OFFICE OF THE CONVENOR,CO-ORDINATION COMMITTEE, PATNA
-CUM-DISTRICT & SESSIONS JUDGE, PATNA
Personal Details
1 Name of the post applied for :- *
2 Name of the Candidate :- *
(In block letters)
3 Name of Father/Husband :- *
4 Sex :- *
5 Date of Birth :-*
(As per matriculation certificate) 		   (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) :- *
9 Physically Handicapped :- *
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 order of preference where the candidate
after being selected and appointed like to be posted :-* 		I     

II   

III  
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