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Applicant Details

Application Sequence No.


100167479

Notification Details ( Examination )

Advertisement/Notification Number
PRPB-ONE-1(135)/2018

Department and Post Name


UTTAR PRADESH FIRE BRIGADE Service Fireman Direct Recruitment 2018

Gender
Male

Order of Post - Preference 1


Fireman

Have you applied for the above mentioned post in 2016


No

Candidate Personal Details

Applicant First Name


RITU

Applicant Middle Name


PARN

Applicant last Name


SINGH

DOB (dd/MMM/yyyy)
07/Jan/1995

Age as on 01/Jul/2018
23 Years 5 Months 25 Days

Father/ Guardian's Full name


ASHOK KUMAR SINGH

Mother's Name
GITA SINGH

Marital Status
Single

Mobile Number
8868980329

Email ID
jaydeepp005@gmail.com

Confirm Email ID
jaydeepp005@gmail.com

Applicant Full Name


RITU PARN SINGH

Application Status
Submitted

Candidate Domicile and Category Details

DOMICILE STATE
U.P

APPLIED CATEGORY
OBC

Candidate Domicile and Category (OBC/SC/ST) Certificate Details

Category Certificate Issuing Authority


SDM

Category Certificate issue Date


23/Jul/2011

Category Certificate Serial No


280321106190

Domicile Certificate Issuing Authority


TAHSEELDAR

Date of Issue of Domicile


04/Dec/2018

Domicile Certificate Serial No


283183025958

Other Details of Candidate

DFF ( Dependent on Freedom Fighter)


NO

Served UP Home Guard for 3 Yrs ?


No

Are you Ex Serviceman?


No

Are you UP. Govt. Employee ?


No

Address Details

Present Address Line 1


VILL CHAKSHAHABUDDINPUR

Present Address Line 2


POST MATIHA

City / District
RAEBARELI

Present Address Police Station


THANA KOTWALI

State/U.T
Uttar Pradesh

Present Address Pin-code


229001

Present Address District/City


RAIBARELI

Permanent Address same as Present Address


Yes

Educational Qualification

High School/10th Details

High School/ 10th Qualification Name of Passing Board/ School


High School/ 10th U P BOARD ALLAHABAD

Date of Passing Roll Number


30/May/2009 1249515

Is Grade System Total Marks Obtained


No 388

Maximum Marks Percentage of Marks/Equivalent percentage value as per CGPA


600 64.67

Intermediate/ 12th Details

Intermediate/ 12th Qualification Name of Passing Board/ School


Intermediate/ 12th U P BOARD ALLAHABAD

Date of Passing Roll Number


06/06/2011 0740352

Is Grade System Total Marks Obtained


No 388

Maximum Marks Percentage of Marks/Equivalent percentage value as per CGPA


500 77.6

Preferential Qualification Details

Preferential Qualification Select applied Option Certificate Number Date of Issue

Obtained a B certificate of National Cadet Corps No

Obtained O LEVEL Certificate in Computer from DOEACC or NIELIT Society No

Served in the Territorial Army for a minimum period of two years No

Candidate Photo

Candidate Signature

Declaration
घोषणा / Declaration

1. म एतत ारा घोषणा करता ँ क मने परी ा हेतु नगत व तृत सूचना/ व त जो क वेबसाइट http://prpb.gov.in पर उपल ध है, म उ ल खत सभी ावधान को यान से पढ़ लया है
तथा उन ावधान का पालन करने का वचन दे ता/दे ती ँ |

I hereby declare that I have read all the provisions in the detailed notice/notification available on website http://prpb.gov.in of the examination
carefully and hereby undertake to abide by them.

2. म घोषणा करता ँ क म रा ीयता, आयु सीमा, शै क यो यता इ या द क यथा न द पा ता क सभी शत को पूण करता / करती ँ |

I declare that I fulfil all the conditions of eligibility regarding nationality, age limits, educational qualifications etc. as prescribed.

3. म घोषणा करता / करती ँ क अनुसू चत जा त / अनुसू चत जनजा त के उमीदवार के प म आर ण के लए मेरा दावा स य एवं सही है तथा म सूचना / व त म दए गए ा प म जा त
माण प धा रत करता / करती ँ |

I declare that my claim for reservation as SC /S T candidate is true and correct and I am in possession of caste certificate in the prescribed format
given in the Notice / notification.

या

म घोषणा करता / करती ँ क OBC उ मीदवार के प म आर ण के लए मेरा दावा वा त वक एवं सही है तथा म सूचना / व त म दए गए ा प माण प जो दनांक 01/04/2018 के
बाद का नगत है, धा रत करता / करती ँ | म यह भी घोषणा करता / करती ँ क म उ०प० सरकार ारा आदे श 13/22/16/92/तक-iii-का-2014 दनांक 17.12.2014 म व णत OBC
ेणी के मी लेयर (creamy layer) से स बं धत वग से नह ँ |

I declare that my claim for reservation as OBC candidate is true and correct and I am in possessio n of caste certificate which is issued after
01/04/2018 in the prescribed format given in the notice/notification. I also declare that as per Govt. order No.13/22/16/92/TC-iii-का-2/2014 dated
17.12.2014, I do not belong to the Category (creamy layer) mentioned therein.

4. म घोषणा करता ँ क (शाद शुदा पु ष अ यथ हेतु) मेरी एक से अ धक जी वत प नी नह है या (शाद शुदा म हला अ यथ हेतु) म यह घोषणा करती ँ क मने कसी ऐसे पु ष से शाद नह
क है जसक पहले से ही एक जी वत प नी है |

I declare that I have no more than one wife living (For Married Male) OR I declare that I have not married a man already having a living wife (For
Married Female).

5. म यह भी घोषणा करता / करती ँ क मुझे व ध ारा था पत कसी भी यायालय के ारा कभी भी दोषी नह ठहराया गया है |

I also declare that I have never been convicted by any court of law.

6. म यह भी घोषणा करता / करती ँ क मुझे सरकारी सेवा से कभी भी बखा त अथवा हटाया नह गया है न ही प रवी ा अव ध के दौरान मेरी सेवा को समा त कया गया है |

I further declare that I have never been dismissed or removed from Govt. Service or my service been terminated during probation.

7. म एतत ारा घोषणा करता / करती ँ क इस आवेदन प म क गय सम त व यां / कथन मेरे ान और व वास के अनुसार वा त वक, पूण और सही ह तथा म नधा रत नयम /
अ धसूचना के अनुसार पा ता के सभी मानदं ड को पूरा करता / करती ँ कसी भी सूचना के झूठा या गलत पाये जाने अथवा अपा ता क थ त म, मेरे चयन से पूव या चयन के उपरा त कभी
भी नयमो के अनुसार बोड मेरे व कायवाई कर सकता है, य द यह पता चलता है क मने कसी भी मु े पर बोड या नयु ा धकारी को गुमराह कया है, तो इसके लए म पूरी तरह से वयं
ज मेदार होऊँगा जसमे अ य दं डा मक कायवाही के साथ व धक कायवाही भी स म लत होगी तथा उसके प रणाम व प सभी दं ड का भागी होऊँगा

I hereby declare that all the entries/statements made in this application are true, complete and correct to the best of my knowledge and belief and I
fulfill the eligibility criteria as per the relevant rules/notification. In the event of any information being found false or incorrect or ineligibility being
detected before or after selection the Board or appointing authority can take action against me as per rules in case it is detected that I have mislead
the Board on any issue and I will be solely responsible for all penal consequences thereof, including but not limited to penal action under the law.

Payment Details
Amount
400

Payment Mode
online

Payment Status
Payment Success

Payment Transaction No.


CPN4980606

Order Id
10016747920190216153604519

Version 13.06.01