KARNATAKA STATE POLICE DEPARTMENT

APPLICATION FOR THE POST OF ARMED POLICE CONSTABLE (MEN)-2016

Pm (g) zU Cf-2016
Notification No /CZ

: 4906983

Application No

AS

: 29/Pw-4/2015-16 AP: 06/01/2016

Applying as a

01. Applicant's Full Name

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: BASAVARAJU L R

02. Mother's Name

vAi g

: YASHODHA

03. Fathers Name

vAzAi g

: RUDRESH L B

05.

Address

: Ex Servicemen

Unit Name

04. Gender
AU

: Shivamogga

: Male

DHAVALAGIRI LAYOUT,1ST CROSS NEAR BARAGERAMMA HIGH

SCHOOL,CHITRADURGA,CHITRADURGA,Karnataka,577501

06. Native District

Av f

: Chitradurga

6a. If Others
Evg

: Nil

07. Email Id
E-

: lalsingbassu@gmail.com

7a. Confirmation Email ID

E- jPgt

: lalsingbassu@gmail.com

08. Mobile Number

AS

: 8050957828

Reservation Details
09. Category
U

: 3B

9a. Sub Caste

: LINGAYATH

9b. Date of issue of Certificate

it v vgu AP

: 27-Jan-2014

10. Are You an Ex-servicemen?

if Pg ?

: No

Height as per discharge certificate

10a. Jvg, Aid it
vzgAv

: 176

10b. Are you presently serving in force ?

Ai wg?

: No

10c. Date of issue of NOC

gPu it v vgu AP :

10d. Date of Discharge from Force

Az AidUAq AP

: Nil

Educational Qualification of
10e. Ex-serviceman
if P zv

Service rendered in Army/Air Force/Navy

10f. Aii Ai Vz
(s/Ai/P)

10g. Service rendered

z

11.

Are you a candidate belonging to

Hyderabad-Karnataka Region ? /

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CsyAi?

12. Are you a Government Employee ?

Pj Pgg ?

wAU

Days
U

:0

: No

: Nil

: No
: Nil

12c. Service rendered

z

: Years
U

12b. Designation
z

: Nil

Date of issue of NOC

13. Age As On Date (05.02.2016)

Months

11a. If yes, to which District you belong to ?

zz, Aii fU AAg

: No

12a. Department
ES

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12d.
AP

0
: Years
U :

10h. Whether availed ex-servicemen benefit previously for any other post in government
Az AidUAq Avg if P w qz Pj zU Pw Agg

Nil

: Nil

: 23 Years 9 Months 11 Days

Months
wAU

: Nil

Date of Birth (as in SSLC or its

equivalent Marks Card)
13. nz AP (JJJ Cx
vvi CAP nAigAv)

: Nil
Days
U

: Nil

: 25-Apr-1992

:0

14.

Have you been involved in any Criminal

Case / Departmental Enquiry ?/

Aiizzg Cgzs Pgtz / : No

ES ZguAi
zAiiVg ?

Have you been convicted in a Criminal

Case ?
15. Cgzs PzAi PU
Mngg ?

: No

Give details
14a. g qz

: Nil

Give details
15a. g qz

: Nil

16. Have you submitted any application for the same post in any other units
zj zU Evg WlPU Cf g

: No

Educational Qualification Details

Are you a Degree holder or holder of a
Equivalent qualification from Recognized
University ?
17. zszg Cx CAVPv
zAiAz vvi zv
Agg?

: Yes

Educational Qualification for

18. ExServicemen
zv

: SSLC- STATE BOARD

19. If Equivalent, Please specify

vvi zv Azg . :

20. Year of passing

Gwtgz

: 2007

21. Maximum Marks

Uj CAPU

: 625

22. Secured Marks

Uz CAPU

: 417

23. Percentage
Pqg

: 66.72

24. Date of Challan Generation

Z fz AP

: 01-Feb-2016

25. Fee Paid

wz

: Nil

26. Date of Payment

wz AP

: 04-Feb-2016

27. Journal No.

d AS

: Nil

28. Bank Branch Code

AP AZPq

: Nil

29. Bank
AP

: Nil

30. Bank Address

AP

: Nil

Nil

Payment Details

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Date

: 11 March 2016 02:09 PM

IP Address

: 103.231.218.158

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Applicants signature / Cfzg /-