Boi-Data for Mpsc Exam

www.mpsc.com

Note:      Please ensure that no column is left blank; but you may not fill up the column which does not concern you.

MAHARASHTRA PUBLIC SERVICE COMMISSION

PROFORMA  FOR  BIODATA

FOR OFFICE USE ONLY Index No.:_________________ 1. File No.__________________________      2. Date of Empanelment:______________________ 3    Degree/Diploma/Subject________________________               Code:___________________ 4.   Specialisation_________________________________                 Code:__________________ 5.    Super/Sub Specialisation:______________________                  Code:_________________

(Only column nos.        to       are to be filled in by the Expert)

Shri

Smt.

Kumari

Prof.

Dr.

6.Please Tick (ü) on Appropriate Box  :

7.Full Name     

Surname ...................

First Name ..............

Father’s / ................

Husband’s Name

 

DD			MM			YYYY

8.Date of Birth :

Male

Female

9.Gender                      :                                                               

10.  Please indicate whether serving under Central Govt./State Govt./Autonomous Organization/University/any other Institution/Pvt. Organization/Central or State Govt. Undertaking or Self employed             :       _______________________________

 

11.  Present Designation, if serving      :           _______________________________

 

12. Name of your Office/Organisation/

Institute/University             :           __________________________________

     

13.  Last Designation and the name of the last Organisation,

if retired from service                     :           _______________________________

14.  Date / month /year of

Retirement from service                 :          

 

15.Particulars of employment/assignment

     taken after retirement from service, if any :

      ___________________________________________________________

      ___________________________________________________________

      ___________________________________________________________

16. Kindly indicate the name of Service to which you belong/belonged e.g. IAS/ IA&AS/

      CSS/IFS/IPS/IRS/and other services under Government of India or State Civil

      Service or any other service under  a state Government or service under any other

      autonomous organisation under the state  Government/Government of India/Private

      Sector/Self Employed        : _________________________________________________________

17. Scale of Pay                       :           __________________________________

(If retired, indicate the scale of pay at the time of retirement or the last pay drawn)

18. Present basic Pay               :           __________________________________

      (If still in service)

19.If self employed please indicate

average monthly income    :           __________________________________

20.  Office Address                   :           __________________________________

      (If still in service including             __________________________________

employment after retirement)         __________________________________       

                                                            Dist __________________ State _________________

                                                                                PIN CODE

21.  Last Office Address            :           __________________________________

      (If retired and not employed           __________________________________

in any capacity)                             __________________________________

 

                                                            Dist __________________ State _________________

                                                                                PIN CODE

22.  Postal Address                   :           __________________________________

      (If residential address is the           __________________________________

postal address,please indicate so) _________________________________

(Please note that the MPSC will     

send all the correspondence          Dist __________________ State _________________

to you at this address)                                                                               

                                                                                PIN CODE

23. Telephone No(s) with STD Codes:   Office: __________________________   

(Strike out if you do not                 Residence: ______________________________

have Fax No. or Email)                   Mobile : _____________________________

Fax No. Residence: __________________

                                                            Email:

24.  Academic/Professional Qualification starting with First Degree or Equivalent : (Example if you are a scholar with a doctorate in any subject, the first degree will be either BA/BSc or equivalent)

Sr. No.	DEGREE/ DIPLOMA	YEAR	NAME OF THE UNIVERSITY/INSTITUTION	SUBJECT:MAJOR/ SUBSIDIARY
1
2
3
Sr. No.	DEGREE/ DIPLOMA	YEAR	NAME OF THE UNIVERSITY/INSTITUTION	SUBJECT:MAJOR/ SUBSIDIARY
4
5
6
7
8
9
10

25.  Field of specialisation: ( To be filled in on the basis of Academic Qualifications and Job/ Service Experience only)

(Please see the bottom of this page before filling it up)

Sr.No.	MAIN FIELD	SPECIALISATION	SUPER-SPECIALISATION

# Illustration:

MAIN FIELD OF STUDY	SPECIALISATION	SUPER-SPECIALISATION
MEDICAL SCIENCES MANAGEMENT LAW	SURGERY PERSONNEL MGT. INTERNATIONAL LAW	THORACIC SURGERY INDUSTRIAL RELATIONS LAW OF THE SEAS

26.  Jobs/Positions held during the last 15 years including Current/Last position held (Please state chronologically starting with the job/position held 15 years ago)

Sr. No.	Name of the Office/ Organization	Designation	Year From            To	Job Description
1
2
3
4
5
6
7
8
9
10
Sr. No.	Name of the Office/ Organization	Designation	Year From            To	Job Description
11
12
13
14
15

Illustration:-

Field	Sub Field	Nature of Job
Surgery	Orthopaedic Surgery	Teaching
Surgery	Thoracic Surgery	Applied Side
Management	Personnel Management	Research
Civil Engineering	Geotechnical Engineering	Applied Side
Law	Income Tax Law	Applied Side
Chemistry	Analytical Chemistry	R&D

Note:    Experience in the field other than Teaching and Research is treated as experience on the “Applied side”.

27.  If you claim Research Experience, Please indicate:

27.1   Nos. of Independent/Co-Authored

Research Papers Published in         

recognized Journals             :__________________________________

27.2   Total No. of Students guided for

Doctoral/Post Doctoral Research :_______________________________      

27.3  Total No. of such Students who have

successfully completed Research :______________________________

28. If you claim Experience on the Applied Side(Other than Teaching), Please give a brief account of Duties performed/being performed by you:

            ________________________________________________________

            ________________________________________________________

            ________________________________________________________

            ________________________________________________________

29.  Languages Proficiency(Including Foreign Languages):

            (Please see the bottom of this page before filling it up).

Sr.No.	Languages	Level of knowledge

Note:  In the Level of knowledge Column, indicate Excellent/Good/ Fair.

30.  Brief particulars of experience in years as an Expert for Examination Bodies :

            (Please see the bottom of this page before filling it up).

Sr N0.	Experience	Level
		S.S.C.	H.S.S.C.	Diploma	Degree	P. G.	Competitive Examinations	Others
30.1	For Conventional / Descriptive Examinations
30.1.1	As a Paper Setter
	Subject
	Medium of Language
	No. of Years
30.1.2	As a Examiner
	Subject
	Medium of Language
	No. of Years
30.1.3	As a Moderator
	Subject
	Medium of Language
	No. of Years
30.1.4	As a Chief Moderator
	Subject
	Medium of Language
	No. of Years
30.2	For Objective Examinations
30.2.1	For Question Setting
	Subject
	Medium of Language
	No. of Years
30.2.2	For Review of Questions
	Subject
	Medium of Language
	No. of Years
30.2.3	As a Paper Setter
	Subject
	Medium of Language
	No. of Years

    

31.Current Membership of Professional Bodies, if any :

National Level	International Level

32.Awards won, if any (Indicate Year):

National Awards	International Awards

33.Have you ever-faced any Vigilance Enquiry or enquiry by anti-corruption bureau/Central Bureau of Investigation or any other Investigative Organisation :

      Please write YES or NO                                          :           _________________

      If Yes : Please indicate  in brief, the details of the Vigilance Enquiry and outcome thereof (If exonerated, a copy of the order passed by the competent authority may be furnished)    

            ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

34.  Any other information you may like to furnish to the UPSC :

            ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

DECLARATION

      I  DECLARE THAT THE ENTRIES MADE IN THE COLUMNS OF THIS PROFORMA ARE CORRECT AND TRUE TO THE BEST OF MY KNOWLEDGE AND NOTHING HAS BEEN EITHER CONCEALED OR MISREPRESENTED BY ME.

Place:                      

Date :                                                                                                                              SIGNATURE      

                       

Certificate

Certified that, the information given by Shri / Smt./ Kum./ Prof./ Doctor ________________________________________________                                                                                                  is correct to the best of knowledge and he / she is of a  high morality, integrity and devotion to the confidential work of Examination and he / she has no connection with any coaching classes.  

       

       

Signature of Competent Authority with Seal *

        * If Retired please obtain Certificate from the Competent Authority at the time of retirement

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