APPLICATION FORM FOR Permanent Commission Naval Armament Inspection Cadre Jun17 BATCH

(UNMARRIED CANDIDATES ONLY)

FOR INDIAN NAVY OFFICE USE ONLY

Code No:

For Office use only:

Application No:
(Affix Photograph)

VALID / INVALID
PNI1720205395
1. CHOICE OF ENTRY :
[1] PC(NAIC)
2. PERSONAL PARTICULARS AS IN MATRICULATION CERTIFICATE:

NAME:

AMAN
KAUSHAL

DATE OF BIRTH: 1993/02/08

FATHER'S NAME: OM LAL KAUSHAL
FATHER'S OCCUPATION: STOREKEEPER TECHNICAL
DOMICILE:

Punjab

3.NATIONALITY:

INDIAN

6. ADDRESS:

GENDER:
4.MARITIAL STATUS: Unmarried

Male
5.EMAIL: amankaushal122@gmail.com

PERMANENT

PRESENT

VILLAGE BASSI BABU KHAN

VILLAGE BASSI BABU KHAN

POST OFFICE HARIANA

POST OFFICE HARIANA

District

HOSHIARPUR

HOSHIARPUR

State

Punjab

Punjab

Pincode

144208

144208

Telephone --NA--

01886-250989

Mobile

9872028594

--NA--

7. EDUCATION PARTICULARS:
Qualification

Stream

Year of Passing

Percentage

2016

66.95%

Appeared With Final Year Completed/Appearing With Appearing in Final Year - Appeared

B.Tech

Production Engineering

Maximum Marks

Marks Obtained

Maximum Marks

Marks Obtained

1st Semester

750

455

2nd Semester

850

574

3rd Semester

800

525

4th Semester

800

591

5th Semester

800

533

8. DETAILS OF SSB INTERVIEW(S) ATTENDED:

Service

Type of Entry

Name of SSB

Month and Year

Batch No

Rec/Not Rec

Army

ssc tech

19 SSB Allahabad

november 2016

DTSL 39365

Not Rec

9. Details of service under central/state Govt. if any (Candidates already in service should apply through proper channel and obtain NOC from the present employer.) :

NA

DECLARATION
1.I, hereby declare that I am unmarried, governed by nationality condition as laid down by the Government of India and have never been debarred from appearing at any examination. I have never been
arrested/prosecuted and convicted by a criminal court or involved in any other case registered by the Police.
2. I, hereby, solemnly declare that all the statements made in the above application are true and correct to the best of my knowledge and belief.
3. I, fully understand that in the event of any information being found false or incorrect, appropriate action can be taken against me.
4. Eligibility criteria will be verified on reporting at the selection centres. If found ineligible, I understand that criminal proceedings can be initiated against me for fraudulent entry and falsification of GOI
documents. I also accept that no TA/DA will be admissible to me in such cases.
5. I have completed my B.Tech as on date.

NOTE:
Please forward the print out of this application duly signed to the address mentioned in the advertisement along with relevant documents by ORDINARY POST
ONLY. You will be intimated via Email or SMS regarding your SSB Call-up, if shortlisted. Kindly check your Email inbox regularly.
Place ______________

Date _____________

November 21, 2016, 8:16 pm

Signature of Applicant