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DOWNLOAD TIME:- 2019-03-30 12:16:19 (ORIGINAL)

GOVERNMENT OF INDIA
MINISTRY OF RAILWAYS
RAILWAY RECRUITMENT BOARDS
CEN NO. RRC-01/2019 (RECRUITMENT FOR VARIOUS POSTS IN LEVEL 1 OF 7TH CPC PAY MATRIX)

REGISTRATION NO : 1240035750 RAILWAY NAME : SOUTH WESTERN RAILWAY (HUBLI)

1). PERSONAL DETAILS

FULL NAME OF APPLICANT : SAGAR Y R

FATHER'S NAME: RAMU D

MOTHER'S NAME : RATHNAMMA C

DATE OF BIRTH : 30-10-1995

AGE AS ON 01-07-2019 : 23 YEARS, 8 MONTHS, 1 DAYS

GENDER: MALE

AADHAR NUMBER/ENROLLMENT NO : 799145692080

MINIMUM EDUCATIONAL 10TH

QUALIFICATION :

10TH BOARD : STATE BOARD

10TH REGISTRATION NO / ROLL NO : 20120756770

YEAR OF PASSING 10TH : 2012

NATIONALITY : CITIZEN OF INDIA RELIGION : HINDU

MOBILE NUMBER : 9611853131 E-MAIL ID : YRSAGAR5360

2). ADDRESS FOR COMMUNICATION

FULL ADDRESS : SO RAMU D AT POS TYADAMARANAHALLI UYYAMBALLI HOBLI , 562117 ,

STATE NAME : KARNATAKA DISTRICT NAME : RAMANAGARA

CITY : RAMANAGARA PINCODE : 562117

DO YOU BELONG TO VILLAGE

CITY/TOWN/VILLAGE :

3). PAYMENT DETAILS

REFERENCE NO 940260614 AMOUNT 500

SBI REFERENCE NO CPQ2327171 TIME 2019-03-30 11

4). DETAILS OF BANK ACCOUNT IN WHICH REFUND HAS TO BE MADE

WOULD YOU LIKE TO RECEIVE REFUND AMOUNT IN THE SAME BANK ACCOUNT?

5). DEATILS OF ESSENTIAL QUALIFICATION

10TH QUALIFICATION DETAILS

QUALIFICATION: SSLC BOARD: STATE BOARD

STATE IN WHICH STUDIED: KARNATAKA DISTRICT: RAMANAGARA

MARKS: PERCENTAGE PERCENTAGE: 55.68

DO YOU POSSESS ITI QUALIFICATION NO

6). DETAILS OF HIGHER QUALIFICATION

QUALIFICATION TYPE:

QUALIFICATION:

7). POST PREFERENCE DETAILS

CAT.NO RAILWAY DESIGNATION DEPARTMENT VACANCY

 UR SC ST OBC EWS TOTAL EXSM R- R- R- R- B- B-
VI HI LD MD VI HI
8 SOUTH ASSISTANT TRAFFIC 305 114 57 191 74 741 148 0 0 0 0 0 0
WESTERN POINTSMAN
RAILWAY

9 SOUTH ASSISTANT SIGNAL S AND T 245 94 46 169 62 616 123 0 5 16 3 0 0

WESTERN AND TELECOM
RAILWAY

3 SOUTH ASSISTANT C AND W MECHANICAL 124 59 33 112 37 365 73 0 10 2 7 0 0

WESTERN
RAILWAY

17 SOUTH TRACK MAINTAINER ENGINEERING 1304 594 275 1015 354 3542 708 0 0 0 0 0 0
WESTERN GRADE IV
RAILWAY

10 SOUTH ASSISTANT TRACK ENGINEERING 60 23 12 43 15 153 31 0 0 6 0 0 0

WESTERN MACHINE
RAILWAY

11 SOUTH ASSISTANT TL AND AC ELECTRICAL 199 74 37 134 49 493 99 24 6 6 5 0 0

WESTERN
RAILWAY

5 SOUTH ASSISTANT LOCO MECHANICAL 50 20 11 36 13 130 26 14 12 1 0 0 0

WESTERN SHED (DIESEL)
RAILWAY

1 RWF ASSISTANT MECHANICAL 16 6 3 11 4 41 8 0 1 1 0 0 1

BANGALORE (WORKSHOP)

1 SOUTH ASSISTANT MECHANICAL 59 15 10 36 13 133 27 2 1 2 0 0 0

WESTERN (WORKSHOP)
RAILWAY

4 RWF ASSISTANT DEPOT STORES 5 2 1 3 1 14 2 0 1 0 1 0 1

BANGALORE (STORES)

4 SOUTH ASSISTANT DEPOT STORES 15 6 3 11 4 39 8 1 1 1 0 0 0

WESTERN (STORES)
RAILWAY

6 SOUTH ASSISTANT LOCO ELECTRICAL 14 5 3 10 4 36 7 10 0 1 5 0 0

WESTERN SHED (ELECTRICAL)
RAILWAY

9 RWF ASSISTANT SIGNAL S AND T 1 0 0 0 0 1 0 0 0 0 0 0 0

BANGALORE AND TELECOM

12 RWF ASSISTANT TL AND AC ELECTRICAL 2 0 0 1 0 4 1 0 1 0 0 0 0

BANGALORE (WORKSHOP)

12 SOUTH ASSISTANT TL AND AC ELECTRICAL 12 4 2 8 3 29 6 1 0 1 0 0 0

WESTERN (WORKSHOP)
RAILWAY

13 SOUTH ASSISTANT TRD ELECTRICAL 210 80 40 143 53 526 105 0 10 11 4 0 0

WESTERN
RAILWAY

14 SOUTH ASSISTANT WORKS ENGINEERING 65 21 12 43 15 156 31 5 3 4 0 0 0

WESTERN
RAILWAY

15 RWF ASSISTANT WORKS ENGINEERING 3 1 1 3 1 11 2 0 0 1 1 0 1

BANGALORE (WORKSHOP)

16 SOUTH HOSPITAL ASSISTANT MEDICAL 54 20 11 36 13 134 27 2 2 2 0 0 0

WESTERN
RAILWAY

17 RWF TRACK MAINTAINER ENGINEERING 2 0 0 1 0 3 1 0 0 0 0 0 0

BANGALORE GRADE IV

8). COMMUNITY DETAILS

COMMUNITY OBC-NON CREAMY LAYER

STATE KARNATAKA DISTRICT RAMANAGARA

CASTE II A

9). PWBD DETAILS

ARE YOU A PWBD CANDIDATE? NO

10). EX SERVICEMEN DETAILS

ARE YOU AN EX-SERVICEMEN ? NO

11). APPRENTICESHIP COURSE DETAILS

HAVE YOU COMPLETED APPRENTICESHIP COURSE UNDER APPRENTICESHIP ACT 1961 ? NO

12). EMPLOYEE IN STATE / CENTRAL GOVT / PUBLIC SECTOR UNIT ?

13). DO YOU BELONG TO ANY OF THE FOLLOWING AGE RELAXATION CATEGORIES ?

A) DOMICILED IN JAMMU AND KASHMIR DURING 1.1.1980 TO 31.12.1989 ?

B) SERVING RAILWAY EMPLOYEE

C) EMPLOYEE IN QUASI-ADMIMINISTARTIVE OFFICES(CANTEENS, COOPERTAIVE SOCEITIES/INSTITUTES) OF RAILWAY ORGANISATION

14). ARE YOU A CANDIDATE FROM ECONOMICALLY BACKWARD CLASS WHOSE FAMILY INCOME IS LESS THAN RS NO
50000 PA ?

15). MOTHER TONGUE KANNADA

16). DETAILS OF VISIBLE IDENTIFICATION MARKS/MOLES/CUT MARKS ON THE BODY

IDENTIFICATION MARK ON RIGHT STOMOCH

MARKS/MOLES/CUT MARKS-I

IDENTIFICATION NON
MARKS/MOLES/CUT MARKS-
II

17). CHOICE OF EXAM LANGUAGE IN ADDITION TO ENGLISH(ENGLISH IS DEFAULT LANGUAGE) KANNADA

18). YOU HAVE TO BRING ANY ONE OF THESE CURRENT VALID PHOTO-ID CARD IN ORIGINAL FOR APPEARING IN THE AADHAAR CARD
CBT AND SUBSIQUENT STAGES

ID CARD NO 799145692080

19). DECLARATION

I HEREBY DECLARE THAT I HAVE GONE TROUGH THE ELIGIBILITY CRITERIA FOR THE POST(S) APPLIED FOR AND MEET ALL THE REQUIREMEN
THAT ALL THE DETAILS FURNISHED BY ME IN THE APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE & BELIEF AND
BEEN CONCEALED OR SUPPRESSED. I ALSO UNDERSTAND THAT IN CASE , ANY OF THE DETAILS FURNISHED IS FOUND UNTRUE DURING ANY
RECRUITMENT OR THEREAFTER RAILWAY ADMINISTRATION SHALL DISQUALIFY ME FOR THE POST(S) APPLIED FOR AND /OR I SHALL BE LIAB
OTHER ACTION UNDER THE EXTANT RULES.

SIGNATURE

DOWNLOAD TIME:- 2019-03-30 12:16:19(ORIGINAL)