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FORMAT OF APPLICATION FORM

(To be filled in block letters)

Please paste your


recent passport size
photograph and sign
on it. Please do not
staple it.

To,
The General Manager
Ordnance Factory Dehu Road,
Pune 412 101.
Subject: Application for the Post- ____________________________________________
Reference: OFDR Advertisement published in the Employment News dated ____________
1.
2.

Full Name in Block Letters


(as per SSC/10th Std. Certificate)
Fathers/Husbands Name
(in Block Letters):

3.

Nationality

4.

Religion

5.

Date of Birth

6.
7.

Category (General/OBC/SC/ST)
Whether Ex-Serviceman ?
If YES, Date of entry in Armed forces
Date of discharge from Armed Forces
Whether you are a person with disability (PWD) ?
If YES, nature of disability
Extent of disability (in %)
Address for correspondence in full with PIN-Code

8.

9.

Day:_______ Month: _______ Year:______


(as per the SSC/10th Std. Certificate)
YES/ NO

YES/NO

Nearest Railway Station


10. Whether you are employed in Central/State Govt.
Service/PSU ?
If YES, name of the organization

YES/NO

Date of Appointment & post held


No.
Date
11. Details of Demand Daft or
Postal Order No. & Date:
12. Academic/Professional Qualifications (Starting from Matriculation or Equivalent Examination)
Exam Passed

13.

NCVT Trade

14.

Whether ExTrade
Apprentice
of Ordnance
Factories

Board/University

Year of Passing

YES / NO
(Strike off whichever is
not applicable)

15

Experience, if any

16
17

E-mail address :
Mobile No. :

Post Held

Left Hand Thumb Impression

Subjects

Div & % of Marks

If Yes, furnish following details in respect of NCVT


(NAC/NTC) examination passed by you (Enclose marksheet)
Month

Pay Scale

Year

Nature of
duty

Maximum marks

Period
From
To

Marks obtained

Name of
Employer

DECLARATION
I_____________________________________________, do hereby declare that all the statements made
in this application are true, complete and correct to the best of my knowledge and belief. In the event of any
information being found false/incorrect/incomplete or ineligibility being found before or after recruitment
test/appointment, my candidature will stand automatically cancelled.

Signature of the applicant


Place: ________________
Date: ________________

DECLARATION FOR OBC CANDIDATES ONLY **


I, _______________________________________son/daughter of Shri_________________________________
resident
of
village/town/city_________________
,
District
________________
,State______________________, hereby declare that I belong to the _____________________ community
which is recognized as a backward class by the Government of India for the purpose of reservation in services
as per orders contained in the Department of Personnel and Training Office Memorandum No. 3601/22/93-Estt
(SCT) dated 08.09.1993. It is also declared that I do not belong to persons/section (Creamy Layer) mentioned in
column 3 in the Schedule to the above referred Office Memorandum dated 08.09.1993
_______________________________
Signature of the applicant

Date:_________________

UNDERTAKING FOR EX-SERVICEMEN ONLY **


I understand that, if selected on the basis of the recruitment/examination to which this application relates,
my appointment will be subject to my producing documentary evidence to the satisfaction of the appointment
authority that I have been duly released/retired/discharged from the Armed Forces and that I am entitled to the
benefits admissible to ex-servicemen in terms of Ex-Servicemen (Re-employment in Central Civil Services and
Posts) Rules, 1979, as amended from time to time.
2.
I also understand that I shall not be eligible to be appointed to a vacancy reserved for Ex-Servicemen in
regard to the recruitment covered by this examination, if I have at any time prior to such appointment, secured
any employment on the civil side (including Public Sector Undertaking, Autonomous bodies/Statutory bodies,
Nationalized banks etc.) by availing concession of reservation of vacancies admissible to Ex-servicemen.

Date:_________________

_______________________________
Signature of the applicant

** Strike off whichever is not applicable


Encl: (1*) 02 Passport size photographs, (2*) Self-Attested copy of caste certificate, (3*) Self-Attested copies of
qualification (4*) Self-Attested Proof for Date of Birth (SSC/10th Std. Certificate), (5*) Non-Creamy Layer
Certificate (only for OBC candidates), (6*) Self-Attested copy of Discharge certificate, (7*) Self-Attested copy
of PWD certificate, (8*) NCVT(NAC/NTC) examination mark-sheet, (9*) IPO/DD No________________
(*Strike off whichever is not applicable)