CPL Driver 2

                                                                        2

                                                                                                                                                Appex ‘A’

Photo

BIO- DATA 

1.         Name in full (In block capital letters)   :

2.         Code No & Trade                                     :  

3.         Present Address :    

4.         Permanent Address                                 :        

5.         Father’s Name                                        :   

6.         Mother’s Name   :                                

7.         Name & Address of NOK (relation)        :   

8.         Nationality :                   

9.         Religion                                                     :      

10.       Are you SC/ST/OBC/UR                         :   

11.       Date of Birth     :         

12.       Place of Birth                                            :   

13.       Present age (Attach proof) :

14.       Educational Qualification                        :    

15.     Details of driving licence                           :  

            (1) Issuing authority                                  :

            (2) Date of issue                                       :  

            (3) Type of vehicle auth to drive              :

16.       Experience if any                                     : 

 17.      NRS                                                          :

18.       Nearest Police Station                           :

19.       Name of two responsible persons of    :         1………………………………..         

 your locality or to reference to whom you:                  2………………………………..

 are known (A Govt servant or a permanent    

 local society)

I certify that the foregoing information is correct and complete to the best of my knowledge and belief. I am not aware of any circumstance, which might impair my fitness for employment under Govt.

Place :-

Date :-                                                                                    (Signature of the candidate)

Code No

Name