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Application Form

Application Number
Token / Transaction Number

: 100120102197406
: 1335004010079987

Application Filled Date


Reference Application

: 30/07/2013 11:01 AM
: 100120102197406

1. Exam Details
1.1 Examination
1.2 Post
1.3 District Head Quarter for
1.4 General Subjects (PRE)

:
:
:
:

1.5 Optional Subjects (PRE)

1.6 General Subjects (MAINS)


1.7 Optional Subjects (MAINS)

: General Studies I | General Studies II | General Studies III | General Hindi and General English
:

1.8 Number Of Attempts

: 1

RAS COMB COMP PRE EXAM 2013


RAJ STATE AND SUBORDINATE SERVICES
JAIPUR
General Knowledge and General Science

2. Department Preferences
2.1 Department Preference

1 - Raj.Administration Service (State Service) , 2 - Raj. Police Service (State Service) , 3 - Raj. Account Service (State Service) , 4 - Raj. Commercial Taxes Service (State
Service) , 5 - Raj. Transport Service (State Service) , 6 - Raj. Tehsildar Service

3. Applicant's Details
:
3.1 Applicant's Full Name
3.2 Applicant's Father Full Name
:
3.3 Applicant's Mother Maiden Name :
3.4 Date Of Birth (dd/mm/yyyy)
:
3.5 Gender
:
3.6 Marital Status
:
:
3.7 Category
:
3.8 Home State (Bonafide
3.9 Home District
:

JATIN SUKHADIYA
BHANWAR LAL SUKHADIYA
SITA SUKHADIYA
13/06/1990
MALE
Unmarried
SC
RAJASTHAN
JALORE
Photo & Signature
Of Candidate

4. Other Special Categories


4.1 Category for Disabled
4.2 Specific Category for Female
4.3 Other Category

:
:
: NCC Cadet

5. Correspondence Details
5.1 Address

5.2 Email
5.3 Phone
5.4 Mobile
6. Qualification

: JAGJEEVAN RAM COLONY


NEAR HOLI THAN,
BHINMAL,
Tehsil : BHINMAL,City/Village : BHINMAL - 343029
Dist : JALORE, State : RAJASTHAN
: jatinsukhadiya19@gmail.com
:
: 8896164622
Year

6.1 Secondary
: 2005
6.2 Sr. Secondary
: 2007
6.3 Graduation
: 2009
6.4 Post Graduation
:
7. Additional Qualifications/Specifications
7.1 Other
7.2 Examination passed
7.3 Internship Period
7.4 Experience
8. Identification
8.1 Body Mark
9. Disclaimer

Division/Grade

First
First
Appearing

:
:
: From :
: Year :

To :
Months :

Days :

: burning mark on right hand palm

I hereby declare that all information made in this application are true, complete and correct to the best of my knowledge and belief. In the event of my information being found false or incorrect or the ineligibility
being detected before or after the Screening Test/Interview, action can be taken against me by the Commission. I have read the provisions of the relevant rules and the Advertisement carefully and I hereby
undertake to abide by them. I further declare that I fulfill all the conditions of eligibility regarding age limits, educational qualification and required experience etc. prescribed for admission to the Screening
Test/Interview. Also I accept SMS facility provided by the Commission.

Rajasthan Public Service Commission


Ghooghara Ghati, Jaipur Road, Ajmer
Phone : +91+145+ 5151200, 5151240 & 5151090

Nodal Officer: Mr. Akhilesh Mittal, System Analyst (Joint Director)


Help Line : 0145-5151212

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