Print Application Form

http://onlinehssc.in/printapplicationform.aspx

HARYANA

STAFF

SELECTION

COMMISSION

Bays No. 67-70, Sector-2, Panchkula-134151 For Office Use Only Control No. : Roll No. : Online Application Form Treasury : Panchkula Advertisement No. : 2/2013 Candidate Particulars : Registration Candidate Name Father's/Husband's Name Mother's Name Date of Birth Age on (As Per advt.) Mailing Address : Address Contact Details : Contact Number Email ID Personal Details : Have you passed Hindi/Sanskrit upto Matriculation Nationality Gender Are you domicile of Haryana ? Area Are you employed in Govt/Public sector undertaking? Identification Mark Qualification Details : Examination Matriculation Stream 10th Board/University PUNJAB SCHOOL EDUCATION BOARD Subjects ENGLISH, MATH, SST, SIC, HINDI, PUNJABI ENGLISH, PUNJABI, TH. AND PRAC OF MANAGEMENT, ACCOUNTANCY, ECONOMICS, BUSINESS STATISTICS Passing Year 1995 Marks Obtain 441 Total Marks 650 % 67.85 Div 1 : : : : : : : : : : Yes Indian Female No Urban No mark on right Arm Physical Handicap PH Sub-Categories Marital Status Category : : : : : : Married General No : 3014, SECTOR 45D CHANDIGARH CHANDIGARH Chandigarh (UT)-160047 9780341776 komalsethi786@gmail.com Paste here your latest stamp size, attested photograph : : : : : : 1501757420 SWEETY RANI SANDEEP SUSHMA RANI 29/11/1979 34 Years 1 Months 21 Days Journal No.: .............. Category No. : 12 Date : .............. Amount : .............. Scrutiny By :

Post Name : Sub Inspector Food & Supplies

Intermediate

COMMERCE

PUNJAB SCHOOL EDUCATION BOARD

1997

270

450

60.00

Graduation

COMMERCE

ENG, PUNJABI, COST ACCOUNTING, MANAGEMENT PUNJABI UNIVERSITY ACCOUNTING AND PATIALA BUSINESS FINANCE, INCOME TAX LAW AND PRACTICES, INDIAN ECONOMIC PROBLEMS,

2000

826

1600

51.63

Reason For Gap (If Any) Experience Details : Nil Total Experience : Non

Documents To Be Attached : Matriculation Certificate With Marksheet Copy, Intermediate Certificate with Marksheet copy, Graduation Degree with all MarksheetsCopy, Copy of Challan Declaration : I hereby declare that:1. All statements made in this application form are true, complete and correct to the best of my knowledge and belief. In the event of any information being found false or incorrect, or ineligibility being declared before or after the interview/appointment /selection, my candidature may be cancelled and action can be taken against me by the commission. 2. I have read the provisions in advertisement of the Commission carefully and I hereby undertake to abide by them. I fulfill all the conditions of the eligibility regarding age limits,educational qualifications etc. prescribe in the advertisement and other relevant rules and instructions.

1 of 2

1/18/2014 7:33 PM

Print Application Form

http://onlinehssc.in/printapplicationform.aspx

3.

I have never been convicted by Criminal Court.

Candidate Signature SWEETY RANI Name in capital letters Place : Date : 18/01/2014

[ Signature of the Candidate ] Note : Incomplete and unsigned application form shall be rejected.

2 of 2

1/18/2014 7:33 PM