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Telephone No. – 0141-2385813 Fax:- 0141-2385813, 2385467 Email:- [email protected] Website-centralexcisejaipur.nic.in

Qk-l- II-31¼01½CCU/JZ/2016 fnaukd .03.2016

To, As per list enclosed, (Annexure-A). Subject :- Recruitment to the post of Inspector, Central Excise through Combined Graduate Level Examination’ 2014 – reg.

You have been nominated for appointment to the post of Inspector, Central Excise & allocated to Central Excise, Jaipur Zone on the basis of Combined Graduate Level Examination’ 2014 conducted by Staff Selection Commission.

2. You are directed to appear before the under signed on 04.04.2016 at 10.00 hrs for submissions of documents, Physical Test & Medical Examination. The candidates are required to possess physical standards and pass the Physical Test as below.

Physical Standards (Minimum) Physical Test Male Height- 157.5 cms. Candidate (relaxable by 5 Cms. in the case of Walking-1600 Metres

Garhwalis, Assamese, Gorkhas and in 15 Minutes members of the Scheduled Tribes) Chest -81 Cms. (fully expanded with Cycling -8 Kms. in 30

minimum expansion of 5 Cms.) minutes

Physical Standards (Minimum) Physical Test Female Height- 152 cms. Candidate (relaxable by 2.5 Cms. in the case of Walking -1 Km. in

Garhwalis, Assamese, Gorkhas and 20 Minutes members of the Scheduled Tribes) Weight- 48 Kg. (relaxed by 2 Kgs for Garhwalis, Assamese, Gorkhas and Cycling – 3 Kms in 25 Members of the Scheduled Tribes) minutes

Orthopedically disabled candidates are eligible for relaxation for Physical Test as per Govt. orders.

Candidates should make their own arrangement for procuring bicycle for undergoing

the Physical Test.

Office of the Chief Commissioner, Central Excise, Jaipur Zone, Jaipur List of candidates called for physical test and medical examination

Date 04.04.2016 (Monday) Time : 10 A.M. 1 SHRI HIMMAT SINGH NARUKA 19 SHRI MOHIT GARG

C/o Sh. Mohar Singh Rathore, Near Ram

Krishna Ashram, Phase II, Karni Nagar

Lalgarh, Bikaner, Rajasthan, 334002

D-28, Indra Nagar, Behind Heeradas Petrol

Pump, Bharatpur, Rajasthan - 321001

2 PAVAN KUMAR 20 SHRI ANKIT GOYAL

Village Samantpura, Post Alipur, Tehsil

Weir, Bharatpur, Rajasthan 321615

House No. 87, Kharadi Gali, Near Dhokre

Ke Balaji, Jhalawar, Rajasthan - 326001

3 SHRI PUNEET KUMAR GUPTA 21 SHRI ANKUR JAIN

677 C-A , Surya Nagar, Behind Narayan

Niwas, Gopalpura Bypass, Jaipur,

Rajasthan - 302015

Iron Shop, Main Market, Govindgarh,

Alwar, Rajasthan - 301604

4 SHRI HANUMAN SINGH 22 SHRI ANUJ KUMAR

22 Gatta Factory Road, Near Gochar

Cycle Store, Kansuwa, Kota, Rajasthan -

324004

Village - Kalba, P.O. Nangal Nunia, Tehsil -

Narnaul, Mohinder Garh, Haryana - 123023

5 SHRI BHARAT SHEWANI

23 SHRI SHAHBAZ KHAN KAYAMKHANI

7-GA-3, Jawahar Nagar, Jaipur ,

Rajasthan - 302004

Nadi Mohalla, Dovnia Balaji Road,

Gulabpura, Bhilwara, Rajasthan - 311021

6 SHRI RAMESHWAR LAKSHKAR

24 SHRI ANKUR AGARWAL

Raja Reddy Ration ke Dukan, Ward No.

23, Madangarh Kishangarh, Ajmer,

Rajasthan - 305801

House No. 180 B K Kaul Nagar, Near Gyan

Vihar, Ajmer, Rajasthan - 305001

7 NARENDRA SINGH RATHORE

25 SHRI ABHISHEK SHARMA

Uttam Block Binders Shop No. 9,

Ambedkar Complex, Near Head Post

Office, Jhunjhunu - 333001

94 Indira Colony, Mantown Sawai

Madhopur, Rajasthan - 322001

8 Ms. ADITI MAAN

26 SHRI KARAMJEET SINGH

2/102, Housing Board, Jhunjhunu,

Rajasthan - 333001

H.No. 12, Dayanand Colony, Near Jindal

Hospital, Model Town, Hisar Haryana -

125005

9 SHRI MAHAVEER PRASAD SAINI 27 SHRI GIRDHARI LAL BHAMBU

By Pass Road, Patwari Ka Bass Moad,

Srimadhopur, Sikar, Rajasthan - 332715

Street No. 20, Rampura Basti Lalgarh,

Bikaner, Rajasthan - 334004

10 SHRI DEVESH KUMAR SHARMA 28 SHRI LAXMAN SINGH

Raghunath Puri, Bara Takhta, Tonk

Rajasthan, 304001

VPO- Sendhly, Via - Bhusawer, Teh. Weir ,

Bharatpur, Rajasthan - 321406

11 Ms. NISHA GOKULKA 29 SHRI AMIT PARASHAR

Baleshwar Mohalla, Ward No. 14,

Reengus, Sikar, Rajasthan, 332404

Parashar Motors, Dholpur Road, Anaj

Mandi, Rupbas, Bharatpur , Rajasthan -

321404

12 SHRI RAM NIWAS YADAV 30 SHRI VISHAL GUPTA

VPO Baghawas, Tehsil - Kishangarh

Renwal, Distt. Jaipur, Rajasthn 303603

41, Shanti Priya Nagar, Near Kamla Nagar

Hospital, Pal Link Road, Jodhpur,

Rajasthan - 342008

13

SHRI ARVIND SINGH SHEKHAWAT

31 SHRI DEEPAK MAHLA

H.No. A-232, Karni Nagar, Near

Narendra Bhawan Lalgarh, Bikaner,

Rajasthan - 334001

College Stadium Road, Behind Sat Sahib

Ashram, Charkhi Dadri Bhiwani, Charkhi

Dadri, Haryana - 127306

14 SHRI GAURAV KUMAR SINGHAL 32 SHRI VIKRAM SIHAG

Rakesh Oil Mill Jatmashi Road, Jagan

Colony, Near Narega Office Roopbas,

Bharatpur, Rajasthan - 321404

Room No. 33, P.G. Men's Hostel, University

of Delhi, New Delhi - 110007

15 SHRI VINOD KUMAR 33 SHRI ARPIT SHARMA

C/o Future Series, 1-E-235, JNV Colony,


B 110 , Gaur Grandeur Apartments, Sector

119, Noida, Gautambudh Nagar,

Uttarpradesh - 201301

16 SHRI ARUN KUMAR SONI 34 SHRI NIRMAL KUMAR NEHRA

A-1/6, Rawan Ka Chauraha, Vyas Colony,

Shastri Nagar, Jaipur (Rajasthan) 302016

House No. 170 Near Rajana Johra, VPO

Sihot Chhoti Via Phaglwa, Tehsil - Dhod ,

Sikar, Rajasthan , 332041

17 SHRI DINESH KUMAR SAINI 35 SHRI ANKUR KUMAR GARG

AAM Wali Dhani, VPO - Jhanpda, Teh.

Lalsot, Distt. Dausa(Rajasthan) 303503

V/PO- Pareeta , Teh- Karauli, Rajasthan -

322219

18 SHRI ABHISHEK SHARMA

Gayatri Electronics, Main Market,

Udaipur Road, Mavli Jn. Udaipur,

Rajasthan - 313203


dk;kZy; eq[; vk;qDr















the Physical Test.

Office of the Chief Commissioner, Central Excise, Jaipur Zone, Jaipur List of candidates called for physical test and medical examination Date 05.04.2016 (Tuesday) Time : 10 A.M.

36 SHRI ISHWER SINGH

54 SHRI VIPIN KUMAR SINGH

M.N. - 584, Ganesh Nagar, Near Khade

Ganesh Ji Temple, Kota, Rajasthan -

324009

E-278, Prem Nagar Linepar, Moradabad,

Uttar Pradesh - 244001

37 SHRI ARPIT AGRAWAL 55 SHRI HIMANSHU CHAUDHARY

Joshi Mohalla, Sadar Bazar, Chhoti

Sadri, Pratapgarh, Rajasthan - 312604

J 200, Sec 41, Noida, Gautam Budh Nagar,


38 Ms. PREETI RATHORE

56 SHRI PUNEET NEWALIA

10/47C, Karkar Dooma, Near Karkar

Dooma Metro Station, East Delhi -

110092

C-2-C Pocket 12 Flat No. 49 Janakpuri ,

New Delhi 110058

39 SHRI RAJ GAJENDRA SINGH 57 SHRI AMIT KUMAR GARG

83-A, Dr. Rajendra Prasad Nagar, Near

200 Feet Bypass, Ajmer Road, Jaipur,

Rajasthan - 302020

WA-206, Ist Floor, Main Shakarpur, New

Delhi - 110092

40 SHRI GOPAL SHARMA 58 SHRI RAHUL SHARMA

B-39, SHRI Ganpat Nagar, Near Civil

Court, Sanganer, Jaipur, Rajasthan-

302029

Riddhi Chandra Sharma(Advocat) Street

No. 2, Behind PG College, Anand Colny,

Dausa, Rajasthan - 303303

41 SHRI MANINDER SINGH DAGAR 59 SHRI ANISH BHALLA

RZ 1A, Baba Haridas Enclave, Jharoda

Kalan South West, Delhi - 110072

238, Govind Nagar, Opposite Hotel

Jhankar, Delhi Road, Alwar, Rajasthan -

301001

42 SHRI DUSHYANT KUMAR SHARMA

60 SHRI JITENDER

172/39 5th Lane, Vigyan Nagar, Adarsh

Nagar, Ajmer, Rajasthan - 305002

V.P.O. Samaspur Majra, District Tehshil -

Jhajjar, Haryana, Jhajjar, Haryana -

124109

43

SHRI SWAROOP SINGH

SHEKHAWAT

61 SHRI MANDEEP RATHEE

VPO Govati, Via Palsana,

Dantaramgarh, Sikar, Rajasthan -

332402

H.No. - 925/7 Jain Bagh Colony, Gohana

Road, Sonipat , Haryana - 131001

44 SHRI ABHISHEK 62 SHRI MOHIT DRALL

House No. 139, Ward No. 5, Near

Telephone Exchange, Mohindergarh,

Haryana - 123029

GH 6/29, White Apartment, Paschim Vihar,

Delhi - 110087

45 SHRI AMIT KUMAR

63 SHRI GAGANDEEP RATHI

Umed Sangwan S/o Sh. Jaikaran, Village

- Adampur, Post Office - Adampur

Dadhi, Bhiwadi, Haryana - 127310

V.P.O. RAJPUR, TEH. GANAUR, DISTT.

SONIPAT, HARYANA - 131101

46 SHRI UMESH SHARMA 64 SHRI VAIBHAV SINGH

VPO Panhera Khurd, Teh. Ballabgarh,

Faridabad, Haryana - 121004

H.No. L1-02-FF, BPTP Park Elite Floors,

Sector-84 Faridabad, Haryana-121002

47 SHRI BHARAT KALRA 65 MS. MEENAKSHI KUMARI

Kalra General Store, Main Hospital

Road, Tehsil - Padampur, Sri

Ganganagar, Rajasthan- Jaipur 335041

Satish Medical Store, Main Market,

Halena, Bharatpur, Rajasthan - 321601

48 SHRI PUSHPANSHU MANGAL 66 SHRI DURGESH SINGH BISEN

313, Bazar Mohalla, Vill-Pinan, Teh.

Raini, Alwar, Rajasthan 301413

161, Bhawani Nagar, Kanpur Nagar, Uttar

Pradesh - 208013

49 SHRI PARDEEP MALIK

67 SHRI DHEERENDRA KHANDELWAL

VPO Dabodha Khurd, Tehsil

Bahadurgarh, Jhajjar, Haryana - 124507

C/o Shri Khandelwal Stationers, Lanka

Chowk, Chhabra Road, Bapawar Kalan,

Teh. Sangod, Kota, Rajasthan - 325207

50 SHRI JITENDRA KUMAR AVASTHI 68 SHRI ANKUL CHOUDHARY

V.P.O. Khoh, Teh. Laxmangarh, Alwar,

Rajasthan - 301035

#215, Kaka Nagar, Shamli (U.P.) - 247776

51 MS. NILAM KUMARI 69 SHRI PRINCE

28, Shiv Colony Moti Nagar, Vaishali

Nagar, Jaipur , Rajasthan- 302021

House No. 372, Pole No. 64, V.P.O.

Malikpur, New Delhi, Southwest Delhi,

Delhi - 110073

52 SHRI ABHISHEK SANGAR

70 SHRI SAGAR SHARMA

DG-3/123 , M-243 Vikas Puri, Delhi -

110018

H.No. 352, Kishangarh Manimajra,

Chandigarh - 160101

53 SHRI NITESH SAMSUKHA

Bhanwar Lal Munna Lal Samsukha,

Ranka Chopra Mohalla, New Line

Gangasahar, Bikaner, Rajasthan - 334401


dk;kZy; eq[; vk;qDr















the Physical Test.

Office of the Chief Commissioner, Central Excise, Jaipur Zone, Jaipur List of candidates called for physical test and medical examination Date 06.04.2016 (Wednesday) Time : 10 A.M.

71 SHRI RAJEEV TOMAR 89 SHRI ASHOK KUMAR

E-40/41, E Block Nehru Vihar (Near

Timarpur) North Delhi, Delhi - 110054

S/O Shri Devkaran Ji, Village Kherla Po -

Narhar, Distt. Jhunjhunu, Rajasthan - 333035

72 SHRI DINESH KUMAR LUNIYA

90 SHRI VAIBHAV JAIN

Surya Nagar Near Railway Station

Dakaniya Talav Opposite Subash School,

Kota, Rajasthan - 324003

268 G1 Yash Apartment, Patel Nagar,

Muhana Mandi Road, Mansarovar, Jaipur

302020

73 MS. SHIVANI THAKUR 91 SHRI DHARMENDRA SHARMA

V-Bhandiaran, PO-Dulehar, Teh. Haroli,

Distt. UNA (Himachal Pradesh) 176601

Near Shiv Temple, Mukundpura Road Basri,

Via Bhankrota, Jaipur Rajasthan - 302026

74 SHRI ANKIT SHOKEEN 92 SHRI SAMIT KUMAR

House No. 9, Mangol Pur Khurd, New

Delhi, Delhi - 110083

House No. 236, Sector 23-A Chandigarh -

160023

75 SHRI NAVEEN JOON 93 MS. NEHA GARG

VPO - Patheri, Tehsil - Maneser, Distt.

Gurgaon (Haryana) 122413

House No. 502-B, Sector 61, Chandigarh-

160062 (U.T.)

76 SHRI NITIN KHARBANDA

94 SHRI AKASH SINGH

H.No. 594 Ward No. 5, Diamond Chowk,

Jhajjar, Haryana-124103

Malawali Dhani, Neem Ka Thana, Sikar,

Rajasthan - 332713

77 SHRI HARPINDER SINGH

95 SHRI SOURAV BHATIA

1114, Phase-9, Sas Nagar, Punjab -

160062

A-2, Khasra No. 882 Sant Nagar, Village

Burari, Delhi - 110084

78 SHRI KAMALDEEP KUMAR

96 SHRI RAVI LALWANI

House No. 24622, Street No. 8, Hazi

Ratan, Bathinda, Punjab - 151001

Near Banshiwala Temple, Kathariyon Ka

Chowk, Nagaur, Rajasthan - 341001

79 SHRI SANJEEV CHAUDHARY 97 SHRI RAJPAL MUND

H.No. 359, Sec. 17 A, Gurgaon, Haryana -

122001

Near Khetar Ji Mandir, VPO Moondsar, Teh.


80 SHRI ADARSH KUMAR 98 MS. ANUJ DHAMA

23 Nasirpur Scheme, Opposite Aastha

Public School, Nehru Nagar, Gaziabad,


RZ 8A Street No. 2, Kapur Wali Gali, Raghu

Nagar, Pankha Road, New Delhi - 110045

81 SHRI GOURAV 99 SHRI RAHUL SHARMA

311/25 Gandhi Nagar, Rohtak, Haryana -

124001

S/o Rameshwar Lal, VPO Laharpur,

Sadhaura, Yamunanagar - 133204

82 SHRI SANTOSH KUMAR TIWARI

100 SHRI PRINCE MEHARCHANDANI

95 Shanti Niketan Colony, Kishan Marg

Tonk Phatak, Barkat Nagar, Jaipur ,

Rajasthan - 302015

92, Sati Devi Niwas, Sindhi Colony Khwas Ji

Ka Bagh, Durgapura, Jaipur, Rajasthan -

302018

83 SHRI VIPIN AGRAWAL 101 SHRI SUNNY GARG

Near Old Laxman Temple, Bharatpur,

Rajasthan - 321001

C/o Bhupen Kumar Sharma, 40/13 Mangal

Kamna Guest House, Swarn Path,

Mansarovar, Jaipur Rajasthan - 302020

84 SHRI SUMIT BHARDWAJ 102 MS. KOMALJEET KAUR SEERA

House No. 1299/31, Gali No. 6, Laxman

Vihar Phase - 2, Gurgaon, Haryana-

122001

WZ-197, Virendra Nagar, Street No. 3A, New

Delhi, West New Delhi - 110058

85 SHRI ADITYA PANCHOLI 103 SHRI BHARAT GUPTA

Mahapragya Chaya, 18 Koti Field,

Shahpura, Bhilawara, Rajasthan - 311404

Main Bazar Mania Tehsil - Dholpur,

Rajasthan - 328024

86 SHRI DEEPAK KUMAR GUPTA 104 MS. DEEPIKA RANI

Agarwal Medical Store, V.P. Bilona

Kalan, Tehsil - Lalsot, Dausa, Rajasthan -

303503

House No. 1762 Deepika Garments, Boga

Mandi, Mandi Adampur, Hisar, Haryana -

125052

87 SHRI VASU JOSHI 105 SHRI BHANU PRATAP SINGH

H.No. 2/54, Sector -5, Rajendra Nagar,

Sahibabad, Gaziabad, Uttar Pradesh -

201005

The Spark Institute, Vijay Nagar Colony,

Thandi Sarak, Etah - Uttar Pradesh - 207001

88 SHRI GOURAV SANDAL

House No. 59, Near Old Primary School,

Talwandi Bhai, Ferozpur, Punjab -

142050


dk;kZy; eq[; vk;qDr















the Physical Test.


Date 07.04.2016 (Thursday) Time : 10 A.M.

106 SHRI ABHISHEK SHARMA 124 SHRI NEMI CHAND DADARWAL

74-A, Ayodhya Enclave, Sector - 13,

Rohini, Delhi - 110085

Village- Sanga KA Bas, Post - Doongri

Kalan, Via - Renewal, Jaipur, Rajasthan -

303603

107 MS. PRANJALI 125 SHRI RATAN LAL JAKHAR

411/5 Scheme No. 5, Gandhi Nagar, Jind,

Haryana - 126102

VPO - Jorpura , Via Jobner, Tehsil -

Phulera, Jaipur, Rajasthan - 303328

108 SHRI NANAK GUPTA 126 SHRI NEERAJ KUMAR

4 D 28, Back to Gupta Nursing Home,

Jawahar Nagar, Sriganganagar,

Rajasthan - 335001

C/o Adarsh Book Depot, Nawalgarh

Road, Sikar, Rajasthan, 332001

109 SHRI UMAKANT SHARMA 127 SHRI DEEPAK SAGAR

Vill + Post Chhapar, Distt.

Muzaffarnagar, State Uttarpradesh,

Pin:251307

72 Chandra Nagar B 9 Dukan Opp.

Kardhani Kalwar Road, Jhotwara,

Jaipur - Rajasthan - 302012

110 SHRI RAJKUMAR BALODA 128 SHRI MANISH SAHARAN

Village - Keriya , Post - Nimera, Teh.

Phagi, Jaipur, Rajasthan - 303005

V.P.O. Bhalau Tiba, Taranagar, Churu,

Rajasthan - 331304

111 SHRI ANKIT DHINGRA

129 SHRI PRAFFUL KUMAR CHANDORA

110 Bal Vihar Colony Luv Kush Path ,

Kalwar Road, Near 200FT By Pass

Jhotwara , Jaipur, Rajasthan - 302012

H-124, Pratap Nagar, Jodhpur,

Rajasthan - 342003

112 SHRI ANKIT KUMAR GOEL

130 SHRI ANKIT KUMAR CHOUDHARY

570/150, Bhartiya Colony, Balaji Road,

New Mandi Muzaffarnagar,


A39, Behind of Jodla Power House,

Sudamapuri-I, VKI Area, Sikar Road,

Jaipur, Rajasthan 302013

113 SHRI ANJANI KUMAR SINGH

131 MS. PRIYANKA DHAKA

677, Lodi Road Complex, New Delhi -

110003

Opposite Vishva Karma Mandir, Ward

No. 4, Raisinghnagar, Sriganganagar,

Rajasthan - 335051

114 SHRI VINAY KUMAR 132 SHRI MANOJ YADAV

Patti Mehar, Near Old Power House,

Baraut, Baghpat, Uttar Pradesh - 250611

R-3, University Campus, University of

Rajasthan, Jaipur - 302004

115 SHRI SHUBHAM KUMAR 133 SHRI MANISH CHOUDHARY

Village + Post Dabathwa Meerut State -


2, Jatwari, Inside Hathipole, Udaipur,

Rajasthan - 313001

116 SHRI HOSHIYAR SINGH 134 SHRI RAHUL KUMAR YADAV

Surajmal Nagar Colony, Behind Radhika

Palace, Central School, Bharatpur,

Rajasthan-321001

789, Shanti Nagar, Near Durgapura

Railway Station, Durgapura, Jaipur,

Rajasthan - 302018

117 SHRI MAHENDRA PAL GURJAR

135 SHRI DEVENDRA GURJAR

C/o Nathu Lal Gurjar TRA, Vill and Post

Gyangarh, Via Rajaji Ka Karera Mandal

Bhilwara, Rajasthan - 311804

36, Vidhyut Nagar-C, Near Swami

Narayan Mandir, Chitrakoot, Vaishali

Nagar, Jaipur, Rajasthan, 302021

118 SHRI ABHISHEK YADAV

136 SHRI KHETA RAM

Ward No. 7, Udairamsar, Bikaner,

Rajasthan - 334402

Godaro Ka Tala Leelsar, Via Sanawara,

Teh. Chohtan, Barmer, Rajasthan-344708

119 SHRI RANVEER SINGH DADARWAL

137 SHRI SANDEEP KUMAR

Village-Mohanpura, Post Doongari

Kalan, Via - Renewal, Jaipur, Rajasthan

- 303603

House No. 107, Sarvjanik Gram Chok ,

VPO - Nunia Gothra , Teh. Chirawa,

Jhunjhunu, Rajasthan - 333026

120 SANJEEV KUMAR YADAV 138 SHRI SURESH KUMAR

789 Shanti Nagar, Near Durgapura

Railway Station, Jaipur, Rajasthan -

302018

CO Ordination Section (GSSA), O/o The

Principal Accountant, General(GSSA),

Trivandrum, Kerla - 695001

121 SHRI BUDDHI PRAKASH BAIRWA 139 SHRI LILADHAR POONIA

Taran Ward No. 19, Sawai Madhopur

Road, Tonk, Rajasthan - 304001

Vill Post - Jalabsar, Teh. Shri

Dungargarh, Bikaner, Rajasthan - 331803

122 SHRI YOGESH SOLANKI 140 SHRI SUNIL KUMAR

In front of Mahajhan Dera, Old Ginnani


New Customs Quarters, Qtr No. 105

Southern End, Willingdon Island, Cochin,

Kerala - 682003

123 SHRI DINESH SINGH BAINSLA

House No. B-131, Near Jain Temple,

Surya Nagar, Alwar, Rajasthan - 301001


dk;kZy; eq[; vk;qDr















the Physical Test.


Date 11.04.2016 (Monday) Time : 10 A.M.

141 SHRI USMAN KHAN 158 SHRI GAURAV KUMAWAT

Village - Devnagar, Post - Ladana, Teh.

Phagi Distt. Jaipur 303005

E-694 Onkar Sadan, Lal Kothi Scheme,

Nakul Path, Jaipur Rajasthan - 302015

142 SHRI D SHAKTI RAJ SWAMI 159 SHRI VIKAS PRAJAPAT

35, Tilak Nagar, Opp. Jat Hostel ,

Rankawat Niwas, Bikaner, Rajasthan -

334001

Rajiv Gandhi Colony, Ward No. 38, JB

Road, Sujangarh, Rajasthan - 331507

143 SHRI PRASUN KUMAR 160 SHRI NARENDRA SINGH LAKHAWAT

C/o Prahalad Singh, D-21, Kedia Palace

Road, Murlipura, Jaipur, Rajasthan,

302039

Village Post - Rendari, Teh. Sojat City, Pali,

Rajasthan - 306103

144 SHRI PANKAJ BADOLIYA 161 SHRI ASHOK KUMAR

Plot No. 237, Shyama Prasad Mukharji

Nagar, Teh. Newai, Tonk, Rajasthan

304021

Sanjay Colony, Ward No. 16, Gandhipura

Balotra, Barmer, Rajasthan - 344022

145 SHRI GHANSHYAM POONIA 162 SHRI NITISH DUNIWAL

Infront of Bablu Book Centre , Gali No.

18, Rampura Basti, Lalgarh, Bikaner ,

Rajasthan 334004

232/29, Haldighati Marg, Sector 23, Pratap

Nagar, Jaipur - 302017

146 SHRI RAKESH KUMAR

CHOUDHARY

163 SHRI SUMIT KUMAR SONI

8/22, South Patel Nagar, Near Patel

Nagar Metro , New Delhi , Delhi -

110008

40, Lions Lane Colony, Panchyawala, Jaipur

- 302034

147 SHRI JITENDRA YADAV

164 SHRI DEEPAK KUMAR YADAV

VPO - Rampura Bega Ka Nangal Viya -

Patan, Teh. Neemka Thana, Distt. Sikar -

332718

C-21, Friends Colony, Sirsi Road

Panchyawala, Jaipur, Rajasthan-302034

148 SHRI SANDEEP KUMAR OLA

165 SHRI RAJESH

VPO Gothara, Via Jhajhar, Teh.

Nawalgarh, Distt. Jhunjhunu

(Rajasthan) 333304

C/o Ravindra Gurjar, Mansinghpura Tonk

Road, Jaipur, Rajasthan - 302018

149 SHRI SATYENDRA SINGH 166 SHRI KAMLESH KUMAR

835 Huda Sector 1, Narnaul, Haryana -

123001

Dhani - Devi Singh Wala, Post - Puranabas,

Teh. Neem Ka Thana, Sikar, Rajasthan -

332713

150 SHRI GANESH MACHARA 167 SHRI MUBARIK ALI

VPO - Amarsar, Teh - Bidasar, Distt.

Churu, Rajasthan - 331517

Village - Mirchuni, PO Tapukara, Teh.

Tijara, Alwar, Rajasthan 301707

151 SHRI ANUBHAV SONI

168 SHRI SURESH KUMAR DHAYAL

7-B-45 Mahaveer Nagar 3, Kota

Rajasthan - 324005

B-11, Shri Ram Nagar B, B/H Kanta

Kalwara Road, Jhotwara, Jaipur, Rajasthan

- 302012

152 MS. SUNIL KUMARI

169 SHRI LALA RAM MEENA

Village Rayla, Post - Jherli, Teh

Surajgarh, Junjhunu, Rajasthan 333031

Dhani Singhalo Ki VPO, Papad VIA

Kanota, Tehsil Jamwaramgarh, Jaipur,

Rajasthan - 303012

153 SHRI SAMPAT SINGH

170 SHRI NEERAJ BASWAL

Vill - Keshav Ka Was, PO - Dansroli,

Teh. Dantaramgarh, Distt. Sikar,

Rajasthan - 332742

75, Bal Mandir Colony, Sawaimadhopur,

Rajasthan - 322001

154 SHRI NARESH KUMAR

171 SHRI DINESH KUMAR TAWARIYNA

144, Jat Mohalla School Ke Pass, VPO -

Ojatoo, Teh. Chirawa, Distt. Jhumjhunu

- Rajasthan - 333026

344-A Heera Nagar-A, Heerapura 200 Feet

Bypass Ajmer Road, Jaipur, Rajasthan -

302021

155 SHRI NARENDRA SINGH 172 SHRI RAMJI LAL MEENA

C-263, Amar Nagar, Sirsi Road, Gali No.

1, Panchawala, Jaipur, Rajasthan -

302034

Village / Post Kashipura, Teh - Bassi, Jaipur

, Rajasthan - 303908

156 SHRI SHASHANK YADAV 173 SHRI VIKASH KUMAR MEENA

B-285, 80 Feet Road, Mahesh Nagar,

Jaipur, Rajasthan - 302015

Village - Jaisinghpura, Tehsil - Sikrai, Via -

Geejgarh, Dausa, Rajasthan - 303502

157 SHRI MOHIT RAO 174 SHRI PRAHLAD KUMAR MEENA

VPO Kashni, Teh. Surajgarh,


Village - Chainpura, Post - Chawandia, Teh.

Bassi, Jaipur, Rajasthan, 303301

175 SHRI VIJAY KUMAR BAIRWA

23, Doodh Ki Dairy, Surajpura Road Ke

Pass, Karni Nagar, Dausa, Rajasthan -

303303


dk;kZy; eq[; vk;qDr















the Physical Test.


Date 12.04.2016 (Tuesday) Time : 10 A.M.

176 SHRI DHAIRYA CHOUHAN 193 SHRI SURENDRA KUMAR

H 86 UIT Colony, Pratap Nagar,

Jodhpur, Rajasthan - 342003

50 No Gate, New Jairam Nagar, Joniha

Chauraha, H.No. 409 Fatehpur,


177 SHRI TUSHAR KUMAR 194 MS. SWEETY

House No. 38, Kalyan Kunj Colony,

Kanta, Jhotwara, Jaipur, Rajasthan -

302012

Vill-Nimana, Po. Sondhi, Teh. Jhajjar,

Haryana - 124105

178 SHRI SHARWAN KUMAR 195 SHRI ASHOK ATAL

Ambedkar Colony, Kalwa Road, Buhana,


Plot No. 10 Prem Vihar, VPO Benar, Via

Jhotwara, Jaipur, Rajasthan - 302012

179 SHRI DESH RAJ MEENA 196 SHRI PUNEET KUMAR

C/o Bharat Lal Meena, Vill-Kaleshan,

Post. Ballupura, Th-Rajgarh, Alwar,

Rajasthan - 301408

S-532 OPP. Satya Girija Public School,

School Block Shakarpur, New Delhi -

110092

180 SHRI KAMAL MEENA 197 SHRI SANTOSH KUMAR MAHAWAR

Village Devta, Post Mamdoli, Tehsil -

Bonli, Sawai Madhopur, Rajasthan -

322024

92/4 Jhalana Gram, Malviya Nagar, Jaipur,

Rajasthan 302017

181 SHRI NITIN SURESH BAINLE

198 SHRI DHARMESH KUMAR BAIRWA

H.No. 178, New Shakti Nagar, Aam Ka

Talab Naka Madar, Ajmer, Rajasthan -

305007

A-137, Gole Market Sector - 2 Jawahar

Nagar, Jaipur Rajasthan - 302004

182 SHRI SUDHIR KUMAR

199 SHRI YOGESH PAWAR

C-5/9, SBI Officer Apartment,

Binnystone Garden, Binny Mill, Magadi

Road, Bangalore, Karnataka - 560023

Village / P.O. Petwar, Tehsil Narnaund,

Hisar, Haryana - 125074

183 SHRI PIYUSH KUMAR

200 SHRI MUKESH KUMAR

108 Tagore Nagar, Hiran Magri Sector 4,

Udaipur, Rajasthan - 313002

Ward No. 3, Near Adarsh Bal Bharti School,

Pokhara Shivnagar, Dholpur, Rajasthan -

328001

184 SHRI PRANJAL SINGH 201 SHRI SUNIL MAHAWAR

2-A, Surya Apartments, Sector - 13,


Q.No. JS 29B, Railway Loco Colony, Jaipur,

Rajasthan - 302006

185 SHRI RAJESH MEENA 202 SHRI DIVYANSHU KUMAR

Village - Nangi Ka Badh Indergarh, Post-

Indergarh, Tehsil - Jamwaramgarh,


3/3434, Kapil Vihar, Paper Mill Road,

Saharanpur, Uttarpradesh- 247001

186 SHRI RAVI KANT

203 MS. PRIYANKA

H.No. 102-C, New Police Line Barwala

Road, Hisar, Haryana - 125001

K-1/211, Prem Nagar 2, Kirari Suleman

Nagar, North West Delhi, Delhi - 110086

187 SHRI MUKESH MEENA

204 MS. PALLAVI VERMA

S/o Mool Chand Meena, Village Kuli,

VIA Khachariyawas, Danta - Ramgarh,

Sikar, Rajasthan - 332710

286, Kalpana Nagar, Shibbanpura Patel

Marg, Opposite Prince Force Motors,

Ghaziabad, Uttarpradesh - 201001

188 SHRI AVINASH JAIPAL

205 SHRI ANIL

Near Ambedkar Bhawan, V.P.O. Udasar,


Outside Khajuri Gate, Mohalla Balmiki,

Ajit Nagar, Batala - District - Gurdaspur,

Punjab - 143505

189 SHRI DHARM SINGH MEENA

206 MS. NANDITA SALONIA

Near Railway Station, Village Kherli Rail

Teh. Kathoomar, Alwar, Rajasthan

321606

C-2/192, Yamuna Vihar, Delhi, New Delhi -

110053

190 SHRI JAYANT MEENA 207 SHRI PAWAN KUMAR

H.No. 48, Gopal Vihar Ist, Police Line,

Kota, Rajasthan - 324001

H.No. 193, Ward No. 9, Govt. Colony,

Mirzapur Road, Hisar, Haryana - 125001

191 SHRI AKHIL RAJ 208 SHRI GAURAV GAUR

House No. 121, Pocket D17, Sector 3


G-214, Sector 22 Noida Dist., Gautam Budh

Nagar, Uttar Pradesh 201301

192 SHRI KAMALESH KUMAR MEENA

209 SHRI GAUTTAM RISHI MEENA

Vill - PO- Chudiyawas, Teh. Nangal

Rajawatan, Dausa, Rajasthan - 303505

Vill. Post - Jeewali, Tehsil - Gangapur City,

Distt. - Sawai Madhopur (Rajasthan)

322219

210 SHRI ADITYA SINGH

F-140, Vikaspuri, Delhi - 110018

211 SHRI ISHWAR SINGH

Village - Rasgan, Post Rasgan, Teh.

Mundawar, Alwar , Rajasthan - 301404

212 SHRI OM PRAKASH MEENA

C-135- Modal Town, Malviya Nagar,

Jaipur, Rajasthan 302017

213 SHRI SARVAGYA MEENA

3A Krishna Nagar B, Mahesh Nagar,


214 SHRI AJAY MEENA

A-5, Ashok Vihar, New Sanganer Road,

Mansarovar, Jaipur, Rajasthan - 302020

215 SHRI KULJEET

Village Sonta, Post Alipur Kheri, Distt.

Shamli, U.P.- 251301

216 SHRI AMAN CHOT

1981 Sector - 4 , Huda, Near Allahabad

Bank, Rewari, Haryana - 123401

217 SHRI RANJEET KUMAR

181, Pathara, Post Mughalsarai, Distt.

Chandauli (Uttar Pradesh) 232101

218 SHRI ANOP SINGH

Near Nagour Road, Behind Gas Godam,

Dholabala Phalodi, Jodhpur, Rajasthan -

342301

219 SHRI ASHUTOSH LUNIWAL

E-190, Shastri Nagar, Lohagal Raod,

Ajmer, Rajasthan - 305001

220 SHRI PRASHANT SRIVASTAVA

292, Z-1, Hemant Vihar, Barra-2,

Kanpur, Uttar Pradesh . 208027

221 SHRI AYUSH SHARMA

617-3, Mangal Pandey Nagar, University

Road, Meerut, Uttarpradesh - 250004

CERTIFICATE OF CHARACTER

Certified that I have known Shri ______________________________ S/o

Shri _________________________________ for the last __________ years

_________ months and that to the best of my knowledge and belief he bears

reputable character and has not antecedents which render him unsuitable for

Government Employment.

2. Shri ___________________________ is not related to me.

Place :________________ *Signature __________________

Date : _______________ Name & Designation __________

(* By a Gazetted Officer)

ATTESTED

Place :________________ **Signature : ________________

Date : _______________ Name & Designation :_______________

(Attesting Authority)

**(To be attested by Stipendiary I Class Executive Magistrate/ District Magistrate

or Sub Divisional Magistrate).

vuqizek.ku&i=

inuke % fujh{kd] dsUnzh; mRikn 'kqYd

vuqizek.ku QkeZ esa dksbZ xyr lwpuk nsuk vFkok fdlh egRoiw.kZ

rF; dks Nqikuk v;ksX;rk le>h tk;sxh rFkk ;g vH;FkhZ dks ljdkjh lsok ds fy, v;ksX; djkj dj ldrh gSA ¼2½ D;k dHkh dkjkokl esa j[ks x,] U;k;ky; }kjk nks"kh fl) ik, x, vFkok fooZftr ?kksf"kr gq, gks rks mldk foLr`r fooj.k] bl QkeZ dks iw.kZ djus ds rFkk izLrqr djus ds i'pkr ml izkf/kdkjh ftlus ;g vuqizek.ku QkeZ Hkstk gS] mls 'kh?kz lwfpr dj nsuk pkfg,A lwpuk u nsus ij ;g le>k tk;sxk fd egRoiw.kZ rF; fNik;k x;k gSA

;fn fdlh O;fDr ds lsokdky ds nkSjku fdlh Hkh le; bl ckr dk irk py tkrk gS fd mlus vuqizek.ku QkeZ esa xyr lwpuk nh gS vFkok fdlh egRoiw.kZ rF; dks fNik;k gS rks mldh lsok,as lekIr dh tk ldsxhA uksV % uhps fn, x, izR;sd dkWye esa okafNr lwpuk iw.kZ :i ls fy[ksa] dksbZ Hkh dkWye [kkyh

vFkok ¼&½ yxkdj u NksM+saA ¼1½ iwjk uke ¼lkQ v{kjksa esa½

¼;fn vkius dHkh fdlh le; vius uke vFkok dqyuke esa dksbZ va’k tksM+k gks vFkok mlesa ls gVk;k gks rks mldk mYys[k djsa½

%

¼2½ orZeku iwjk irk ¼ftleas xkWao] Fkkuk] ftyk] edku u0] xyh] lM+d] 'kgj rFkk ftyk eq[;ky; dk uke fn;k tk;s½

%

¼3½¼v½ LFkkbZ ?kj dk iwjk irk ¼ftleas xkWao] Fkkuk] ftyk] edku u0] xyh] lM+d] 'kgj rFkk ftyk eq[;ky; dk uke fn;k tk;s½

%

¼3½¼c½ ;fn ewy :i ls ikfdLrku ds fuoklh gSa rks ml ns'k esa mudk irk rFkk Hkkjr esa izotu dh frfFk

%

¼4½ jk"Vªh;rk % ------------------------------------------------------------------------------------- ¼5½ ¼v½ tUefrfFk % ¼c½ fnukad 01-01-2014 dks vk;q % ----------------- o"kZ ---------------- ekg ----------------- fnu

Lo;a dk gLrk{kfjr QksVks ¼ikliksVZ lkbZt½ ;gkWa fpidk;saA

¼jktif=r vf/kdkjh ls izekf.kr gks½

¼6½ xr ikWap o"kksZa esa tgkWa vkius ,d o"kZ ls vf/kd fuokl fd;k gS] ogkWa fuokl dh vof/k crkrs gq, LFkkuksa dk fooj.k nsaA ;fn fons’k ¼ikfdLrku lfgr½ esa jgsa gksa] mu lc LFkkuksa dk fooj.k fn;k tkuk pkfg;s tgkWa vkius 21 o"kZ dh mez ds i'pkr ,d o"kZ ls vf/kd dh vof/k ds fy;s fuokl fd;k gksA

fnukad ls fnukad rd fuokl dk iwjk irk

¼vFkkZr xkWao] Fkkuk] ftyk] edku u0] xyh] lM+d] 'kgj vkfn½

fiNys dkWye esa fn, x, LFkku ds ftyk eq[;ky;

dk uke

¼7½ ikfjokfjd fooj.k % uke jk"Vªh;rk

tUe ls@ vf/kokl }kjk

dk;Z djus dk LFkku

O;olk; ¼;fn lsok esa gSa rks dk;kZy; dk irk o inuke

nhft,½

orZeku Mkd dk irk ¼;fn e`r gS rks vkf[kjh irk½

¼1½ ¼2½ ¼3½ ¼4½ ¼5½ ¼1½ firk dk uke

¼miuke lfgr½

¼2½ ekrk ¼3½ iRuh@ifr ¼4½ HkkbZ

¼5½ cgusa

¼8½ ;fn iq= vkSj iqf=;kWa fons’k esa i<+ jgs gksa@jg jgsa gksa rks ml laca/k esa Hkh lwpuk izLrqr dh tk;sa %

uke jk"Vªh;rk ¼tUe ls@ vf/kokl ls½

tUe LFkku iwjs irs lfgr ml ns'k dk uke tgkWa i<+ jgs gSa@jg jgsa gSaA

frfFk ftleas fiNys dkWye esa mYysf[kr ns'k esa jg@i<+ jgs gSa

¼9½ ¼v½ tUe LFkku %

ftyk rFkk jkT; ftlesa fLFkr gS %

¼c½ ftyk rFkk jkT; dk uke ftlds vki fuoklh gSa

¼l½ ml ftys rFkk jkT; dk uke % ftlesa vkids firk ewy :i ls lEc) gS

¼10½ ¼v½ /kEkZ %

¼c½ D;k vki vuqlwfpr tkfr@vuqlwfpr tutkfr@ vks-ch-lh- ds lnL; gSa \ mRrj

gkWa ;k uk esa nsa ;fn mRrj gkWa esa gS rks mldk uke crk;sa % gkWa@ugha -----------------------------------------------------

¼11½ 'kS{kf.kd ;ksX;rk % 15 o"kZ dh mez ds i'pkr Ldwyksa@dkWystksa esa tgkWa f’k{kk izkIr dh gS muds uke rFkk f’k{k.k o"kZ %

Ldwy dkWyst dk uke izos'k dh

frfFk NksM+us dh frfFk

mRrh.kZ dh xbZ ijh{kk

vadksa dk izfr’kr

¼12½ D;k vki fdlh dsUnzh; vFkok jkT; ljdkj vFkok v)Z ljdkjh vFkok ljdkjh o`r

fudk; vFkok fdlh Lok;Rr fudk; vFkok ifCyd v.MjVsfdax ¼lkoZtfud laxBu½ vFkok futh QeZ ;k laxBu esa fdlh in ij gSa] vFkok iwoZ esa ,sls in ij fu;qDr gq, Fks ;fn gkW rks fu;kstu dk v|ru frfFk;ksa lfgr iwjk fooj.k nhft, A

vof/k inuke] ifjyfC/k;kWa rFkk

fu;kstu dh izd`fr fu;kstu dk iwjk uke o irk

fiNyh ukSdjh NksM+us ds dkj.k

ls rd

¼13½ D;k fiNyk jkstxkj Hkkjr ljdkj@jkT; ljdkj@ljdkj }kjk fu;af=r vFkok futh

v.MjVsfdax@Lok;Rr fudk;@fo’ofo|ky;@LFkkuh; fudk; ds v/khu Fkk \ ;fn lfoZl NksM+h gS rks D;k vkius dsUnzh; flfoy lfoZl ¼vLFkkbZ lsok;sa½ fu;e 1965 ds fu;e 5 ds v/khu ,d ekg dk uksfVl fn;k Fkk vFkok blh rjg ds fu;eksa ds v/khu vkids fo:) fdlh izdkj dh vuq’kklukRed dk;Zokgh dh xbZ Fkh] vFkok lsok ls R;kxi= dk uksfVl nsrs le; vFkok okLrfod :i ls vkidh lsok;sa lekIr djus ds iwoZ vuqorhZ frfFk ij D;k vkidks fdlh Hkh ekeys esa vius vkpj.k dks Li"V djus ds fy, cqyk;k x;k Fkk \

¼14½ fuEufyf[kr izR;sd iz’u dk lqfuf’pr mRrj gkWa vFkok ugha tSlk Hkh ekeyk gks] dks iz’u

ds lkeus mYys[k djsaA ¼d½ D;k vki dHkh fxj¶rkj fd, x, gSa \ ¼[k½ D;k vkids fo:) dHkh vfHk;kstu pyk gS \ ¼x½ D;k vki dHkh utjcan fd, x, gSa \ ¼?k½ D;k vki ij dHkh U;k;ky; }kjk n.M yxk;k x;k \ ¼M-½ D;k vki dHkh u’ks esa /kqr ik, x, \ ¼p½ D;k vki dHkh fdlh U;k;ky; }kjk vijk/k ds fy, ¼fl)nks"kh½ Bgjk;s x;s \

¼N½ D;k vkidks la?k yksd lsok vk;ksx }kjk dHkh mudh ijh{kkvksa@p;uksa esa lfEefyr gksus ls vioftZr vFkok v;ksX; ?kksf"kr fd;k x;k \

¼t½ D;k vkidks fdlh ijh{kk esa csBus ls jksdk x;k vFkok fdlh fo’ofo|ky;@laLFkk }kjk fu"dkflr ¼jsLVhdsV½ fd;k x;k \

¼>½ bl vuqizek.ku QkeZ ds Hkjrs le; D;k fdlh U;k;ky; esa vkids fo:) dksbZ ekeyk cdk;k iM+k gS \

¼¥½ bl vuqizek.ku QkeZ ds Hkjrs le; D;k fdlh fo’ofo|ky; esa vFkok fdlh vU; 'kS{kf.kd izkf/kdkjh ds le{k vkids fo:) dksbZ ekeyk cdk;k iM+k gS \

;fn mijksDr iz’uksa dk mRrj gkWa esa gks rks ekeys ds fxj¶rkjh ds fo:) gksus ds@tqekZuk fd, tkus ds@dqdhZ gksus [email protected]’k fd, tkus [email protected] gksus vkfn ds iwjs fooj.k nsa vkSj@vFkok U;k;ky; esa@fo’ofo|ky; esa@’kS{kf.kd izkf/kdkjh ds le{k cdk;k iM+s ekeyksa dh izo`fr dk Hkh iw.kZ mYys[k djsaA

uksV % d`i;k bl vuqizek.ku QkeZ ds Åij nh xbZ psrkouh dks Hkh ns[ksaA ¼15½ vius bykds ds nks ftEesnkj O;fDr;ksa ds uke tks vkidks tkurs gksa % 1- ----------------------------------------------------------- 2- ----------------------------------------------------------- irk % irk % eSa izekf.kr djrk gwWa fd esjh tkudkjh vkSj fo’okl ds vuqlkj mi;qZDr lwpuk lgh vkSj iwjh gSA eq>s ,slh fdlh vkSj ckr dk Kku ugh gS tks ljdkj ds vUrxZr esjh fu;qfDr dh mi;qDrrk dks nwf"kr dj ldsaA vH;FkhZ ds gLrk{kj ----------------------------------------------- frfFk % LFkku %

¼izek.k&i= fuEufyf[kr esa ls fdlh ,d ds }kjk gLrk{kfjr fd;k tkos½ 1- dsUnz vFkok jkT; ljdkj ds jktif=r vf/kdkjhA 2- ml fo/kkulHkk {ks= ds izkFkhZ vFkok mlds ekrk&firk@laj{kd lkekU;r% jg jgk@jgsa gksa

ds fo/kkulHkk lnL; vFkok laln lnL;A 3- mi e.Myh; eftLVªsV@vf/kdkjhA 4- rglhynkj vFkok uk;c rglhynkj ftUgsa eftLVªsV dh 'kfDr;ksa ds iz;ksx ds fy,

izkf/kd`r fd;k x;k gksaA 5- tgkWa vH;FkhZ igys Nk= jg pqdk gks ,sls ekU;rk izkIr fo|ky;@egkfo|ky;@laLFkk ds

fizalhiy@iz/kkuk/;kidA 6- [k.M fodkl vf/kdkjhA 7- iksLV ekLVjA 8- iapk;r fujh{kdA izekf.kr fd;k tkrk gS fd eSa Jh@Jhefr@dqekjh -------------------------------------------------- iq=@iq=h@iRuh Jh -------------------------------------------------- dks fiNys -------------- o"kZ ------------- ekg ls tkurk gwWa rFkk muds }kjk fn, x, fooj.k esjh tkudkjh vkSj fo’okl ds vuqlkj lgh gSA LFkku % gLrk{kj % irk % ------------------------------------------------------------- uke o eqgj lfgr ------------------------------------------------------------- frfFk %

Phone No.2385021/025/007

Extn.232

FAX No. (0141) 2385222

Government of India

Ministry of Finance

Department of Revenue

OFFICE OF THE CHIEF COMMISSIONER

CENTRAL EXCISE (JAIPUR ZONE), JAIPUR (NEW CENTRAL REVENUE BUILDING, STATUE CIRCLE, C-SCHEME, JAIPUR-302005)

(CADRE CONTROL UNIT)

CANDIDATE STATEMENT AND DECLARATION

The candidate must make the statement required below prior to his medical examination and must sign. the declaration appended thereto. His attention is specially directed to the warning contained in the note below:- 1 State Your Name in Full

(In block letters)

2 State your age and place of birth

3 a) Have you ever had smallpox, intermittent or any other fever, enlargement or suppuration of glands, spitting of blood, asthma, heart disease, lung disease fainting attacks rheumatism, append cities.

b) Any other disease or accident requiring confinement to bed and Medical or surgical treatment

4 When were you last vaccinated

5 Have you or any of your near relations have been affected with consumption scrofula, gout, asthma, fits, epilepsy or insanity

6 Have you suffered from any form of nervousness due to overwork or any other cause

7 Have you been examined and declared unfit for Govt. service by a Medical Officer/ Medical Board, within the last three years.

Contd. .......2/- :: 2 ::

8 Furnish the following particulars concerning family:-

Father's age if living and state of health

Fathers age at death and cause of death

No. of brothers living their ages and state of health

No. of brothers dead their ages at death and cause of death

1 2 3 4

Mother's age if living and state of health

Mother's age at death and cause of death

No. of Sisters living their ages and state of health

No. of Sisters dead their ages at death and cause of death

5 6 7 8

I declare all the above answers to be, to the best of my belief, true and correct.

I also solemnly affirm that I have not received disability certificate/pension on account of any disease or other condition.

Candidate's signature

Signed in my presence

Signature of Medical Officer

NOTE:- The candidate shall be held responsible for the accuracy of the above

statement. By willfully suppressing any information be will incur the risk of losing the appointment and if appointed, forfeiting all claim to superannuation allowance of gratuity.

dk;kzy; eq[; vk;qdr

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