Form Page-3 | My Site 4

Details form

Are you graduate or possess higher education as on 01.01.2026?

. No change in category will be permitted after Complete Registration of your application

Kindly indicate state/UT from which you have passed SSC/Matriculation ?

Centre for examination[preference 1]

Centre for examination[preference 3]

Select the office you are applying for?

Centre for examination[preference 2]

Language for LPT:

. All Blindliness & Low vision Candidates gets extra time by default

Are you person with benchmark disability 40% or above?

Do you need Compensatory time at time of examination?

If yes, Do you need Compensatory time at time of examination?

Type of disability

Nature of disability

Are you suffering from cerebral palsy and you writing speed is affected

Whether your writing hand is affected?

If yes, Do you need Compensatory time at time of examination?

Do you intend to use service of scribe ?

Are you a persons with specified disabilities covered under the definition of Section 2(s) of the RPWDAct, 2016 but not covered under the definition of Section 2(r) of the said Act, i.e. persons having less.than 40% disability and having difficulty in writing ?

If yes, Do you need Compensatory time at time of examination?

Name of scribe

ID card of scribe

ID card number of scribe

| confirm that, | am eligible for Scribe as per the revised guidelines issued by Department ofEmpowerment of Persons with Disabilities (Divyangjan), Ministry of Social Justice & Empowerment,Government of India.

I undertake to produce UDID/disability certificate/ Appendix-I as applicable under revised guidelines, atthe time of examination.

1, also, confirm the educational qualification of the Scribe is as per the stipulation given in theadvertisement and documentary evidence to prove the education qualification of Scribe along with thePhoto ID card issued by the present college/university will be produced at the time of examination.

Are you Ex-servicemen?

Are you disabled Ex-servicemen?

Period of service[in months]

Are you dependent of Ex-servicemen killed in action?

Have you passed the S.S.C./Matriculation and rendered at least 15years of defence service ?

Are you seeking relaxation under widow /divorced women / womenjudicially Separated from their husbands and who are not re-married

Have you passed the S.S.C./Matriculation and rendered at least 15years of defence service ?

Consent to aadhhar card verification

Nationality

Whether employed in Government Service/ Quasi Govt.Organization/ Government owned industrial undertakings/ PSU /PSB / Public sector Financial Institutions, Public Enterprises or othersimilar organizations ?

aadhhar card Number

PAN card number

Are you proficient in the language (i.e. know to read, write, speakand understand the language) of any of the State/UT falling underthe recruiting office ? *

High School [10th]

Intermidiate [12th]

Passing Date

Marks Obtained

Marks obtained

Percentage