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Nsi Verification

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CONFIDENTIAL

VERIFICATION ROLL
NAME OF THE POST :

1. a) Name (As per SSC Certificate) :


 bvg (evsjvq) :
 Alias (if any) :
b) Nationality :
2. a)  Father's Name (As per SSC Certificate) :
 wcZvi bvg (evsjvq) :
 Designation of Service :
 Nationality :
b)  Mother's Name :
 gvZvi bvg (evsjvq) :
 Designation of Service :
 Nationality :
3. Permanent Address (detailed) : Village:
Post Office:
Upazilla/Police Station:
District:
4. Present Residential Address (detailed) : Holding No./Village:
Block No.:
Post Office:
Upazilla/Police Station:
District: Cell Phone:
5. Addresses of the last 05 years where the candidate stayed/has stayed for more than six months:

Address From To

6. Date & Place of Birth (Village, :


Post Office, Upazilla/police station &
District etc.)

7. Educational qualification showing places of education with years in School, College and
University from 15th years of the Candidate.

Name of School, College and Date for entering Date of leaving Living address
University

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(2)
8. Full particulars of the near relations if any i.e. brothers, sisters, first uncles and first relations-
in law who are in the service of the Government of Bangladesh, specifying the posts and where
posted:

Name of Relations Designation Posting Place & Organization

9. Name of close relations with their profession, age & address :


(a) Paternal grandfather & paternal uncles:

(b) Maternal grandfather & maternal uncles:

(c) Brothers including cousin & brother-in-law:

(d) Sisters including cousin & sister-in-law:

10. Name of friends and classmates of College & University with their profession & present
address:

BOY FRIENDS GIRL FRIENDS

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(3)

11. Name of association, clubs or other organizations including College Unions he/she is/has
been associated with:

1)

2)

3)

12. Name and value of properties held by the candidate, his wife & children (also how acquired):

Movable Properties Immovable Properties

I solemnly affirm that the particulars supplied therein are correct to the best of my knowledge.

Date: Signature of the Candidate

OFFICIAL USE ONLY

REMARKS:

Signature :
Name :
Designation :
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CONFIDENTIAL

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