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ON-LINE APPLICATION FOR TNPSC REGISTRATION

41029
Registration # :

418522298

Notification. No. :

18/2014

Full Name :

P PRAGALATHAN

Do you have One Time Registration ID? :

YES

One Time ID :

12092569

Name of The Post Applying for :

Junior Assistant/Bill Collector/Field Surveyor/Draughtsman

Are you a Destitute Widow? :

NA

Are you a Differently Abled Person? :

NO

Are you an Ex-Serviceman ? :

NO

PPO No :

--

Date of Discharge / Probable date of Discharge :

--

Are you a Government Employee? :

NO

Nationality :

Indian

Application Fee / Intimation Charges details:

Payment Mode:

Net Banking

Amount :

75.00

Personal Details :
Date of Birth :

06/04/1981

Gender :

MALE

Marital Status :

Married

Spouse's Name :

P SARANYA

Religion :

Hindu

Candidate's Place of Birth :

AVARIKKADU

Native District :

Nagapattinam

Father's Name :

A PASUPATHY

Father's Place of Birth :

Nagapattinam

Mother Tongue :

Tamil

Mother's Name :

P SUSILA

Communal Category :

Most Backward Class(MBC)

Name of the SubCaste :

Vanniakula Kshatriya

Certificate No :

104621

Date Of Issue :

12/06/1996

Issuing Authority :

Zonal Deputy Tahsildar

Taluk :

Vedaranyam

District :

Nagapattinam

Address for Correspondence :

2/21F, AVARIKKADU POST

KARIYAPPATTINAM VIA
VEDARANIYAM TALUK

District

Nagapattinam

State :

Tamil Nadu

Pin :

614806

Permanent Address :

2/21F, AVARIKKADU POST

KARIYAPPATTINAM VIA

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KARIYAPPATTINAM VIA
VEDARANIYAM TALUK
District

Nagapattinam

State :

Tamil Nadu

Pin :

614806

Contact Details :
Email ID :

vsqure2003@gmail.com

Mobile No :

9698991978

EDUCATIONAL QUALIFICATION PARTICULARS :

Exam Passed

Date of
Publication of

Medium of
Instruction

Degree

Tamil

N/A

Tamil

H.S.C

Major Subject

Board / University

N/A

STATE BOARD OF
TAMILNADU

N/A

STATE BOARD OF
TAMILNADU

Results
S.S.L.C :
H.S.C or Equivalent
Qualification :

17/06/1999
28/05/2001

Others :

I.T.I - 2003

Do you claim reservation for Persons Studied in Tamil Medium (PSTM)? :

No

Are you trained person in Survey in ITI, Tamil Nadu?

(Eligible for Field Surveyor and Draughtsman post only)? :

No

Whether you are applying with the Educational Qualification as Prescribed in

Prescribed Qualification
the notification or with an equivalent qualification :
Details regarding the prescribed qualification :
Qualification Details :

SSLC

Certificate No :

0627770

Year of Passing :

2009

Name of the Authority/ University :

STATE BOARD OF TAMILNADU

Preferential qualification for per notification :

No
English

Type writing / Short hand Qualification

Cert. No. Issued by Dir. of

Technical Education

Tamil

Cert. No. Issued by Dir.

of Technical Education

Type
Writing

--

--

--

--

Short
hand

--

--

--

--

Computer Qualification (for Typist and Steno-Typist, Grade III) ?

Do you possess Certificate Course in Computer on Office Automation
awarded by the Technical Education Department? :

No

Physical Standards as per notification :

Yes

Name of the Examination Centre District:

Nagapattinam

Name of the Examination Centre :

Vedaranyam

Optional Subject :

General Studies with General Tamil (S.S.L.C Standard)

Do you claim Age Concession? :

No

Do You Claim Fee Exemption? :

No

Criminal Case (Registered/Pending/Punishment awarded) :

Not Applicable

Participation in Political Activities (In agitation/As a Member of Political

Organisation/Candidature in Election) :

Not Applicable

Experience Details :
Name of the Organisation

Designation

From(mm/yyyy)

To(mm/yyyy)

Nature of Duty

Previous appearance for Oral Test / Written Test

DECLARATION:

Name of the Post

Register No.

Year

--

--

--

--

--

--

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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.

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 / disqualified by the TNPSC or any other recruiting agency.

8. I am not a dismissed Government Employee.

I accept the above declaration

Place:

Date: 2014-10-31 16:40:36

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

Signature of Applicant