Application of Job: SAILOR [AA],SAILOR [SSR] - 02/2020

Application No: SSR202080016995 Application Date: 29/06/2019

PRIORITY

1. SAILOR [SSR] 02/2020

PERSONAL PARTICULARS

Name: SHIVAM CHOUDHARY

Father's/Mother's Name: SATISH KUMAR
Guardian's Name:
Nationality: INDIAN
Identification Mark 1: ROUGH MARK ON NOSE
Identification Mark 2: ---------
Pancard: ---------
Date of Birth: 03/07/2002

EDUCATION PARTICULARS

Details of 12th Science

Subjects Total Marks Obtained Marks

English 100 78

Physics 100 74

Chemistry 100 81

Maths 100 77

Computer Science 100 82

Total Marks: 500 Marksheet Serial Number: 19013506

Obtained Marks: 392 State Conduct: HIMACHAL PRADESH
Percentage: 78.40 Board Conduct: Himachal Pradesh Board of School Education

Details of 10th

Total Marks: 700 Marksheet Serial Number: 17027010

Obtained Marks: 619 State Conduct: HIMACHAL PRADESH
Percentage: 88.43 Board Conduct: Himachal Pradesh Board of School Education

MILITARY RECORD
Have you ever been enrolled in
NO
Armed Forces before?:
Have you been
discharged from
NO
Armed forces
before?:

COMMUNICATION PARTICULARS

Details of Permanent Address

Address 1: VILL. JALANDHAR LAHAR Address 2: POST. MUHAL

State: HIMACHAL PRADESH District: KANGRA Pincode: 177117
Domicile: HIMACHAL PRADESH Phone No.: 7018815490 Mobile No.: 7018815490
choudharyshivu101@
Email id: satishkhabli@gmail.com Alternate Email id:
gmail.com

Details of Correspondence Address

Same as Permanent Address

Alternate Mobile Number: 7018928199

A. I hereby declare that I am unmarried, governed by nationality condition as laid down by the Government of Indian 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.
B. 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.
C. I fully understand that in the event of my information being found false or incorrect, appropriate action can be taken
against me.
D. Eligibility criteria will be verified on reporting at the selection centres. I found ineligible, I understand that criminal
proceedings can be initiated against me for fraudulent entry and falsification of Government of Indian documents. I also
accept that no TA/ DA will be admissible to me in such cases.