4/9/2018 https://mahampsc.mahaonline.gov.in/MPSC/Forms/ApplicationFormView.aspx?

ID=5005&AdvNo=22/2018&str=FsLVz00jOo3qnTGO…

Maharashtra Public Service Commission

Online Application System

Insp_Cert_Sch_&_Inst_Gr_B
Profile Details
Examination Details
Exam Year : 2018 Adv No : 22/2018
Inspector Certified School And Institutions/Organisation and Methods Officer/Lecturer/District Women and Child
Post Name :
Development Officer/Superintendent/Statistical Officer,Group-B

Personal Details
Salutation : Shrimati
Full Name (In
English and in capital
SAPNA NAMDEVRAO Full Name
letters as per : : सपना नामदे वराव नकोसे
NIKOSE (Devnagri)
SSC/CBSE/ICSE
Certificate)
Surname : NIKOSE First Name : SAPNA Middle
Full Name :
Name : NAMDEV
Mother's Name : HARSHA Gender : Female
Date Of Birth : 25 Dec 1995 Age : 22
Mobile Number : 9975141301 Landline Number :0
Email Id : kripaekkaasdf@gmail.com
Whether Married : No
Age as on Date 01-07-
: 22 Years 6 Months 6 Days
2018

Aadhaar Details
Are you holding an
: Yes
Aadhaar card?
Name In English : (Exactly as mentioned on SAPNA NAMDEVRAO
Aadhaar No. : 559721445973 :
Aadhaar Card) NIKOSE

Physical Details
Height(In Cms.) : 156 Weight(In Kgs.) : 50

Permanent Address
Flat / Room / Door / Block Name of Premises /
: 35 : PINK BUILDING
/ House No. Building
Road / Street / Lane / Post
: HUDKESHWAR ROAD Area / Locality : GURUKRUPA NAGAR
Office
Landmark : PUNYADHAM MANDIR State / Union Territory : MAHARASHTRA
District : Nagpur Taluka : Nagpur (Urban)
Village/City : Nagpur (M Corp.) PinCode : 440034

Correspondence Address
Flat / Room / Door / Block Name of Premises /
: 35 : PINK BUILDING
/ House No. Building
Road / Street / Lane / Post
: HUDKESHWAR ROAD Area / Locality : GURUKRUPA NAGAR
Office
Landmark : PUNYADHAM MANDIR State / Union Territory : MAHARASHTRA
District : Nagpur Taluka : Nagpur (Urban)
Village/City : Nagpur (M Corp.) PinCode : 440034

Caste/Category Details
Category : SC
Do you belong to Non-creamy Layer? : No Exam Fee : 274
Caste Certificate No : MRC-81/8192/2009-2010 Issuing District : Nagpur
Do you have Caste Validity Certificate
: No
?

Other Details

https://mahampsc.mahaonline.gov.in/MPSC/Forms/ApplicationFormView.aspx?ID=5005&AdvNo=22/2018&str=FsLVz00jOo3qnTGOWtFc5gRelKGalq7tAAO9TFQ
4/9/2018 https://mahampsc.mahaonline.gov.in/MPSC/Forms/ApplicationFormView.aspx?ID=5005&AdvNo=22/2018&str=FsLVz00jOo3qnTGO…
Nationality Indian? : Indian Maharashtra Domicile Certificate? : Yes
Domicile Certificate No : 423 Issuing District : Wardha
Domicile Issuing Date : 05 Dec 2017
Mother Tongue : MARATHI
Are you a Person with Disability? : No
Whether Ex-serviceman? : No
Can you read, write and speak
: Yes Read : Yes Write : Yes Speak : Yes
Marathi?
Whether liable to be disqualified for the Government Services according to the provisions of Maharashtra
: No
Civil Services(Declaration of small family) Rules,2005?
Additional Qualification :
Extra Activities :
Hobbies :
Are you a Meritorious Sports Person? : No
Are you an employee of Government of
: No Are you employee of B.M.C.? : No
Maharashtra?
Are you employee of B.E.S.T.? : No

Black List
Whether any prosecution is pending in any Court of Law : No Was any Court Case filed against you? : No
against you?
Whether any disciplinary action has been initiated by : No Whether disciplinary or any other similar action is initiated : No
Government/Semi-Government Organisations against you? by Bar Council or Medical Council or Association or other
Professional/Vocational Institution?
Whether debarred or Black Listed for Examination / Selection : No
held by SSC Board / University / MPSC / Other P.S.C/ UPSC
or any other Organisations?

Qualification Details
Name Course
Qualification Result Percentage Class / Compulsory Optional
of Subject Board/University Attempts Duration(In Mode Remark
Type Date / Grade Grade Subjects Subjects
Degree Months)
1 2 3 4 5 6 7 8 9 10 11 12 13
17-06-
SSC SSC State Board 1 74.73 12
2011
06-06- Second Traditional
HSC HSC Science State Board 1 48.83 12
2013 Class / Regular
Rashtrasant
Tukadoji Maharaj
02-06- Second Traditional
Graduate B.A. Arts Nagpur 1 48.93 36
2016 Class / Regular
University,
Nagpur
Mahatma Gandhi
M.A. Antarrashtriya
Post
Social Hindi 0 0
Graduation
Work Vishwavidyalaya,
Wardha

Publication

Experience Details

Question
If previously recommended by MPSC? * No If previously interviewed by MPSC? * No
Other Questions
Do you possess prescribed educational qualifications as per the advertisement? * Yes

Total Experience after Prescribed Qualification : Years :

Months :
Days :
Income Details
Below 10000
During last one year (previous to last date of filing application) my average monthly gross salary (average monthly salary =
Gross salary earned during one year÷12) was Rs.
Declaration
Declaration:- I SAPNA NAMDEVRAO NIKOSE hereby declare that I have read the advertisement/notification for this Post and read the
information about the Post carefully. I accept it. I have assured for myself that I fulfill all the terms and conditions mentioned in the
advertisement/notification. All the information, provided in this application is true and correct to the best of my knowledge. I am aware that I will be

https://mahampsc.mahaonline.gov.in/MPSC/Forms/ApplicationFormView.aspx?ID=5005&AdvNo=22/2018&str=FsLVz00jOo3qnTGOWtFc5gRelKGalq7tAAO9TFQ
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liable for appropriate action (including loss of the job) if the information provided is found to be incorrect. I the undersigned hereby authorize and
give consent to M.P.S.C. for using my Aadhar details for verification of my identity.

Place * NAGPUR

Date * 09-04-2018

https://mahampsc.mahaonline.gov.in/MPSC/Forms/ApplicationFormView.aspx?ID=5005&AdvNo=22/2018&str=FsLVz00jOo3qnTGOWtFc5gRelKGalq7tAAO9TFQ