ONLINE APPLICATION FOR GAZETTED PROBATIONERS PRELIMINARY EXAMINATION 2014

Final Printout of your Application with photo and signature should be produced at the time of
verification.
Application ID

5292670
Personal Details

Full Name of the

Candidate

SHAHEDA FATIMA

Date of Birth

01-05-1986

Mother Name

TAHERA BI

Father Name

SHAMSHUDDIN

Spouse Name

AHMED SHAH

Gender

FEMALE
Contact Details
H.NO.5-470/15/36

Full Address

BULAND PARVAZ COLONY

GULBARGA

District

GULBARGA

Pincode

585104

E-mail id

galaxycafe5@gmail.com
Qualification Details

Do You Possess a degree ?

Yes

Have you attended the previous Gazetted

Probationers Preliminary Examinations conducted
by the commission ?

No

Category Details
Reservation claimed

CAT1

Sub-caste

DARVESH
Rural Candidate Details

Are you a Rural Candidate ?

No
Kannada Medium Candidate Details

Are You Kannada Medium Candidate ?

No

Hyderabad-Karnataka Region Candidate Details

Are You Hyderabad-Karnataka Region Candidate ?

Yes

Physically Handicapped/Disabled Candidate Details

Are You Physically Handicapped Person ?

No

Ex-Military Person(EX-MP) Details

Are you claiming Ex-MP Reservation?

No

Government Employee Details

Are You Government Employee ?

No
Widow Candidate Details

Are You a Widow Candidate ?

No
Debarred Details

Have you ever been debarred in any examination Conducted by KPSC/UPSC/other States
PSC s or any Selection Authorities/Organizations ?

No

Examination center Details

Examination Centre

GULBARGA
Declaration

I hereby declare that all contents entered in this application are true,complete and correct to the best of
my knowledge and belief. I have read the rules and understand that in the event of any information being
found false or ineligibility being detected before or after the selection, my application is liable to be
rejected. Action can be taken against me by the Commission / Government under rule 20 of the karnataka
Civil Services (General Recruitment) Rules 1977 as amended from time to time. I have read the rules and
instructions carefully and hereby undertake to abide by them. I further declare that I fulfill all the
eligibility conditions regarding age, educational qualification, reservation etc., wherever applicable,
prescribed for the post/Examination. I have not exceeded the number of attempts prescribed for me.
Educational Background Details
Education Details

Bachelor Degree

Selected Qualification

Others