ONLINE APPLICATION FOR THE POST OF CHAIRMAN, PERMANENT LOK ADALAT FOR PUBLIC UTILITY SERVICES IN DISTRICT BEGUSARAI,MOTIHARI,MUNGER

Apply for District(s)

Begusarai

East Champaran

Munger

Name

Father's / Spouse Name

Date of Birth

Age as on

Home State

Home District

Address

Permanent Address (Same as Correspondence Address)

Correspondence Address

Permanent Address

Pin Code

State

Mobile No.

Occupation Detail

Present Occupation

Annual Income

Nationality

Service Status

Whether In Service or Retired?

Date of Joining service

Designation

Scale of Pay

Basic

Date of Superannuation

Any Other Qualification/Experience

Criminal Offence/Proceeding/Charge-Sheeted Details (If Any)

Whether any Criminal case has been registered against the candidate?
If yes, the details thereof

Whether the candidate has ever been charge-sheeted for any criminal offence or in any departmental proceedings?
If yes, the details thereof

Whether the candidate has been convicted by any competent court for any criminal offence?
If yes, the details thereof

Whether the candidate have more than one living spouse?
If yes, the details thereof

Whether the candidate attract any of the disqualification mentioned in the Advertisement?
If yes, the details thereof

Upload Photo, Signature and Declaration

Photo (size must be between 10 kb to 40 kb and type is .jpg)

Signature (size must be between 5 kb to 10 kb and type is .jpg)

Declaration (size must be between 10 kb to 60 kb and type is .jpg)

Declaration (to be handwritten, scanned and uploaded)

"I undertake that I have not concealed any material information. I further undertake that in case at any stage, I have been found guilty of concealing any material information, my candidature/ subsequent appointment be cancelled with immediate effect."

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