1/18/2020 Coal India Limited Form 2019

Applicant Details

Personal Details

Application Sequence No

CIL204275

Candidate's Name

IMDAD AHMED LASKAR

Father's Name Mother's Name

KHASRUL HAQUE LASKAR SALEHA BEGUM LASKAR

Marital Status Visible Identification Mark

Unmarried MOLE AT LEFT HAND

Nationality Have You ever been arrested,prosecuted,convicted by

court of law?
Indian
No

Post Applied Details

Post Applied Post Code

Civil 14

Center Choice 1 Center Choice 2

Guwahati Shillong

Center Choice 3 Category

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Siliguri General(UR)

Category Declaration Gender

I confirm that I belong to the Category Male
selected above, and I agree that any
Date of Birth (DD-MM-YYYY) same as Matriculation/
deviation/discrepancy found at a later stage Secondary Certificate
will lead to cancellation of my candidature
15/Jul/1994

Age as on 01.04.2020
25 Years 8 Months 17 Days

Are you Person with disability (PWD) (degree of disability

40% or above)?
No

Are you medically fit, other than the declared disability?

Yes

Are you an Ex-Service man?

No

Were you originally domiciled in the state of Jammu and Are you an employee of Coal India or its subsidiary
Kashmir between 01.01.1980 and 31.12.1989 ? companies ?
No No

Are you a Government / Semi-Govt. / Public Sector

Undertaking / Autonomous body other than coal India Name of Department/PSU/Company Name
limited and subsidiaries?
PUBLIC WORKS DEPARTMENT
Yes

Place currently working at

SILCHAR

Current Designation
ASSISTANT ENGINEER

Contact Details

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Mobile Number

9706900930

Email ID
imdadahmed64@gmail.com

Present Address

Address Line 1
VILL- MAHAMMED PUR PART-1

Address Line 2
P.O- RONGPUR SOUTH

Country
India

State District

Assam Hailakandi

Pin Code
788163

Permanent Address

Address Line 1
VILL- MAHAMMED PUR PART-1

Address Line 2
P.O- RONGPUR SOUTH

Country

India

State District

Assam Hailakandi

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Pin Code

788163

Matriculation (10th) Details

Name of the Board/Council

BOARD OF SECONDARY EDUCATION, ASSAM

Year Of Passing
2010 Subject Combination

ENGLISH,BENGALI,GENERAL SCIENCE, SOCIAL

SCIENCE,MATHEMATICS, ADVANCE
MATHEMATICS
Percentage of Marks

77.66

Intermediate (12th) Details

Name of the Board/Council

ASSAM HIGHER SECONDARY EDUCATION COUNCIL

Year Of Passing
2012 Subject Combination

ENGLISH,BENGALI,PHYSICS,CHEMISTRY,MAT
HEMATICS

Percentage of Marks
87.2

Graduate Degree Details

Please Select status of Qualifying Degree

Passed

Degree Name
B.E

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Discipline Institute Name

Civil Engineering ASSAM ENGINEERING COLLEGE

Year of Passing Percentage of Marks

2016 74.41

Master Degree Details

Degree Name

MASTER OF TECHNOLOGY

Discipline Institute Name

STRUCTURAL ENGINEERING NATIONAL INSTITUTE OF
TECHNOLOGY,SILCHAR

Year of Passing Percentage of Marks

2019 86.4

Payment Details

Amount Payment Status

1000 S

Payment Transaction No.

CPX9126777

Candidate Documents/Images Upload Details

Photo

I Confirm that I have uploaded my Photograph

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Signature

I Confirm that I have uploaded my Signature

Declaration

I hereby, solemnly declare that information provided by me in the form is true to the best of my
knowledge and belief. I understand that my candidature is subject to the conditions laid down in the
detailed advertisement of Recruitment of Management Trainees Advt. No. 01/2019 in CIL website. I
further declare that, I have never been debarred from applying for any Government job.

Version 13.07.01

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