Personal Information

Online application form for examination-2024 for

Exam Name
technical cadre
1. Tube Well Repairer (नलकू प मिस्त्री) - 671
Applied Post
/322/63/2024
Application Number TCE211462

Application Status Completed

Candidate's Name SACHIN RANA

Father's Name/Husband's Name MOHAN SINGH

Mother's Name AMARWATI DEVI

Date of Birth 24/12/1993

Age (As on 01 Jul, 2024) 30 years 6 months 8 days

Gender Male

Marital Status Married

Email Id [email protected]

Mobile No. 90XXXXX832

Place of filling form Delhi

Domicile of Uttarakhand? Yes

Nationality Indian

Required Eligibility
1.Is your name registered in any District Employment Office located in Uttarakhand State? Yes

1(i).Employee Registration Number UA23120244800

Employment
1(ii).Employment Office District Office,Udham Singh
Nagar

1(iii).Date of Registration 15/10/2024

1(iv).Registration Date Valid Upto 31/12/2027

2.Are You Employed? Yes

2(i).Type of Organisation Central/State Corporation

2(ii).Date of Applying NOC 07/10/2024

Have you passed your High School and Intermediate or any other equivalent exam from any recognized
3. Yes
institution situated in the State of Uttarakhand
Are you or your spouse or your parents regular employees of the Armed Forces/Paramilitary Forces
4(i).serving in the state of Uttarakhand and whose services cannot be transferred outside the state of No
Uttarakhand?
Are you or your spouse or your parents regular employees of the State Government/Semi Government
4(ii).organisation serving on a regular basis in the state of Uttarakhand and whose services cannot be No
transferred outside the state of Uttarakhand?
Are you or your spouse or your parents regular employees of Central Government organisation/
4(iii).Central Government Public Service Undertaking and are working regularly in the State of Uttarakhand No
and whose services cannot be transferred outside the State of Uttarakhand?

Category / Sub Category Reservation Details

Category ST
Certification Issuing Authority Tehsildar

Certificate Issuing Date 30/09/2013

Certificate Number 0203041302675

Certificate Issuing District Udham Singh Nagar

Sub Category Details

Differently abled(PH) No

Ex-Servicemen No

Uttarakhand Rajya Andolankari or Their Dependent No

'Skilled player' means a citizen of India who has won a medal or participated in sports at
international/national level and whose original domicile is in Uttarakhand, but has not obtained any
permanent domicile certificate from anywhere else, or whose original domicile is not in Uttarakhand, but
No
has obtained a permanent domicile certificate in Uttarakhand as per Government Order No. 2588/Ek-
4/SA/2001, dated 20th November, 2001 or any other Government order relating to domicile in force at that
time

Dependent of Freedom Fighter (DFF) No

Are you an Orphan (who is a permanent resident of the State of

Uttarakhand covered by Government), for such affected children
(whose biological/adoptive parents both died after the birth of the
child within a period of up to 21 years) OR Orphan Child residing in No
government/voluntary homes functional and registered under the
Department of Women Empowerment and Child Development in
the state of Uttarakhand?

Claimed Category/Sub Category ST

Address Details

Present Address
Line1 Sachin Singh S/O Mohan Singh
Line2 Post office - Lamakhera
City / Town / Village Audali
District Udham Singh Nagar
State Uttarakhand
Pincode 262405

Permanent Address
Line1 Sachin Singh S/O Mohan Singh
Line2 Post office - Lamakhera
City / Town / Village Audali
District Udham Singh Nagar
State Uttarakhand
Pincode 262405

Additional Essential Qualification

For Tube Well Repairer (नलकू प मिस्त्री) - 671 /322/63/2024 Post
1. हाई स्कू ल तथा आई०टी०आई० के साथ - साथ 05 वर्ष का अनुभव । Yes

Have you filled the online application form for any of the posts related to the designation and qualification
advertised in Advertisement No. 55/UKSSSC/2024 (Date-16/02/2024)? If yes, then enter your application
number?(क्या आपने विज्ञापन संख्या- 55/UKSSSC/2024(Date-16/02/2024) में विज्ञापित पदनाम व योग्यता से सम्बंधित में से No
किसी पद हेतु ऑनलाइन आवेदन पत्र भरा है यदि हाँ तो अपना आवेदन पत्र क्रमांक(Application No.) दर्ज करें )

Educational Qualifications Details

Date of Marks Percentage
Maximum
University / University / Issuing Subject / Marks Obtained / Grade of Marks
Qualification Type School/Degree Marks /
Board State Board Final Year Stream Type CGPA / Obtained Obtained /
CGPA / CPI
Marksheet CPI Equivalent
High School(10th) High School(10th) Uttarakhand Uttrakhand 2008 English, MARKS 230.00 500.00 - 46.00
Board of Mathematics,
School Science,
Education Other(Hindi
 Date of Marks Percentage
Maximum
University / University / Issuing Subject / Marks Obtained / Grade of Marks
Qualification Type School/Degree Marks /
Board State Board Final Year Stream Type CGPA / Obtained Obtained /
CGPA / CPI
Marksheet CPI Equivalent
Social
Science )
Biology,
Uttrakhand
Chemistry,
Board of
Intermediate(12th) Intermediate(12th) Uttarakhand 2010 Hindi, MARKS 248.00 500.00 - 49.60
School
Physics,
Education
English
VYAVSAYIK
PARIKSHA
I.T.I I.T.I Uttarakhand PARISHAD 31/07/2015 Fitter MARKS 1902.00 2700.00 - 70.44
DEHRADUN
UTTARAKAND
Hindi
Literature,
Bachelor of Kumaun
Graduation Uttarakhand 05/08/2013 History, MARKS 892.00 1500.00 - 59.47
Arts(B.A.) University
Political
Science

Preferential Qualification
Have you Served in the Territorial army for a minimum period of two years? No

Do you possesses National Cadet Corps 'B' certificate? No

Do you possesses National Cadet Corps 'C' certificate? No

Do you have graduation/post graduation degree? Yes

Other Details
Exam Centre Preference 1 Udham Singh Nagar

Exam Centre Preference 2 Nainital

Is there any criminal case pending against you? No

Whether debarred or Black Listed for Examination/ Selection held by UKSSSC / UPSC / Other
No
State Public Service Commission?

Candidate ID Proof Aadhaar Card

ID Proof Number 41XXXXXXXX35

Fee Details
Bank Reference Number Transaction Date Application Fee Total Amount Payable Status
429019494514 16/10/2024 23:10:59 ₹150.00 ₹ 150.00 Paid

Declaration

1. I SACHIN RANA hereby declare that I have carefully read all the eligibility conditions mentioned in the advertisement and the above
mentioned information in this application form. I accept and complete those requirements.
एतद्द्वारा घोषणा करता हूं कि मैंने विज्ञापन में उल्लिखित पात्रता की सभी शर्तों और इस आवेदन पत्र में दी गई उपरोक्त जानकारी को सावधानीपूर्वक पढ़ लिया है। मैं उन
आवश्यकताओं को स्वीकार करता हूं और उन्हें पूरा करता हूं।
2. I also declare that all the details / information given in this application form is true and correct and I have not hidden any facts in
these particulars / information. If any details / information is found to be false or incorrect or if any facts are hidden by me, then my
candidature should be cancelled. If such situation comes to light after the appointment, then my services should be terminated.
यह भी घोषणा करता हूं कि इस आवेदन पत्र में दिए गए सभी विवरण/सूचनाएं सत्य और सही हैं और मैंने इन विवरणों/जानकारी में कोई तथ्य नहीं छिपाया है। यदि मेरे द्वारा
कोई विवरण/सूचना असत्य या असत्य पायी जाती है या कोई तथ्य छु पाया जाता है तो मेरी उम्मीदवारी रद्द कर दी जाये। अगर नियुक्ति के बाद ऐसी स्थिति सामने आती है तो
मेरी सेवाएं समाप्त कर दी जानी चाहिए।
3. I am / am not a regular employee of State Government / Government of India and I have informed the competent authority about
sending my application, on (Date) 07/10/2024 for providing No Objection Certificate.
मैं राज्य सरकार/भारत सरकार का नियमित कर्मचारी हूँ/ नहीं हूँ और मैंने अपना आवेदन पत्र भेजने की सूचना सक्षम प्राधिकारी को दिनांक 07/10/2024 को विधिवत
अनापत्ति प्रमाण पत्र प्रदान करने के लिए प्रस्तुत कर दी है।
Place of filling form: Delhi
Submitted Date & Time : 16/10/2024 23:10:59
Print Date : 16/10/2024

Signature of Candidate