OFFICE OF THE CONVENOR,CO-ORDINATION COMMITTEE, PATNA
-CUM-DISTRICT & SESSIONS JUDGE, PATNA
Personal Details
1
Name of the post applied for :-
*
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01 Clerk
02 Stenographer
03 Deposition Writer-cum-Typist-cum-Clerk
1a
Typing Language :-
*
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Hindi
English
Bilingual
1a
Typing Language :-
*
Hindi
English
2
Name of the Candidate :-
*
(In block letters)
3
Name of Father/Husband :-
*
4
Sex :-
*
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Male
Female
5
Date of Birth :-
*
(As per matriculation certificate)
DD
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MM
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YYYY
2021
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(dd/mm/yyyy)
6
Sl. No.
Qualification
Board/University
Passing year
Marks Obtained
Division
1
Matriculation
*
2
Intermediate
*
3
Graduation
*
4
Any other Degree
7
Extra qualiication, if any :-
8
Category (Tick whichever applicable) :-
*
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Un-reserved
Schedule Caste
Schedule Tribe
Backward Caste
Extreme Backward Caste
9
Physically Handicapped :-
*
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Yes
No
10
Permanent Address :-
*
Address
District
State
Pin
11
Address for communication
:-
*
Address
District
State
Pin
12
Details of criminal record against you, if any
:-
13
Name of three Judgeships in o
rder of preference where the candidate
after being selected and appointed like to be posted :-
*
I
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Araria
Aurangabad
Begusarai
Banka
Bhagalpur
Bhojpur (Ara)
Buxar
Darbhanga
East Champaran (Motihari)
Gaya
Gopalganj
Jamui
Jehanabad
Kaimur (Bhabhua)
Katihar
Khagaria
Kishanganj
Lakhisarai
Madhepura
Madhubani
Munger
Muzaffarpur
(Bihar Sarif)
Nawadah
Patna
Purnea
Rohtas (Sasaram)
Saharsa
Samastipur
Saran (Chapra)
Sheikhpura
Sheohar
Sitamarhi
Siwan
Supaul
Vaishali (Hajipur)
W. Champaran (Bettiah)
II
-----------Select------------
Araria
Aurangabad
Begusarai
Banka
Bhagalpur
Bhojpur (Ara)
Buxar
Darbhanga
East Champaran (Motihari)
Gaya
Gopalganj
Jamui
Jehanabad
Kaimur (Bhabhua)
Katihar
Khagaria
Kishanganj
Lakhisarai
Madhepura
Madhubani
Munger
Muzaffarpur
(Bihar Sarif)
Nawadah
Patna
Purnea
Rohtas (Sasaram)
Saharsa
Samastipur
Saran (Chapra)
Sheikhpura
Sheohar
Sitamarhi
Siwan
Supaul
Vaishali (Hajipur)
W. Champaran (Bettiah)
III
-----------Select------------
Araria
Aurangabad
Begusarai
Banka
Bhagalpur
Bhojpur (Ara)
Buxar
Darbhanga
East Champaran (Motihari)
Gaya
Gopalganj
Jamui
Jehanabad
Kaimur (Bhabhua)
Katihar
Khagaria
Kishanganj
Lakhisarai
Madhepura
Madhubani
Munger
Muzaffarpur
(Bihar Sarif)
Nawadah
Patna
Purnea
Rohtas (Sasaram)
Saharsa
Samastipur
Saran (Chapra)
Sheikhpura
Sheohar
Sitamarhi
Siwan
Supaul
Vaishali (Hajipur)
W. Champaran (Bettiah)
14
Upload Photograph of Applicant :-
*
(Allowed file size: 10-20KB / Allowed File Type jpeg/jpg)
15
Upload Signature of Applicant :- in English :-
*
(Allowed file size: 5-10KB / Allowed File Type jpeg/jpg)
16
Upload Signature of Applicant in Hindi :-
*
(Allowed file size: 5-10KB / Allowed File Type jpeg/jpg)
17
Place
:-
DECLARATION
I hereby declare that the facts and details given by me in the application are true to the best of my knowledge and belief. I understand that in the event of any of the particulars or information mentioned above being found false or incorrect at any stage, my candidature shall be liable to be rejected.
I Agree