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ASSAM PUBLIC SERVICE COMMISSION ***** ADVT. NO. 03/2020 No. 18PSC/DR-5/1/2020-2021 Dated Guwahati, the 24 th June/2020 Assam Public Service Commission invites application from Indian Citizens as defined in Articles 5 to 8 of the Constitution of India for the under-mentioned posts under Assam Government in the scale of pay as indicated below and carrying usual allowances as admissible under Rules of the Govt. of Assam. N.B.:- Candidates must submit a Declaration in the form-A appended along with the application form while applying for the post in response to the advertisement made by the commission. (A) 1. NAME OF THE POST :- Assistant Engineer (Civil) Under Panchayat And Rural Development Department. 2. NO. OF POST :- 222 (Two hundred and twenty two) Name of the Service/Post Open category Reserved for OBC/MOBC Reserved for SC Reserved For STP Reserved For STH Reserved for EWS Grand Total Post reserved for PWD &Type of Disability Total RFW Total RFW Total RFW Total RFW Total RFW Total RFW Total RFW Assistant Engineer (Civil) Under P&RD Department 91 27 61 18 15 5 21 6 12 4 22 7 222 67 9 (Nine) [Blindness & LV = 3; Deaf & HI=2; Locomotor Disability etc.=2; Autism etc.=2] *Reservation as per draft advertisement received from Government against total numbers of posts in the cadre. 3. SCALE OF PAY :- Rs. 30,000/- to 1,10,000/-; PB – 4 with Grade Pay of Rs.12,700/- plus other allowances as admissible under Rules of the Govt. of Assam. 4. Eligibility Criteria :- (i) The candidate must be a permanent resident of Assam. (ii) The candidate must produce PRC issued in Assam for educational purpose as a proof of residency along with the application form. 5. Educational Qualification : (i) B.E or equivalent degree in Civil Engineering obtained from any institute approved by the AICTE and recognized by Government. (ii) The Bachelors Degree in Civil Engineering must be a Regular Course. Bachelors Degree in Civil Engineering obtained through Distance Mode of Education, by whatever name called, will not be accepted. (iii) Apart from English, the candidate should have adequate knowledge of at least 1(one) official language of the State of Assam (i,e. Assamese/Bengali/Bodo) except candidates belonging to Karbi Anglong Autonomous Council and Dima Hasao Autonomous Council. (Attach self attested valid supporting documents. )

ASSAM PUBLIC SERVICE COMMISSION · (ii) The Diploma/Degree in Civil Engineering must be a Regular Course. Diploma/Degree in Civil Engineering obtained through Distance Mode of Education,

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Page 1: ASSAM PUBLIC SERVICE COMMISSION · (ii) The Diploma/Degree in Civil Engineering must be a Regular Course. Diploma/Degree in Civil Engineering obtained through Distance Mode of Education,

ASSAM PUBLIC SERVICE COMMISSION

***** ADVT. NO. 03/2020

No. 18PSC/DR-5/1/2020-2021 Dated Guwahati, the 24th June/2020 Assam Public Service Commission invites application from Indian Citizens as defined in Articles 5 to 8 of the Constitution of India for the under-mentioned posts under Assam Government in the scale of pay as indicated below and carrying usual allowances as admissible under Rules of the Govt. of Assam. N.B.:- Candidates must submit a Declaration in the form-A appended along with the application form while applying for the post in response to the advertisement made by the commission. (A) 1. NAME OF THE POST :- Assistant Engineer (Civil) Under Panchayat And Rural Development Department.

2. NO. OF POST :- 222 (Two hundred and twenty two)

Name of the Service/Post

Open

category

Reserved for

OBC/MOBC

Reserved for SC

Reserved For

STP

Reserved For STH

Reserved for EWS

Grand Total

Post reserved for PWD &Type of Disability

Total RFW Total RFW Total RFW Total RFW Total RFW Total RFW Total RFW

Assistant Engineer

(Civil) Under P&RD

Department

91

27 61 18 15 5 21 6 12 4 22 7 222 67

9 (Nine) [Blindness & LV = 3;

Deaf & HI=2;

Locomotor Disability

etc.=2; Autism etc.=2]

*Reservation as per draft advertisement received from Government against total numbers of posts in the cadre.

3. SCALE OF PAY :- Rs. 30,000/- to 1,10,000/-; PB – 4 with Grade Pay of Rs.12,700/-

plus other allowances as admissible under Rules of the Govt. of Assam.

4. Eligibility Criteria :-

(i) The candidate must be a permanent resident of Assam. (ii) The candidate must produce PRC issued in Assam for educational purpose as a proof of residency along with the application form.

5. Educational Qualification: (i) B.E or equivalent degree in Civil Engineering obtained from any

institute approved by the AICTE and recognized by Government. (ii) The Bachelors Degree in Civil Engineering must be a Regular Course.

Bachelors Degree in Civil Engineering obtained through Distance Mode of Education, by whatever name called, will not be accepted.

(iii) Apart from English, the candidate should have adequate knowledge of at least 1(one) official language of the State of Assam (i,e. Assamese/Bengali/Bodo) except candidates belonging to Karbi Anglong Autonomous Council and Dima Hasao Autonomous Council.

(Attach self attested valid supporting documents. )

Sunil Choudhary
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6. AGE :- The candidates should not be less than 21 years of age and not more than 38 years of age as on 01-01-2020. The upper age limit is relaxable-

(i) By 5 years for SC/ST candidates, i.e. upto 43 years. (ii) By 3 years for OBC/MOBC candidates i.e. upto 41 years as per Govt.

Notification No. ABP. 6/2016/9 dated Dispur the 25th April 2018. (iii) For Persons with Disabilities (PWD) by 10 years irrespective of

SC/ST/OBC and General Category of candidates as per Govt. Notification No. ABP 144/95/121 dated Dispur the 28th October, 2015.

The age limit of the candidates will be calculated on the basis of the Matriculation /HSLC Admit Card/ Certificate issued by a recognized Board/Council and no other document shall be accepted in lieu of the mentioned documents.

7. For PWD Category Candidates:- To be eligible for consideration under PWD category, a candidate must possess Benchmark Disability and must produce supporting necessary PWD certificate issued by competent authority along with the application form.

(B) 1. NAME OF THE POST :- Junior Engineer (Civil) Under Panchayat And Rural Development Department.

2. NO. OF POST :- 344 (Three hundred and forty four)

Name of the service/post

Open

category

Reserved for

OBC/MOBC

Reserved for SC

Reserved For

STP

Reserved For STH

Reserved for EWS

Grand total

Post reserved for PWD &Type of Disability

Total RFW Total RFW Total RFW Total RFW Total RFW Total RFW Total RFW

Junior Engineer

(Civil) Under P&RD

Department

144

43 89 27 13 4 40 12 23 7 35 10 344 103

14 (Fourteen) [Blindness & LV = 4;

Deaf & HI=4;

Locomotor Disability

etc.=3; Autism etc.=3]

*Reservation as per draft advertisement received from Government against total numbers of posts in the cadre.

3. SCALE OF PAY :- Rs. 14,000/- to 60,500/-; PB – 2 with Grade Pay of Rs.8,700/-

plus other allowances as admissible under Rules of the Govt. of Assam.

4. Eligibility Criteria :-

(i) The candidate must be a permanent resident of Assam. (ii) The candidate must produce PRC issued in Assam for educational purpose as a proof of residency along with the application form.

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5. Educational Qualification: (i) A Candidate must have passed Engineering (Diploma/Degree in Civil

Engineering) obtained from any institution approved by the AICTE and recognized by Government.

(ii) The Diploma/Degree in Civil Engineering must be a Regular Course. Diploma/Degree in Civil Engineering obtained through Distance Mode of Education, by whatever name called, will not be accepted.

(iii) Apart from English, the candidate should have adequate knowledge of at least 1(one) official language of the State of Assam (i,e. Assamese/Bengali/Bodo) except candidates belonging to Karbi Anglong Autonomous Council and Dima Hasao Autonomous Council.

(Attach self attested valid supporting documents.)

6. AGE :- The candidates should not be less than 21 years of age and not more than 38 years of age as on 01-01-2020. The upper age limit is relaxable-

(i) By 5 years for SC/ST candidates, i.e. upto 43 years. (ii) By 3 years for OBC/MOBC candidates i.e. upto 41 years as per Govt.

Notification No. ABP. 6/2016/9 dated Dispur the 25th April 2018. (iii) For Persons with Disabilities (PWD) by 10 years irrespective of

SC/ST/OBC and General Category of candidates as per Govt. Notification No. ABP 144/95/121 dated Dispur the 28th October, 2015.

The age limit of the candidates will be calculated on the basis of the Matriculation /HSLC Admit Card/ Certificate issued by a recognized Board/Council and no other document shall be accepted in lieu of the mentioned documents.

For PWD Category Candidates:-

To be eligible for consideration under PWD category, a candidate must possess Benchmark Disability and must produce supporting necessary PWD certificate issued by competent authority along with the application form.

(C) 1. NAME OF THE POST :- Assistant Architect under Public Works (Building &

NH) Department. 2. NO. OF POST :- 11 (Eleven)

Name of the service/post

Open

category

Reserved for

OBC/MOBC

Reserved for SC

Reserved For

STP

Reserved For STH

Reserved for EWS

Grand total

Post reserved for PWD &Type of Disability

Total RFW Total RFW Total RFW Total RFW Total RFW Total RFW Total RFW

Assistant Architect

under Public Works

(Building & NH)

Department

4

1 3 1 1 0 1 0 1 0 1 0 11 2 NIL

*Reservation as per draft advertisement received from Government against total numbers of posts in the cadre.

3. SCALE OF PAY :- Rs. 30,000/- to 1,10,000/-; PB – 4 with Grade Pay of Rs.12,700/- plus other allowances as admissible under Rules of the Govt. of Assam.

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4. Eligibility Criteria :- (i) The candidate must be a permanent resident of Assam. (ii) The candidate must produce PRC issued in Assam for educational purpose as a proof of residency along with the application form.

5. Educational Qualification: (i) Bachelors Degree in Architecture from an Indian or Foreign University

recognized by the Government. (ii) Should be registered with the Council of Architecture, India. (iii) Apart from English, the candidate should have adequate knowledge of at

least 1(one) official language of the State of Assam (i,e. Assamese/Bengali/Bodo) except candidates belonging to Karbi Anglong Autonomous Council and Dima Hasao Autonomous Council.

(Attach self attested valid supporting documents. )

6. AGE :- The candidates should not be less than 21 years of age and not more than 38 years of age as on 01-01-2020. The upper age limit is relaxable-

(i) By 5 years for SC/ST candidates, i.e. upto 43, years. (ii) By 3 years for OBC/MOBC candidates i.e. upto 41 years as per Govt.

Notification No. ABP. 6/2016/9 dated Dispur the 25th April 2018. (iii) For Persons with Disabilities (PWD) by 10 years irrespective of

SC/ST/OBC and General Category of candidates as per Govt. Notification No. ABP 144/95/121 dated Dispur the 28th October, 2015.

The age limit of the candidates will be calculated on the basis of the Matriculation /HSLC Admit Card/ Certificate issued by a recognized Board/Council and no other document shall be accepted in lieu of the mentioned documents.

7. For PWD Category Candidates:- (i) OH with at least one arm and one leg. (ii) Hearing handicapped may be considered if he or she can perform with

the use of aids and appliances. (iii) Low vision may be considered if he or she can perform with the use of

aids and appliances. (iv) To be eligible for consideration under PWD category, a candidate must

possess Benchmark Disability and must produce supporting necessary PWD certificate issued by competent authority along with the application form.

N.B: Since there is no post reserved for PWD candidates they will have to compete with other candidates without any PWD reservation.

HOW TO APPLY

a. The candidates should carefully go through the terms and conditions of the advertisement, particularly (i) Educational qualification (ii) Age limit and (iii) Experience where experience is necessary.

b. Only those candidates who fulfill all the terms and conditions of the advertisement in respect of the post for which they are applicants shall be entertained. Others need not apply.

c. The candidates shall have to produce identity proof like Pan Card, Driving Licence,Passport, Current ID card issued by the educational institutions, Voter ID Card, Aadhar Card (wherever applicable) at the time of Screening/Written test and Viva- Voice/ Interview.

Sunil Choudhary
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d. The candidates should visit the commission’s website www.apsc.nic.in regularly. If the commission decides to hold written examination/screening test, the syllabus will be uploaded only in the APSC website.

e. The name of the post applied for should be clearly written in “bold letters” in the Envelope containing the application form and it should be addressed to the Deputy Secretary, APSC, Jawaharnagar, Khanapara, Guwahati-781022.

f. Application form may be obtained by downloading from the APSC’s website www.apsc.nic.in . Application form DR (New form).

g. The last date of receiving duly filled up application form in the Commission’s office is fixed on 24-07-2020 during office hours.

h. Applications (including applications received through post) received after the last date fixed for receipt shall not be entertained.

i. Only applications which are signed by the candidates and accompanied by all particulars as called for in the application form prescribed by the Commission shall be considered and candidates fulfilling all the terms of the advertisement of the respective posts shall be called for a Screening/Written test / Viva-voce interview, where necessary and as decided by the Commission.

j. (i) All candidates, whether in Government Service or in Government owned undertaking or other similar organizations/Corporations/boards/ or in private employment may intimate their controlling authority instead of routing it through them. However, the fact of the endorsement by the controlling officer may be duly intimated to the Commission by the candidate. In cases where the applications are to be moved through proper channel as per terms of advertisement or subsequent announcements, the applications must be received before the last date of submission of the applications.

(ii) The Commission shall in no way be responsible if any candidate is not allowed to sit in the examination or after appointment is not released by the concerned authority.

k. The candidates must clearly state the documents enclosed with the application in the relevant section of the application form.

APPLICATION FEES :

As per Govt. Notification No. FEG.32/2016/8-A dated Dispur the 28th October, 2016 communicated vide letter No. ABP.60/2014/11 dated 2nd February 2018 the Application Fees for all post under the State Govt. of Assam shown as below:

1. For General/EWS Candidate : Rs.250/- (Rupees two hundred and fifty) only. 2. For SC/ST/OBC/MOBC : Rs.150/- (Rupees one hundred and fifty) only. 3. For BPL Candidate : Nil (Candidate having BPL certificate should produce

their photocopy of certificate along with the Application Form). 4. As per Govt. Notification No. ABP 144/95/121 dated Dispur the 28th October, 2015 for

persons with disabilities (PWD) candidates, the Application Fees for all posts under the State Govt. of Assam is Nil. PWD candidates should enclose with the application from photocopy of necessary certificate from a competent authority. Fees should be deposited through Treasury Challan in the Head of Account “NON TAX REVENUE, OTHER NON TAX REVENUE 0051 PSC, 105 STATE PSC APPLICATION FEE RECEIPT OF APSC” showing name of post and department. Original copy of Treasury Challan should be submitted along with the application form. OR Fees can be deposited online using Government Receipt Accounting System-GRAS (Website: https://assamegras.gov.in). Candidates may pay the requisites fees (as admissible for the category mentioned above). Printed copy of Treasury Challan generated through GRAS should be submitted along with the application form. In Remarks column, candidate may write post applied for.

Page 6: ASSAM PUBLIC SERVICE COMMISSION · (ii) The Diploma/Degree in Civil Engineering must be a Regular Course. Diploma/Degree in Civil Engineering obtained through Distance Mode of Education,

6 HOW TO FILL UP THE FORM

a. Applicants must affix 1 (One) copy of recent photograph firmly on the space provided in the application form with good quality glue/adhesive and should also enclose another copy along with the application form. The photograph must be signed prominently. The Commission shall not be responsible for detachment/ loss of the photograph.

b. Since the practice of furnishing attested copies of certificates/mark sheets etc. by competent authority has been discontinued by the Govt., the applicant shall furnish copies of certificate/mark sheet etc. declared by himself/herself as “certified to be true copy of the original” along with the application form.

c. Applications must be accompanied by self attested copies of the under-mentioned documents, which should be tagged well without any chance of getting lost in transit.

Applications which are not accompanied by anyone of the under-mentioned documents/ requirements will not be entertained.

1. Original treasury Challan depositing prescribed application fee wherever necessary as per terms of advertisement containing details of posts applied for.

2. Age proof certificate (HSLC/Class X Board Admit Card/Pass Certificate).

3. Certificates & mark sheets of all examinations from HSLC onwards up to the level of qualifying examination.

4. Caste certificate (wherever necessary) of reserved categories issued by appropriate authority.

5. Disability certificate(wherever necessary)

6. Two copies of recent passport size photograph with white background.

7. Signature( scanned copy to be uploaded in online mode when available)

8. Experience certificates (wherever necessary) indicating the period of Service/Experience with dates.

9. BPL certificate/EWS certificate (wherever necessary).

Self attested photocopies should be tagged properly without any chance of getting lost during transit. The Commission will not be responsible for any such loss due to improper tagging.

Incomplete application in terms of the Advertisement will be summarily rejected. No documents will be entertained after the last date of submission of application.

POINTS TO NOTE :

1. The candidates before applying for the post(s)/service(s) should ensure that they fulfill all the eligibility conditions. Their admission at all the stages of selection in which they are admitted by the Commission will be purely provisional and under scrutiny, subject to their satisfying the prescribed eligibility conditions. If on verification at any time or any stage before or after the Preliminary Examination/Screening Examination or/and Main/Written Examination and Interview Test, it is found that they do not fulfill any of the eligibility conditions; their candidature for the post(s)/service(s) will be cancelled by the Commission.

2. It is for the candidates themselves to see whether they satisfy the prescribed physical requirement (physical standard) and whether he/she is eligible to apply where Examination of physical standard is conducted by the State Govt. before making any appointment.

3. No request for withdrawal of candidature received from a candidate after he/she has submitted his/her application will be entertained under any circumstances.

4. At any stage of the selection process no candidate shall be allowed to change his/her category (of caste etc)/sub-category/sub-categories as claimed by him/her in the original application form/online application form submitted to the Commission.

Page 7: ASSAM PUBLIC SERVICE COMMISSION · (ii) The Diploma/Degree in Civil Engineering must be a Regular Course. Diploma/Degree in Civil Engineering obtained through Distance Mode of Education,

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5. The candidates who furnish wrong, erroneous or incorrect information in their application form may be disqualified from appearing for any post before the Commission up to a period to be specified by the Commission.

6. In case of detection of any false declaration / statement made by any applicant, his/her application will be rejected and will also be penalized as per prevailing Rules/Law. If in any case, submission of false material facts with a view to hoodwinking the Commission is detected even after the recommendation is made, the Commission may refer the matter to Government for taking necessary action.

DIRECT RECRUITMENT: The selection procedure will be notified later on followed by issuing

corrigendum/addendum, if required.

The commission will decide the provision for selection in respect of any post/posts or service/ services considering the status, cadre and grade or the number of applications received for the advertised post/posts or service/ services. The Commission will also decide to conduct examination/test etc. zone wise, depending upon the numbers of candidates against the districts shown below: Sl NO Name of Zones Districts covered under the Zones

1 Silchar Hailakandi, Karimganj, Cachar 2 Jorhat Golaghat, Dibrugarh, Jorhat, Majuli, Charaideo, Sivasagar &

Tinsukia 3 Nagaon Dima Hasao, Hojai, Nagaon, Morigaon, Karbi Anglong & West

Karbi Anglong 4 Tezpur Biswanath, Dhemaji, Lakhimpur, Sonitpur, Udalguri 5 Kokrajhar Bongaigaon, Chirang, Dhubri, Goalpara, Kokrajhar, South Salmara 6 Guwahati Barpeta, Baksa, Kamrup, Kamrup (Metro), Nalbari and Darrang

NB: The Commission has the discretion to reduce or increase the number of zones depending upon the number of candidates.

The list of candidates whose applications are found valid or rejected after scrutiny will be made available in the Assam Public Service Commission’s website (www.apsc.nic.in) showing grounds of rejection in due course.

! The Advertisement has been issued as per the sevice rule. Sd/-

Under Secretary Assam Public Service Commission

Jawaharnagar, Khanapara, Guwahati-22

Sunil Choudhary
Page 8: ASSAM PUBLIC SERVICE COMMISSION · (ii) The Diploma/Degree in Civil Engineering must be a Regular Course. Diploma/Degree in Civil Engineering obtained through Distance Mode of Education,

H OW TO AP P L Y ( I N S TR U CT IO N S TO C A N D I D A TE S ) (Detach this page while submitting the application form)

1. The Candidates should carefully go through the terms and conditions of the advertisement, particularly (i) Educational qualification (ii) Age limit and (iii) Experience where experience is necessary.

2. Only those candidates who fulfil all the terms and conditions of the advertisement in respect of the post for which they are applicants shall be entertained. Others need not apply.

3. The amount of Examination fees/Application fees if specifically asked in the Advertisement shall be deposited by the candidate through treasury challan/online mode, wherever applicable.

4. (i) All candidates whether in Government Service or in Government owned undertaking or other similar organizations/Corporations/Boards/Bodies or in private employments may submit their application direct to the Commission subject to fulfilling the condition laid down in the advertisement and with intimation that his/her controlling officer has been informed about his/her application for the posts If any such candidate forwards his/her application through his/her Controlling Officer/Employer, he/she should ensure that the application reaches the Assam Public Service Commission within the closing date, failing which it is liable to be rejected even if it had been submitted to the Controlling Officer/Employer before the closing date. In cases where there is necessity to obtain NOC from the employer before applying, the candidate may obtain NOC as required and furnish copy along with the application form.

(ii) The Commission shall in no way be responsible in the event of any candidate after appointment is not released by the concerned authority to enable him/her to join the new post.

5. Applications must be accompanied by self attested copies of the under-mentioned documents, which should be

tagged well without any chance of getting lost on transit.

Applications which are not accompanied by anyone of the under mentioned documents will not be entertained. (a) Original treasury receipt depositing prescribed examination fees. (b) Age certificate (HSLC/Class X Board Admit Card/Pass Certificate). (c) Certificates & mark sheets of all examinations from HSLC onwards up to the level of qualifying examination. (d) Caste certificate (wherever necessary) of reserved categories issued by appropriate authority. (e) Disability certificate(wherever necessary) (f) Two copies of recent passport size photograph with white background. (g) Signature( scanned copy to be uploaded in online mode when available) (h) Experience certificates, if necessary (The experience column of the application form should be filled as and when

specifically mentioned in the advertisement) (i) BPL certificate/EWS certificate (wherever necessary)

No document other than the HSLC or Class X Board Examination Admit Card/Pass Certificate, in which the date of birth is recorded, will be accepted by the Commission for determination of age.

6. The candidates shall have to produce identity proof like Pan Card, Driving License, Passport, current ID card

issued by educational Institutions, Voter ID Card at the time of Written Test and Viva-Voce Interview. Aadhar card may be produced, if available.

7. The candidates should visit the Commission’s website www.apsc.nic.in regularly. If the Commission decides to hold written examination/screening test, the syllabus will be uploaded only in the APSC website. The eligible candidates shall have to download the Admit cards/Call letters from the APSC website.

*****

USE ONLY BLUE / BLACK BALL POINT PEN

Page 9: ASSAM PUBLIC SERVICE COMMISSION · (ii) The Diploma/Degree in Civil Engineering must be a Regular Course. Diploma/Degree in Civil Engineering obtained through Distance Mode of Education,

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----------------State:---------------------------------

ASSAM PUBLIC SERVICE COMMISSION

A P P L I C A T I O N F O R M

1. Applicant’s Name in full (as recorded in HSLC or equiva

2. Father’s Name in full

3. Mother’s Name in full

4. Gender 5. Date of Birth (As per HSLC certificate) (Male – M/Female – F) D D M

8. Category (GEN/EWS/SC/STP/STH/OBC&MOBC Note: attach supporting documents (except GEN)

10. Permanent Address

12. Optional Subjects (wherever applicable)

1.------------------------------------------------------------------------------

13. Examination Zone 14. Details of fee: Application/Examination Fee

ACCOUNTS, “NON TAX REVENUE OTHER NON TAX REVENUE 0051 PUBLIC SERVICE COMMISSION 105 STATE PUBLIC SERVICE COMMISSION APPLICATION/EXAMINATION FEE RECEIPT OF ASSAM PUBLIC SERVICE COMMISSION”. (No fee is to be paid if not asked for and the column should be left blank.)

*BPL candidates must submit BPL certificate issued by competent authority for exemption from payment of fees.

Name of the Treasury Office No. and Date of Treasury Receipt

NOTE: enclose copy of the original Treasury Receipt. No duplicate/photocopies will be accepted.

ADVERTISEMENT NO……………………NAME OF THE POST AND DEPARTMENT APPLIED FOR………………………………………………………………………………………………………………………….…………………………………………………………………………………………………………………………..............................................................................................................................

(Candidate MUST choose one of the zones advertisement as per his

----------------------------------------------------------------------------

----------------------------------------------------------------------------

----------------------------------------------------------------------------

-----PIN:---------------

--------------------------------------------------------------------

--------------------------------------------------------------------

--------------------------------------------------------------------

----------------State:------------------------------

ASSAM PUBLIC SERVICE COMMISSION

A P P L I C A T I O N F O R M

Name in full (as recorded in HSLC or equivalent certificate in BLOCK LETTERS IN ENGLISH

r’s Name in full

Date of Birth (As per HSLC certificate) 6. Age on 1st January, 20........ M Y Y Y Y Y Y M M D D

/SC/STP/STH/OBC&MOBC) 9. PWD status [Please tick (9) approattach supporting documents (except GEN) Note: attach supporting documents

11. Present Address For Communication

------------------------------------------------------------------------------ 2.--------------------------------------------

Application/Examination Fee to be paid as per the rate specifically mentioned in the advertisement in the HEAD OF THE “NON TAX REVENUE OTHER NON TAX REVENUE 0051 PUBLIC SERVICE COMMISSION 105 STATE

PUBLIC SERVICE COMMISSION APPLICATION/EXAMINATION FEE RECEIPT OF ASSAM PUBLIC SERVICE (No fee is to be paid if not asked for and the column should be left blank.)

*BPL candidates must submit BPL certificate issued by competent authority for exemption from payment of fees.

No. and Date of Treasury Receipt Amount

(GEN Rs. P.

NOTE: enclose copy of the original Treasury Receipt. No duplicate/photocopies will be accepted.

……………………........ NAME OF THE POST AND DEPARTMENT APPLIED FOR…………………………………..................………………………………………………………………………………………………………………………….....………………………………………………………………………………………………………………………….......................................................................................................................................

OH HI VI

(If the permanent address is same as that of present address, please put a tick (9) mark only)

choose one of the zones listed in the as per his/her convenience.)

------------------------------------------------------------------------

------------------------------------------------------------------------

------------------------------------------------------------------------

-------------------------PIN:--------------

BLOCK LETTERS IN ENGLISH)

January, 20........ 7. Nationality D

) appropriate box.] attach supporting documents

Communication

----------------------------------------------------------------------------

in the advertisement in the HEAD OF THE “NON TAX REVENUE OTHER NON TAX REVENUE 0051 PUBLIC SERVICE COMMISSION 105 STATE

PUBLIC SERVICE COMMISSION APPLICATION/EXAMINATION FEE RECEIPT OF ASSAM PUBLIC SERVICE

*BPL candidates must submit BPL certificate issued by competent authority for exemption from payment of fees. Category (GEN/EWS/SC/STP/STH/OBC & MOBC)

Paste here a copy of your recent passport size photograph of size 3.5 cm×4.5 cm & Sign in the box below.

.................. .... ....

......

Others (please specify)

(If the permanent address is same as that of present address, please

Page 1 of 4

Page 10: ASSAM PUBLIC SERVICE COMMISSION · (ii) The Diploma/Degree in Civil Engineering must be a Regular Course. Diploma/Degree in Civil Engineering obtained through Distance Mode of Education,

15. Academic/Professional Qualification/Training Courses etc. From HSLC onwards (use separate sheet, if necessary) Note: Attach supporting documents

16. Employment/Experience (The experience column should be filled as and when specifically mentioned in the advertisement) (Particulars of all previous and present employment/experience relevant to advertisement are to be furnished)(Use separate sheet, if necessary)

Sl. No.

Name and address of the employer Post Held Nature of Work/Duty

Period Whether Central/ State govt. Undertaking/ Private

From To

17. If Ex-Servicemen mention (only for Grade-III post) (attach copy of discharge certificate/Ex-Servicemen ID card)

Personal Number :-...............................................................................................

Rank :-...............................................................................................

Name of Service :-...............................................................................................

Period of Service :-...............................................................................................

Date of Retirement/Release :-...............................................................................................

Name of Exam Division /Grade/ Class

PC(%) of Marks Obtained

Year of Passing Duration of Course

Institution/Board/ University Subjects Taken

18.(a) Are you debarred from any examination and /or selection conducted by the UPSC or any State P.S.C. ? [Please tick (9) appropriate box.]

YES NO

18.(b) Are you debarred from applying for any Government post ? [Please tick (9) appropriate box.]

(If yes, submit details)

YES NO

Page 2 of 4

Page 11: ASSAM PUBLIC SERVICE COMMISSION · (ii) The Diploma/Degree in Civil Engineering must be a Regular Course. Diploma/Degree in Civil Engineering obtained through Distance Mode of Education,

19. For Doctors (All branches, please specify)

I) Registration No : -------------------------------------------------------------------------------

II) Name of registering authority : ------------------------------------------------------------------------------ Note: attach supporting documents

20. Details of Enclosures (Put serial numbers on Annexure):-

Sl. No. Details No. of sheets Sl.

No. Details No. of sheets

DECLARATION

I hereby declare that all the statements made in this application are true and complete to the best of my knowledge and belief. I understand that action can be taken against me by the Commission if I am declared by them to be guilty of any type of misconduct mentioned herein.

* I have informed my Head of Office/Department in writing that I am applying for the post (in case of Service holder).

Place : __________________________

Date : __________________________

---------------------------------------------------------

Signature of the Candidate (in full)

* Strike off the sentence if not applicable.

WARNING: Applications which are not in conformity with the requirements laid down in the advertisement and applications which are not in the prescribed form or incomplete or improperly filled in or are not accompanied by self attested copies of certificates, mark sheets, documents etc. shall be rejected. Application received in the Commission’s office after the closing date will not be considered.

Canvassing by a candidate directly or indirectly either to the Chairman or Members of the Commission in respect of his/her candidature shall be treated as a disqualification.

*****

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Page 12: ASSAM PUBLIC SERVICE COMMISSION · (ii) The Diploma/Degree in Civil Engineering must be a Regular Course. Diploma/Degree in Civil Engineering obtained through Distance Mode of Education,

DECLARATION

Form- “A”

[See rule 5 (1)]

I , Shri / Smti ………………………………………………………………….Son / daughter / husband / wife of Shri/ Smti………………………………………………Aged ………………years, resident of …………………………………………………………………………………………………………………………………...................................................................................................do hereby declare as follows:

1) That I have filled my application for the post of………………………………………………………. advertised vide ………………………………

2) I have ……….. (number) living as on today. Their names , sex and date of birth are:

3) I am aware that if I have more than two living children, I am liable to be disqualified for the appointment to the post.

4) I also declare that: I am not married / I am married and my spouse and I have not violated the provision of legal age of marriage.

5) I am aware that marrying in violation of the provision of the Prohibition of Child Marriage Act, 2006 (Act No. 6 of 2007) shall be disqualification for appointment to the post applied for.

Place: …………………………………

Date: …………………………………..

Signature of the applicant

Name Sex Date of Birth

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