Application Registration No: 63005817296 for the Multi Tasking(Non - Technical) Staff In Different States/ UTs, 2016

Your Application is Completed

1.& 1.1. Name of Center and Center Code : SR-Tirupati(8006)
SR-Chennai(8201)
SR-Hyderabad(8601)
2.Candidate Name : PUTTAMCHETTY SRINIVASA SAI
3.Father's Name : P LAKSHMI RAYULU
4.Mother's Name : P ESWARAMMA
5.Date of Birth (dd/mm/yyyy) : 09/08/1997
6. Age(as on 01.08.2017) : 19.11
7. Nationality : Indian
8.Gender : Male
9.Category : General
10. Whether PH (PWD) : No
10. If yes, indicate code :
10.1. Whether Ex-Serviceman? : No
10.2. For Ex-Serviceman-Length of Service(in years) :
10.2. Date of discharge (dd/mm/yyyy) :
11. Whether seeking Age relaxation? : No
11.1. If yes, indicate code :
12. Whether suffering from cerebral palsy? :
12. If VH/Cerebal Palsy candidate, whether scribe is required ?
13. if yes indicate medium :
14. Whether you belong to Religious Minority Community ? : No
15. Aadhar Card Number (If available):
16.Mark of Visible Identification :
17. State/UT Code : 34672ABCDEFGHUIJKLMNOPQRSTVWXYZ15
18. Educational Qualification : Graduate
19. Details of Work Experience :
Period of
Period of
Service
Name of the organisation Designation Nature of Duty(ies) Service To
From
(mm/yyyy)
(mm/yyyy)
20.Postal Address : 6-203 GANDLA STREET NEWPET CHANDRAGIRI
Village/City : TIRUPATI
District : CHITTOOR
State : Andhra Pradesh
Pincode : 517101
21.Permanent/Domicile Address : 6-203 GANDLA STREET NEWPET CHANDRAGIRI
State : Andhra Pradesh
Pincode : 517101
STD Code : 0877
Phone Number : 2276435
Mobile Number : 8919486136
Email ID : spider.seenu2010@gmail.com
22.Photo 23.Signature
Payment Details :
Transaction id : IK00BZTCP2
Transaction Date(yyyy-mm-dd) : 2017-02-01
Amount : 100
Declaration
I hereby declare that all the statements made in this application are true, complete and correct to the best of my knowledge and
belief. I understand that in the event of any information being found suppressed false or incorrect or ineligibility being detected
before and after examination, my candidature/appointment is liable to be cancelled.
Place:
Date (yyyy-mm-dd):2017-02-01
Signature of Candidate

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