1. Post applied for Lower Division Clerk Group-C2. Name ROHIT S KHATRY(in block letters)3. Fathers Name BIHARI LAL KHATRY4. Date Of birth 21/06/1993(att copy of birth certificate duly attested)5. Age as on last date prescribed for receipt of application21 Years 6 Months 6. Address for correspondence with Tele No.House No. /Street VillagePost OfficeDisttStatePIN Code7. Permanent address House No. /Street /VillagePost OfficeDisttStatePIN Code8. Caste: OBC9. Educational qualifications 10. Any other qualification /Experience11. Category for which applied12. Tech training /Experience13. Domicile14. Whether registered with any Employment Exchange:-Yes/No: if yes, mentioned Registration No. And Name of employment exchangeI do hereby declare that all particulars furnished by me above are correct and true to best of my knowledge and belief. I understand that in the event of any particulars or information given by me found false or incorrect at any stage, my candidature is liable to be rejected or cancelled at any stage.

Dated: Signature of the candidate with date For Official record Only1.Received on