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ON-LINE APPLICATION FOR TNPSC REGISTRATION

24041
Registration # : 3727320

Full Name :

K SUBA

One Time ID : Name of The Post Applying for : Are you a Destitute Widow? : Are you a Differently Abled Person? : Are you an Ex-Serviceman ? : PPO No : Date of Discharge / Probable Discharge / Date : Are you a Government Employee? : Nationality / Citizenship : Application Fee / Intimation Charges details: Payment Mode: Amount : Personal Details : Date of Birth : Gender : Married : Spouse's Name : Religion : Candidate's Place of Birth : Native District : Father's Name : Father's Place of Birth : Mother Tongue : Mother's Name : Communal Category : Name of the SubCaste : Certificate No : Date Of Issue : Issuing Authority : Taluk : District : Address for Correspondence :

-Village Administrative Officer NO NO NO --NO Indian

Net Banking 125.00

29/06/1986 FEMALE Yes SUBASH Hindu NAMAKKAL Namakkal V KANDASAMY Namakkal Tamil K SELVI Backward Class(BC) KONGU VELLALAR 4347956 02/11/2000 Deputy Tahsildar Namakkal Namakkal W/O, V.SUBASH SENGODAMPALAYAM, SILUVAMPATTI(PO),NKL(DT)

District State : Pin : Permanent Address :

Namakkal Tamil Nadu 637003 W/O, V.SUBASH SENGODAMPALAYAM, SILUVAMPATTI(PO),NKL(DT)

District

Namakkal

District State : Pin : Contact Details : Email ID : Mobile No : EDUCATIONAL QUALIFICATION PARTICULARS : Exam Passed S.S.L.C : Others : Whether studied Tamil as one of the subject : Details regarding the prescribed qualification : Qualification Details : Other Equivalent Qualification Details : Certificate No : Year of Passing : Name of the Authority/ University : Preferential qualification for per notification : Preferential Physical Standards for per notification : Year of Passing 2001 Medium of Instruction Tamil

Namakkal Tamil Nadu 637003

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subash.maths@gmail.com 9843798767

Degree N/A ---

Major Subject N/A

SSLC -1252830 2001 STATE BOARD No No English Tamil ---

Type writing / Short hand Qualification

Type Writing Short hand

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Name of the Examination Centre District: Name of the Examination Centre : Compulsory Subject : Do you claim Age Concession? : Do You Claim Fee Exemption? : Under What Category? : No of free Attempts : Post Preference : Criminal Case (Registered/Pending/Punishment awarded) : Participation in Political Activities (In agitation/As a Member of Political Organisation/Candidature in Election) : Post Qualification work experience (Start from present Employer) : Name of the Organisation Previous appearance for Oral Test / Written Test Name of the Post Designation

Namakkal Namakkal General Knowledge with Tamil No Yes Backward Class/Backward Class (Muslims) 1 -Not Applicable Not Applicable

From(mm/yyyy)

To(mm/yyyy)

Nature of Duty

Register No.

Year

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DECLARATION:
1. I hereby declare that all the particulars furnished in this application are true, correct and complete to the best of my knowledge and belief. In the event of any information being found false or incorrect or ineligibility being detected before or after the examination, action can be taken against me by the TNPSC. 2. I hereby declare that I will not be a party to any kind of canvassing on my behalf.

3. I further declare that I fulfil all the eligibility conditions prescribed for admission to the examination.

4. I have informed my employer in writing that I am applying for this Examination.

5. I have gone through the Instructions etc. to candidates and the Commissions notification for this Recruitment before filling up the application form.

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6. I declare that I possess the medical standards prescribed for the post(s) which I am now applying.

7. I certify that I have not been debarred by the TNPSC or any other recruiting agency.

8. I am not a dismissed Government Employee.

I accept the above declaration

Place:

Date: 2012-08-09 21:35:02

Signature of Applicant

Please retain your Registration No. and Password emailed to you carefully for further reference