Registration Date:21-02-2017 11:28 AM Print Date:24-11-2018 08:51 PM

INDIAN ARMY
Directorate General of Recruiting
SSC(JAG)-22/901147

Application Details

MY
AR
Personal Details AN
1. Roll No SSC(JAG)-22/901147
2. Course Applied For SSC(JAG)-22
DI

3. Candidate's Name (As per Matriculation PIYUSH SHARMA

Certificate)
4. Father's/Guardian's Name JANARDAN SHARMA
IN

5. Mother's Name NALINI SHARMA

6. Date of Birth (As per Matriculation 05-11-1994
Certificate)
IN

7. Nationality INDIAN
8. Nationality, If‘Others’
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9. Marital Status Unmarried

10. Gender Male
11. Mobile No 8989402576
12. Email Address piyushchhotu@gmail.com
13. Aadhar No XXXXXXXX5617
14. (a)Permanent Address (b)Correspondence Address
Address 8, Ganesh Mandir Address 8, Ganesh Mandir
Road ,shujalpur Road ,shujalpur
mandi district- mandi district-
shajapur shajapur
City / Town / Village shujalpur City / Town / Village shujalpur
District Shajapur District Shajapur
State Madhya Pradesh State Madhya Pradesh
PIN 465333 PIN 465333
15 Previous SSB Attepmts
(a) Entry (b) Location (c) Year/Month (d) Result
16 Education Details
Registration Date:21-02-2017 11:28 AM Print Date:24-11-2018 08:51 PM

INDIAN ARMY
Directorate General of Recruiting
SSC(JAG)-22/901147

(a) Year of Passing LLB 2017

(b) Total Marks 3200.00
(c) Marks Obtained 2114.00
(d) Marks Percentage Obtained 66.06
(e) Name of College/Institute indore institute of law

MY
Address rau pithampur road,opp. iim
indore
City / Town/ Village Indore

AR
State Madhya Pradesh
District Indore
Pin AN 452001
17. BAR Council Certificate Yes
18. Whether College/University recognized Yes
DI

by Bar Council of India/State for LLB

Course
19. Are you eligible for registration with Bar Yes
IN

Council of India/State
Declaration
1. I have read the course notification as well as the instructions for filling this application on
IN

www.joinindianarmy.nic.in. I undertake to abide by all instructions /guidelines mentioned

therein.
2. I affirm that all information supplied by me as above is true and correct. I also fully
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understand that if at any stage, it is discovered that any attempt has been made by me
to willfully conceal or misrepresent the facts, my candidature may be summarily rejected
or employment terminated. I also undertake not to make any claim or compensation, if at
any stage of selection, my ineligibility is detected and my candidature is cancelled as a
result thereof.

Place:
Date:07-08-2018 05:16 PM

Signature of Applicant