1/3

ON-LINE APPLICATION FOR TNPSC REGISTRATION

This online application is provisional subject to payment of application fees/ intimation charges

22040
Registration # : 608260

Full Name :

P PRABHAKARAN

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 : 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 :

-Combined Engineering Services Examination NA NO NO --NO Indian

Indian Bank 175.00

27/05/1988 MALE No Hindu NALLAMANGALAM Virudhunagar B PANNEERSELVAM Virudhunagar Tamil P SANTHANAMARI Backward Class(BC) NADAR 4455415 16/07/2001 Deputy Tahsildar Rajapalayam Virudhunagar 2/133,PILLAIYAR KOVIL STREET, NALLAMANGALAM,POTTALPATTI(PO), RAJAPALAYAM(TK),

District State : Pin : Permanent Address :

Virudhunagar Tamil Nadu 626111 2/133,PILLAIYAR KOVIL STREET, NALLAMANGALAM,POTTALPATTI(PO), RAJAPALAYAM(TK),

2/3
District State : Pin : Contact Details : Email ID : Mobile No : EDUCATIONAL QUALIFICATION PARTICULARS : Exam Passed S.S.L.C : H.S.C : Degree : 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 : Name of the Examination Centre : Optional Subject (As per Notification) : Do you claim Age Concession? : Do You Claim Fee Exemption? : 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 INNOVETECHPRO SOLU TIONS Previous appearance for Oral Test / Written Test Name of the Post Register No. Year Designation PROJECT ENGINEER From(mm/yyyy) 02/2010 To(mm/yyyy) 02/2012 Nature of Duty HARDWARE B.E (Electronics and Communication Engineering) -H455349 2009 ANNA UNIVERSITY Yes Yes Chennai Electronics and Communication Engineering (Code No.044) No No 1.Assistant Engineer (Electrical) PWD 2.Assistant Inspector of Factories 3.Junior Electrical Inspector Not Applicable Not Applicable Year of Passing 2003 2005 2009 Medium of Instruction Tamil Tamil English N/A N/A others -hsc N/A N/A ELECTRONICS Degree Major Subject ppkaran44@gmail.com 9894293201 Virudhunagar Tamil Nadu 626111

---

---

---

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.

3/3
5. I have gone through the Instructions etc. to candidates and the Commissions notification for this Recruitment before filling up the application form.

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: 2013-01-18 12:51:40

Signature of Applicant

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