GOVERNMENT OF MAHARASHTRA

MAHAPARIKSHA MUMBAI , MAHARASHTRA

Maharashtra Information Technology Corporation Ltd. (MAHA IT), 514, 5th Floor, Mantralaya,
Hutatma Rajguru Chowk, Madam Cama Road, Mumbai - 400032
E-mail:[email protected]

Personal Details
Posts/Services Applied for Driver ( Grade -II)
Application Id MIDC_DGII_0133595
First Name YOGESH
Middle Name GORAKH
Last Name PAGARE
Mother's Name SHAKUNTALA
Father's Name GORAKH
Nationality INDIAN
No of Children 1
Whether liable to be disqualified for the Government Services according to the pro No
visions of Maharashtra Civil Services (Declaration of small family) Rules, 2005?
Gender MALE
Date of Birth Mar 2, 1990
Candidate's Name YOGESH PAGARE
Mobile Number 8180998877
Marital Status SINGLE
Name Change Status NOT CHANGED
Changed First Name NOT APPLICABLE
Changed Middle Name NOT APPLICABLE
Changed Last Name NOT APPLICABLE
Domicile of Maharashtra YES
Category (Category through which you want to apply for the recruitment) : GENERAL

Note:Candidate opting for reservation category have to provide original caste category certificate during document verification else your reservation benefits will be rejected.

Caste Certificate NOT APPLICABLE

Caste Validity Certificate NOT APPLICABLE
Caste Certificate Number NOT APPLICABLE
Place of Issue NOT APPLICABLE
Are you an existing Permanent MIDC (Maharashtra Industrial Development Corpor NOT APPLICABLE
ation) employee?
Select your Highest Educational Qualification SSC
Are you 1991 Census employee? YES
Are you 1994 Election Officer? NO
Are you a son/daughter/wife of a Freedom Fighter ? NO
Do you want to avail the benefit of female Reservation ? NOT APPLICABLE
Physical Disability NOT APPLICABLE

Note :Physical Handicapped Reservation will be provided as per the reference GR mentioned in the advertisement and available vacancies against a Physically Handicapped
type for a cadre/post.

Do you have disability certificate (minimum 40%?) (SADM, Software for Assessme
NOT APPLICABLE
nt of disability)

Note :Medical certificate of disability issued by competent authority prior to SADM and the other certificates or SADM will be accepted once verified at the time of document
verification.
One Arm affected(OA) NOT APPLICABLE
OL : One Leg affected NOT APPLICABLE
OAL : One Arm and One Leg Affected NOT APPLICABLE
BL : Both Leg Affected NOT APPLICABLE
HH :Hearing Handicapped NOT APPLICABLE
LV : Low Vision NOT APPLICABLE
Blind NOT APPLICABLE
Scribe/Assistant Needed NO
Aadhaar Card Number 455958231931
Aadhaar Enrollment Number NOT APPLICABLE
Are you Orphan as per Women and Child Development Department's Government R
esolution No.अमुजा- २०११/ . . २१२/ का- ३, द. २ए ल२०१८ ? NOT APPLICABLE

Project Affected or Dependent on Project Affected? NOT APPLICABLE

Earthquake Affected (Whether death of any family member or the house collapsed NOT APPLICABLE
in the earthquake has been rebuilt by the government ?)
Are you Anshakalin (Part-time) Employee? (As per reference GR शासन नणय . प अं
NOT APPLICABLE
क-१००९/ . . २०० /२००९/१६-अ , द . २७. १०. २००९) ?

Note: Candidate applying for Anshakalin (Part Time Employee Quota) should have “registration Certificate of Employment exchange office” at the time of appointment.

Name of Office (Anshakalin): NOT APPLICABLE

Appointing Authority (Anshakalin): NOT APPLICABLE
Part Time Experience in Years NOT APPLICABLE
Part Time Experience in Months NOT APPLICABLE
Part Time Experience in Days NOT APPLICABLE
Do you have MSCIT certification or equivalent certification ? NOT APPLICABLE
Marathi Language Proficiency(READ) APPLICABLE
Marathi Language Proficiency(WRITE) APPLICABLE
Marathi Language Proficiency(SPEAK) APPLICABLE
Are you son/daughter of a suicidal farmer? NOT APPLICABLE
Non-Creamy layer certificate NOT APPLICABLE
Are you an Ex-Serviceman? NOT APPLICABLE
Retired Ex-Service man NOT APPLICABLE
Years of service (Ex-Servicemen) NOT APPLICABLE
Differently abled Ex-Serviceman NOT APPLICABLE
Are you government / semi-government employee? NOT APPLICABLE
Name of the Office/Department: NOT APPLICABLE
Joining date: NOT APPLICABLE
Sports Quota NOT APPLICABLE
Meritorious sportspersons Reservation: NOT APPLICABLE
Have you sent all sports certificate from director/deputy director, sport for verificat NO
ion?
Do you have Minimum 2 years experience of driving after obtaining Driving Licence(HMV) ? YES

Note 1:Entering the education qualification is mandatory. Please ensure you have original documents and marksheet for the qualification you have entered as this will be
checked at the time of document verification during the appointment and selection process by the concerned department.

Note 2: If you don't fulfill the education and eligibility criteria as per details in the published advertisement for this recruitment exam, please do not apply. If the required proof
and documents are not submitted during further stages of selection process, your candidature will be rejected.

Address Details of the Candidate

Address Type Address
Both Permanent and Current Addr
ess Near kalbhor sabhagruh , Komal complex pandharkar wasti , Akurdi,HAVELI MAHARASHTRA 411035

Educational Qualification Details

Educational Quali Name of the c Qualified fro Name of the Bo Marks Obtain Marks Maxim
fication ourse m ard/University N Passed on ed um Percentage Percentile CGPA GRADE
ame
Maharashtra St
ate Board of Se
SSC condary and Hi Jun 26, 2007 343 650 52.77
gher Secondary
Education
Adarsh madhya
VIIth Std. mik vidyamandi May 1, 2005 629 1000 62.9
r vinchur
Exam Center Details
Preferred Exam Center Location1 Preferred Exam Center Location2 Preferred Exam Center Location3
PUNE DHULE NASHIK
Payment Details
Transaction Type Transaction Id Transaction Status Transaction Date Total Fees
ONLINE MAHAIT_MIDC_000000223216 SUCCESS 04/08/2019 06:25 PM 700
Before logging on to the registration portal
 Sr.No Undertakings
1. I have read and understood the Advertisement carefully before filling in the form.
2. I have scanned my photograph and signature ready on my desktop confirming to the specified standards mentioned in the information Brochure.
3. I have downloaded the advertisement and read it carefully before filling the form.
4. I have the details for payment (Credit Card / Debit Card / Internet Banking) available with me for making Online payment.
5. I agree that my application form will be treated as complete only if I finally submit the application along with the payment of necessary fees.
6. I agree to bear the payment gateway additional charges
7. I accept to receive messages from MAHA-IT even if my mobile number falls under Opt-in and / or DND (Do Not Distrub)/ DNC(Do Not Call) category.
Before submitting the form
Sr.No Undertakings
1. I fulfill the conditions as specified in the eligibility criteria and registration guidelines.
2. All the particulars provided by me in this application are true, correct and complete to the best of my knowledge and belief.

3. I shall produce all the original documents along with the attested copies as and when required, failing to which I will be considered as blacklisted
and debarred.

4. In case any particulars given by me in this application are found to be false, incorrect and /or misleading, I shall be liable for being blacklisted or
debarred from all further examinations and selection processes of Maharashtra Industrial Development Corporation,Mumbai.
Printed On:04/08/2019 06:30:23 PM