Ta Application Form - Ssbcrack (Page 2 of 3) in pdf

In lieu of IAF (TA)-9

APPLICATION FORM FOR COMMISSION IN THE TERRITORIAL ARMY FOR NON DEPT (INF) TA

1. Candidate’s

Self-attested

Name

photograph of

the candidate

size 4.5x 3.5 cms

To be filled in BLOCK CAPITALS in blue ball point pen.

(To be pasted)

2. Father’s

Name

House No

Block/Pkt

Village/Town

Post Office

3. Permanent

Tehsil

District

Address

State

Pin Code

e mail

Telephone No

House No

Block/Pkt

Village/Town

Post Office

4. Present

Tehsil

District

Address

State

Pin Code

Mobile No

Land Line No.

4 (a) Choice of written exam centre :

Chandigarh-01

Lucknow - 02

Patna-03

Kolkata

- 04

Shillong-05

Pune

-06

Bangalore-07

Jaipur - 08

Hyderabad-09

Udhampur - 10

Srinagar

-11

5. Date of Birth as given in Matric

6. Gender

7. No of attempts already made in SSB for :-

Certificate

(Strike out whichever is not applicable)

NDA

CDSE

Day

Month

Year

8. Educational Qualification

9. Educational Stream

10. Nationality

Code : Graduation

- 01

Code : Arts – 01, Science – 02,

Post Graduation - 02

Commerce – 03, Engineering – 04

Medical – 05, MBA – 06 & Any other – 07

11. Marital Status :

12. Next of Kin

12 (a). Name of next of kin

Code : Single -01

Code : Father – 01, Mother – 02, Wife- 03,

Married – 02 Divorced - 03

Son – 04, Daughter – 05 & Other - 06

13. Nature of employment

Code : Central Govt/Union Territory

- 01

State Govt/Semi Govt

- 02

with code

Self Employed

- 03

Pvt Sector

- 04

DETAILS OF PREVIOUS SERVICE IN THE ARMED FORCES (IF APPLICABLE)

14.

Details of previous service in the Armed Forces (write code wherever applicable).

(a)

Service

Code : Army-01, Air Force-02, Navy-03, TA-04

(b)

Substantive Rank

(c)

Service Number

(d)

Date of commission

(e)

Date of Retirement

(f)

Arms / Service &

(g)

Medical Category at

Unit

the time of release

15.

Reason for Discharge

Code : Med Bd Out

- 01

Voluntary Discharge

- 02

Disciplinary Ground

- 03

On Superannuation

- 04

Resignation

- 05

Any Other

-06

16. DECLARATION.

In the event of my selection for commission in the Territorial Army, I am willing to serve anywhere in India for longer duration

also, whenever required, or as per the rules and orders in force from time to time.

I clearly understand that if at any time during the period of probation I am not found suitable, I shall have to resign my

commission in accordance with the rules and orders in force from time to time and in case I decline to do so I am liable to be

discharged/removed from the Territorial Army.

I am fully aware that if it is found at any stage that I have knowingly furnished any details which is/are false or have

suppressed material information or I fail to comply with the above undertakings, my candidature will be rejected summarily and

if already commissioned, I shall be liable to be discharged/removed from the Territorial Army.

Dated :

Signature of Candidate

Ta Application Form - Ssbcrack Page 2

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