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Uttar Pradesh
Subordinate Services Selection Commission

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Uttar Pradesh Subordinate Services Detailed Application Form ( िवस्तृत आवेदन पत्र )
Selection Commission,Lucknow Under: PRELIMINARY ELIGIBILITY TEST (PET)
उत्तर प्रदेश अधीनस्थ सेवा चयन आयोग, लखनऊ 2023

Notification Details :

Advertisement Number : 07-EXAM/2024

Applied For : Technical Assistant Group C,

Personal Details

Registration Number. 56200087109 Advertisement / Notification No 07-EXAM/2024

Candidate's Name SATYAM PATEL Father's / Husband's Name NAND KISHOR VERMA

Mother's Name MAYA VERMA Date of Birth 09/02/2002

Domicile of Uttar Pradesh Yes Home State UTTAR PRADESH

Home District FATEHPUR Gender Male

Category OBC Economically Weaker Sections No

(EWS)

Are you Married ? No Mobile Number 82* * * *5071

Email ID * * *[email protected]

Other Details

Are you a Dependent of UP No Are you a U.P. Ex. Army? No

Freedom Fighter?

Are you an ECO/SSCO/CO Of No Are you Handicapped of Uttar No

Army ? Pradesh?

Are you Blind Or Have Vision No Are you Deaf or Have hearing No
problem? problem?

Have you any physical Problem? No

Have you psychological/ No Have you Multiple Disabilities? : No

neurological problem? :

Are you a Skilled Player of Uttar No Level of Player N/A

Pradesh?

Employment Details Never Employment in Uttar

Pradesh

Additional age relaxation other than above reasons(Caste category,Sub category,Service duration etc.)
Are you claiming any additional age No
relaxation ?

Academic Details

Examination Board Name Year of Roll Is Obtained Total Percentage

Passed Passing Number Grade Marks Marks
System

High School UTTAR PRADESH BOARD OF HIGH SCHOOL AND INTERMEDIATE 2017 1835302 No 418 600 69.67
EDUCATION

Intermediate UTTAR PRADESH BOARD OF HIGH SCHOOL AND INTERMEDIATE 2019 1225365 No 731 1000 73.1
EDUCATION

Bank Transaction Details

Bank Name - Payment Mode : State Bank Of India - UPI Fees, Transaction ID - Date: Rs. 25.00 , 8471396763227
-2024/05/06

Details of essential qualifications for the post (Technical Assistant Group C, ) ↓

Sr Qualification Acquired Name of Board/ Year Of Certificate/Roll Marks Detail

No. Institute/University Passing Number
Issue Date

1 Bachelors degree in Agriculture from Yes 2023 191161108201 Is Grade: Yes

a recognized Institution or from a Bundelkhand Obt Marks: N/A
University established by law in university jhanshi 07/08/2033 Tot Marks: N/A
India. Bachelors Degree in Per: 76.90
Agriculture or equivalent to
Bachelors Degree in Agriculture as-
B.Sc. (Hons.) Ag., BSc. Horticulture/
B.Sc. (Hons.) Horticulture, B.Sc.
Forestry/ B.Sc. (Hons.) Forestry,
B.Tech (Agriculture Engineering)
University of Agriculture and
Technology awarded four years
Degree in B.Sc. (Home
Science)/Community Science.

Preferential Qualification Details

S No. Qualification Acquired

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

2 Obtained B certificate of National Cadet Corps No

↓ Address Details ↓ Permanent Address Correspondence/Mailing Address

Name , C/O: SATYAM PATEL C/O NAND KISHOR VERMA SATYAM PATEL C/O NAND KISHOR VERMA

House no./Village : 77 IN FRONT OF PNBANK BINDKI 77 IN FRONT OF PNBANK BINDKI

Street No./PO : PO BINDKI PO BINDKI

Locality/Kasba/City : KASBA BINDKI KASBA BINDKI

State / District Name : UTTAR PRADESH / FATEHPUR UTTAR PRADESH / FATEHPUR

Pin : 212635 212635

Declaration

मैं एतद्द्वारा घोषणा करता/करती हूं िक मैंने िवज्ञापन भलीभांित पढ़ िलया है और मैं इसके सभी िनयम और शतोर्ं को स्वीकार करता/करती हूं ।
I hereby declare that I have read the advertisement and I accept all the terms & conditions of the same.
मैं एतद्द्वारा घोषणा करता/करती हूं िक इस आवेदन में की गई सभी प्रिविष्टयां/िववरण मेरी जानकारी और िवश्वास के अनुसार सत्य, पूणर् और सही हैं।
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.
मैं एतद्द्वारा घोषणा करता/करती हूं िक आवेदन की अंितम ितिथ तक मुख्य परीक्षा के िलए िनधार्िरत सभी शैक्षिणक/अन्य पात्रता मानदं डों को पूरा करता/करती हूं ।
मै अवगत हूं िक मेरे द्वारा प्रस्तुत की गई कोई भी जानकारी गलत/असत्य पाये जाने की दशा में मेरा अभ्यथर्न आयोग द्वारा िनरस्त कर िदया जाएगा ।
I hereby declare that I fulfil all the educational/ other eligibility criteria prescribed for the Main Examination in respect of the
post being applied for, as on the last date of application. I am aware that in case any of the information submitted by me is
found to be incorrect or false, then my candidature shall be liable to be cancelled by the Commission.

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Current status of application

Your application is under processing.
App. form submission date : DATE :05/05/2024 ,TIME :21:32:22 App. form printing Date & Time : [ 06/05/2024 ,2:11:01 PM ]

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