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ON-LINE APPLICATION FOR TNPSC REGISTRATION

25027
Registration # : 3273190

Full Name :

M SATHISH KUMAR

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 Sub Caste : Certificate No : Date Of Issue : Issuing Authority : Taluk : District : Address for Correspondence :

10362109 Village Administrative Officer NA NO NO --NO Indian

NO FEE 0.00

01/06/1982 MALE No Hindu NELLIKUPPAM Cuddalore A MAYAVAN Cuddalore Tamil M KANAGAVALLI Scheduled Caste (SC) ADI DRAVIDA 2153280 19/06/2000 Taluk Tahsildar Panruti Cuddalore 58, DR.AMBEDKAR NAGAR MELPATHI NELLIKUPPAM

District State : Pin : Permanent Address :

Cuddalore Tamil Nadu 607105 58, DR.AMBEDKAR NAGAR MELPATHI NELLIKUPPAM

District State :

Cuddalore Tamil Nadu

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 2002 Medium of Instruction Tamil

Tamil Nadu 607105

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kumarsathish701@yahoo.in 9994477593

Degree N/A -sslc

Major Subject N/A

SSLC -2621276 2002 GOVT.BOYS HIGH SCHOOL Yes Yes 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? : Under What Category? : 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

Cuddalore Cuddalore General Knowledge with Tamil Yes Scheduled Tribes Yes SC/SC(A) 3 1.Village Administrative Officer (Post Code:2025) 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: 2012-07-26 21:19:22

Signature of Applicant

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