Application Form Application Number Token Number 1. Exam Details 1.1 Examination 1.2 Post 1.

3 District Head Quarter for 1.4 General Subjects (PRE) 1.5 Optional Subjects (PRE) 1.6 General Subjects (MAINS) 1.7 Optional Subjects (MAINS) 1.8 Number Of Attempts 2. Department Preferences 2.1 Department Preference 3. Applicant's Details : 3.1 Applicant's Full Name 3.2 Applicant's Father Full Name : 3.3 Applicant's Mother Maiden Name : 3.4 Date Of Birth (dd/mm/yyyy) : 3.5 Gender : 3.6 Marital Status : : 3.7 Category : 3.8 Home State (Bonafide 3.9 Home District : DURGESH KUMAR PANDEY RAJESHWAR PANDEY PRAMILA PANDEY 22/05/1984 MALE Unmarried General/OBC( Creamy Layer ) BIHAR : : 100050101896463 : 1301000500041920 : PROGRAMMER COMP EXAM 2013 DoITC : PROGRAMMER : JAIPUR : : : : : 0 Application Filled Date Reference Application : 28/05/2013 12:12 PM : 100050101896463

Photo & Signature Of Candidate 4. Other Special Categories 4.1 Category for Disabled 4.2 Specific Category for Female 4.3 Other Category 5. Correspondence Details 5.1 Address : A-17 STREETNO-1 DASHRATHPURI ,DABRI-PALAM ROAD , JANAKPURI,Tehsil : SOUTH WEST,City/Village : NEW DELHI - 110045 Dist : SOUTH WEST, State : DELHI : : :

5.2 Email 5.3 Phone 5.4 Mobile 6. Qualification

: durgeshkpandey@live.com : 01132080621 : 9953580354

Year Division/Grade

6.1 Secondary : 1999 6.2 Sr. Secondary : 2001 6.3 Graduation : 2007 6.4 Post Graduation : 0 7. Additional Qualifications/Specifications 7.1 Other 7.2 Examination passed 7.3 Internship Period 7.4 Experience 8. Identification 8.1 Body Mark : : : From : : Year : 1

FIRST SECOND FIRST

Passed

To : Months : 1

Days : 17

: BLACK MOLE BELOW LOWER LIPS

9. Disclaimer I hereby declare that all information made in this application are true, complete and correct to the best of my knowledge and belief. In the event of my information being found false or incorrect or the ineligibility being detected before or after the Screening Test/Interview, action can be taken against me by the Commission. I have read the provisions of the relevant rules and the Advertisement carefully and I hereby undertake to abide by them. I further declare that I fulfill all the conditions of eligibility regarding age limits, educational qualification and required experience etc. prescribed for admission to the Screening Test/Interview. Also I accept SMS facility provided by the Commission.

Rajasthan Public Service Commission Ghooghara Ghati, Jaipur Road, Ajmer Phone : +91+145+ 5151200, 5151240 & 5151090

Nodal Officer: Mr. Akhilesh Mittal, System Analyst (Joint Director) Help Line : 0145-5151212