRS C910317NRS
Police Recruitment Board C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
POLICE RECORDS BHAVAN, ARAKSHA BHAVAN, BLOCK -DJ , SECTOR -II,
SALTLAKE, KOLKATA-700091
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Sir,
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
I hereby apply for the post of SI/LSI of Excise 2018. Necessary particulars are furnished below:-
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Post applied for : SI/LSI of Excise 2018
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS

C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS


Name in FullC910317NRS C910317NRS
C910317NRS : RIDAN CHANDRA DAS
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Gender : Male Category : SC Date of Birth : 17/03/1991
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Father's Name : MATI LAL DAS Husband's Name :
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Mother's Name : USHA DAS Marital Status : Un-Married
C910317NRS
Mobile C910317NRS C910317NRS
: 9748322914C910317NRS C910317NRS
Email C910317NRS C910317NRS C910317NRS C910317NRS
: rcds91@gmail.com

C910317NRS C910317NRS C910317NRS


Complete Mailing Address :
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
VILL- CHOWHATI NETAJI BLOCK
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
PO : CHOWHATI
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
POLICE STATION : SONARPUR PS
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
DISTRICT : SOUTH 24 PARGANAS PIN : 700149
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
STATE : WEST BENGAL
C910317NRS C910317NRS C910317NRS
Permanent Address : C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
VILL- CHOWHATI NETAJI BLOCK
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
PO : CHOWHATI
C910317NRS C910317NRS C910317NRS C910317NRS
POLICE STATION C910317NRS
: SONARPUR PS C910317NRS C910317NRS C910317NRS C910317NRS

C910317NRS C910317NRS C910317NRS C910317NRS


DISTRICT : SOUTH C910317NRS
24 PARGANAS C910317NRS C910317NRS C910317NRS C910317NRS
PIN : 700149

C910317NRS C910317NRS C910317NRS C910317NRS


STATE : WEST BENGAL C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS

C910317NRS
Educational C910317NRS
Qualification C910317NRS
: Graduate : C910317NRS
Yes C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Name of C910317NRS
C910317NRS Examination Year of Passing
C910317NRS NameC910317NRS
C910317NRS C910317NRS of the Board / Council / University
C910317NRS C910317NRS C910317NRS
(YYYY)
Madhyamik
C910317NRS (Class X)
C910317NRS 2007 C910317NRS C910317NRS
C910317NRS WEST BENGAL BOARD OF SECONDARY
C910317NRS EDUCATION
C910317NRS C910317NRS C910317NRS
Higher Secondary (10+2) 2009 WEST BENGAL COUNCIL OF HIGHER SECONDARY EDUCATION
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Graduation 2014 WEST BENGAL UNIVERSITY OF TECHNOLOGY
C910317NRS C910317NRS C910317NRS
Post Graduation 2017 C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
VIDYASAGAR UNIVERSITY
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Do you belong to exempted category? : NO Registration & NCO No. issued by the
labour department, Govt. of W.B. :
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Your Community
C910317NRS : C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
C910317NRS C910317NRS

C910317NRS
Religion C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
: HINDUISM

C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS

C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS

C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS Page


C910317NRS
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943E409E13F628B5BBC35AE7E37D174E5FC9B29DE29471C7845E4934584A32E5
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
C910317NRS C910317NRS
Application Sl. No. 40065435C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
40065435MC910317B
Name : RIDAN 943E409E13F628B5BBC35AE7E37D174E5FC9B29DE29471C7845E4934584A32E5
CHANDRA DASC910317NRS C910317NRS C910317NRS
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS

C910317NRS C910317NRS
Language selected C910317NRS
for Preliminary C910317NRS C910317NRS C910317NRS
Written Examination : BENGALI C910317NRS C910317NRS C910317NRS
C910317NRS C910317NRS
Language selected for Paper C910317NRS C910317NRS
– III of Final Combined C910317NRS
Competitive Examination C910317NRS
: BENGALI C910317NRS C910317NRS C910317NRS
Employed inC910317NRS
C910317NRS any GovernmentC910317NRS
: NO
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Organisation
OrganizationC910317NRS
C910317NRS Name : C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
C910317NRS
Have you ever appeared in any examination(s) conducted by WBPSC or any other Agency under the GoWB for this post? : NO
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Details :
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Year of Examination C910317NRS C910317NRS C910317NRS
Name of Commission/Board

C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS


C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS

C910317NRS
Have you ever C910317NRS
been subjected to aC910317NRS C910317NRS
criminal investigation C910317NRS
as an accused involving C910317NRS C910317NRS
moral turpitude? : NO C910317NRS C910317NRS
Details :
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Police Station Name in Full FIR No. FIR Date Sections of Law
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS

C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS

C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS


Application Fees : Rs. 0.00
C910317NRS
Bank ChargeC910317NRS C910317NRS C910317NRS
: Rs. 0.00 C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Processing Charge
C910317NRS : Rs.
C910317NRS C910317NRS 20.00
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Total Fees paid : Rs. 20.00
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS

C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS


Transaction ID : LSBI6101675032 [ Online Payment through Bill Desk ]
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Transaction Date : 03/03/2018 07:33:37
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
(Rupees C910317NRS C910317NRS C910317NRS C910317NRS
Twenty only)
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Declaration :
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
(i) I possess all the Essential Qualifications for the Post.
(ii) I solemnly
C910317NRS declare that all
C910317NRS statements made
C910317NRS in this application
C910317NRS form are C910317NRS
C910317NRS true, complete and correct to the
C910317NRS best of my knowledge
C910317NRS C910317NRS
and belief. In the event of any information being found suppressed / false or incorrect, or if my ineligibility is detected before,
during or
C910317NRS after the tests C910317NRS
C910317NRS and medical examination, my candidature
C910317NRS C910317NRS/ appointment will stand
C910317NRS cancelled andC910317NRS
C910317NRS my claim to recruitment
C910317NRS
will stand forfeited. I also declare that I have submitted no other application form for this examination.
(iii) I have never
C910317NRS been debarred
C910317NRS from any examination
C910317NRS C910317NRSconducted by any Service
C910317NRS CommissionC910317NRS
C910317NRS / Recruitment Board of the Government
C910317NRS C910317NRS
of West Bengal.
C910317NRS C910317NRS
(iv) I have not C910317NRS
been subjected C910317NRS
to a criminal investigation C910317NRS
involving C910317NRS C910317NRS C910317NRS C910317NRS
moral turpitude.
(v) I shall submit the No Objection Certificate from the Head of the Office/ Disciplinary Authority if shortlisted for Personality Test.
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
(vi) I have carefully exercised the language option for both Preliminary & Final Written examination and shall under no circumstances
request for change.
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
Place : KOLKATA
C910317NRS Yours faithfully,
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS
C910317NRS C910317NRS
Date : 03 Mar 2018 07:33:37C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS

C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS


Full signature of the candidate (only in Long Hand)
C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS

C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS

C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS

C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS

C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS C910317NRS Page


C910317NRS
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