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    FCI Registration Slip ANUP

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    Debajyoti Sahoo
    This document is an application form for the post of Assistant Grade III (Depot) in the East Zone of the Food Corporation of India (FCI). The applicant, Anup Kumar Sahoo, is applying for the position. He provides personal details like name, father's name, date of birth, gender, category, educational qualifications, communication address, and experience. He declares that he meets all eligibility criteria for the role and has paid the application fee. He signs to confirm that all information provided in the application is true.

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    FCI Registration Slip ANUP

    Uploaded by

    Debajyoti Sahoo
    65 views2 pages
    This document is an application form for the post of Assistant Grade III (Depot) in the East Zone of the Food Corporation of India (FCI). The applicant, Anup Kumar Sahoo, is applying for the position. He provides personal details like name, father's name, date of birth, gender, category, educational qualifications, communication address, and experience. He declares that he meets all eligibility criteria for the role and has paid the application fee. He signs to confirm that all information provided in the application is true.

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    This document is an application form for the post of Assistant Grade III (Depot) in the East Zone of the Food Corporation of India (FCI). The applicant, Anup Kumar Sahoo, is applying for the position. He provides personal details like name, father's name, date of birth, gender, category, educational qualifications, communication address, and experience. He declares that he meets all eligibility criteria for the role and has paid the application fee. He signs to confirm that all information provided in the application is true.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    65 views2 pages

    FCI Registration Slip ANUP

    Uploaded by

    Debajyoti Sahoo
    This document is an application form for the post of Assistant Grade III (Depot) in the East Zone of the Food Corporation of India (FCI). The applicant, Anup Kumar Sahoo, is applying for the position. He provides personal details like name, father's name, date of birth, gender, category, educational qualifications, communication address, and experience. He declares that he meets all eligibility criteria for the role and has paid the application fee. He signs to confirm that all information provided in the application is true.

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    ~ Home ~

    भारतीय खा य  नगम
    FOOD CORPORATION OF INDIA
                                            ADVERTISEMENT NO. 3/ 2015 FCI CATEGORY ­ III

    ZONE­WISE RECRUITMENT for
    Junior Engineer (JE) (Civil Engineering / Electrical Engineering / Mechanical Engineering),
    Assistant Grade­II (Hindi), Typist (Hindi) and Assistant Grade­III (General / Accounts / Technical / Depot)

    Registered Application Form
    Application Form for the Post of : Assistant Grade III (Depot) ( I )                        EAST   ZONE   
    Registration Number : 39260798534

    1. Candidate's Name :  ANUP KUMAR SAHOO  22.Photo


    (Name as recorded in the Matriculation / Secondary Examination Certificate)

    2. (a) Father's Name :  LATE AKSHAYA KUMAR SAHOO
        (b) Mother's Name :  TILOTTAMA SAHOO
    3. Gender :  MALE
    4. Date of Birth :   04/08/1993 5. Age :  21 Year(s), 4 Month(s), 28 Day(s)  
    (As recorded in the Matriculation /   as on (01.01.2015)
    Secondary Examination Certificate.)

    6. Category :  OBC 23.Signature

    7.  Whether  Domiciled  in  the  Kashmir  Division  in  the  State  of  Jammu  and  NO
    Kashmir during the period 01­01­1980 to 31­12­1989:  

    8. Whether Ex­Servicemen / Availed the benefits of Ex­Servicemen: NO

    9. Whether Person with Disabilities(PWD)/ Physically Handicapped(PH): NO

    10. Whether Departmental (FCI) Employee: NO

    11. Whether belonging to Minority Community: NO
    12. Nationality :  INDIAN

    13. Zone Applied For :  EAST

    14. Name of the Written Test Center:  Bhubaneshwar

    15. Post Applied For :  Assistant Grade III (Depot) ( I )

    16.Educational Qualification
    (a)  Name  of  Academic/  Graduate degree in any discipline from a recognized University
    Professional Degree/ Diploma
    (which makes you eligible): Do you have : Proficiency in use of Computers   YES

    (b)  Name  of  the  University  /  RAVENSHAW UNIVERSITY 


    Board: (Whether Recognized University/ an Institution approved by AICTE or Board) :  YES 

    (c) Year of Passing   2014    (Year)

    (d)  Duration  of  Course  /  36 (in Months)


    Programme :

    (e) Percentage of Marks :  59.85  %
    (Marks  up  to  2  decimal  points  in  aggregate  of  all  years/  semesters  (In  case  of  CGPA  /  OGPA  /  Letter  Grades,  it  is
    equivalent percentage(%).

     (f) Remarks if any :   

    17. Whether completed :  YES

    18 (a). Email Id :  [email protected]
        (b). Confirm Email id:  [email protected]

    19. Mobile Number :  8763764117

    20. Experience :  NO

    21. Communication Address :

      (a). Address Line 1:   AT/PO­BALARAMPUR

      (6). Address Line 2:   VIA­ATHGARH

      (c). City:   CUTTACK

      (d). District:   CUTTACK
      (e). Pin Code:   754295
      (f). State:     Orissa
    24.  Whether FEE Paid :   YES ­ Bank Reference Number : IK72825869 , Deposit Date : 12 Mar 2015 
    Amount {Excluding bank charges but including service tax of Rs. 39/­. Service Tax Code (Registration Number) –
    AAACF0365NST099} : 350.00 (in Rs.)

    25. Declaration  :

    i.  I have not submitted any other application for this examination. I am aware that if I contravene this rule, my application will be rejected summarily by
    FCI.
    ii.  I have read the provisions in the Advertisement carefully and hereby undertake to abide by them.
    iii.  I  further  declare  that  I  fulfill  all  the  conditions  of  eligibility  regarding  age  limits,  educational  qualifications,  experience  etc.  prescribed  for  the  post
    applied for.
    iv.  I also declare that I do not stand debarred by FCI as on date and have never been convicted by any court of law. I also declare that no charge sheet is
    pending against me in any court of law. Further declare that I have never been dismissed or compulsorily retired from the service of the Corporation or
    from a Department of a State or the Central Government or from any Public Sector Undertaking or my service been terminated during probation.
    v.  For Candidate belonging to OBC ­
    I declare that I belong to the community, which is recognized as backward class by the Govt. of India for the purpose of reservation in services as per
    order  contained  in  Deptt.  of  Personnel  and  Training  Office  Memorandum  No.  36012/  22/  93­Estt.(SCT)  dated  8.9.1993.  I  also  declare  that  I  do  not
    belong  to  the  person  /  sections  (creamy  layer)  mentioned  in  column  3  of  the  schedule  of  the  OM  mentioned  above  and  modified  vide  Govt.  of  India
    DOPT  OMs  mentioned  in  the  Notice.  I  further  declare  that  I  am  in  possession  of  OBC  Certificate  in  the  prescribed  format  given  in  the  Notice  of  the
    Advertisement.
    vi.  I hereby declare that there is no Vigilance / Disciplinary case pending against me. I am in possession of ‘No Objection Certificate’ from my employer
    which shall be required to be sent along with other essential enclosures in case of my shortlisting on the basis of the Written Test / Skill test at the
    designated Address which shall be informed / notified through the designated website (www.fcijobsportal.com)
    vii.  I  hereby  declare  that  self­certified  copies  of  relevant  certificates  /  documents  are  in  my  possession.  In  case,  self­certified  copies  of  the  relevant
    certificates  /  documents  are  not  provided  by  me  along  with  the  Registered  Online  Application  Form  Printout,  if  called  for,  my  candidature  will  be
    cancelled without any notice.

      I  hereby  declare  that  all  the  information  given/  statements  made  by  me  in  the  application  are  true,  complete  and  correct  to  the  best  of  my
    knowledge  and  belief  and  nothing  has  been  concealed  or  suppressed.  In  the  event  of  any  information  being  found  false  or  incorrect  or  is  not  in
    conformity with the eligibility criteria mentioned in the advertisement at any point of time my candidature / appointment may be cancelled / terminated
    without any notice and / or I shall be liable for any other action under the extant rules.

    Date:   12 Mar 2015                                                                                                               Signature:

    Place:                                                                                                                Candidate's Name (in Capital letters):

        (Please Print the form for Further Reference)

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