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ON-LINE APPLICATION FOR TNPSC REGISTRATION

44022
Registration # : 317195846

Full Name :

C KALEESWARAN

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 date of Discharge : 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 :

10217859 Group-I Services NA NO NO --NO Indian

NO FEE 0.00

10/02/1990 MALE No Hindu MADURAI Sivaganga S CHINNA KARUPPIAH Madurai Tamil C IRULAYEE Scheduled Caste (SC) Pallan 2651656 17/06/2003 Taluk Tahsildar Manamadurai Sivaganga 2/180 SAYANAPURAM PANAIYUR(POST)

District State : Pin : Permanent Address :

Madurai Tamil Nadu 625009 2/180 SAYANAPURAM PANAIYUR(POST)

District State : Pin :

Madurai Tamil Nadu 625009

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Contact Details : Email ID : Mobile No : EDUCATIONAL QUALIFICATION PARTICULARS : Exam Passed Date of Publication of Results S.S.L.C : H.S.C or Equivalent Qualification : Degree : 04/06/2005 14/05/2007 Medium of Instruction Tamil Tamil N/A H.S.C N/A N/A MATHEMATICS 09/08/2010 English B.Sc. STATE BOARD STATE BOARD MADURAI KAMARAJ UNIVERSITY Degree Major Subject Board / University mathskalees@gmail.com 9500765727

Others : Do you claim reservation for Persons Studied in Tamil Medium (PSTM)? : Details regarding the prescribed qualification : Qualification Details : Other Equivalent Qualification Details : Certificate No : Year of Passing : Name of the Authority/ University : Do you have the preferential qualification as per notification? : Physical Standards as per notification : Name of the Examination Centre : Compulsory Subject : Do you claim Age Concession? : Do You Claim Fee Exemption? : Under What Category? : No of free Attempts : 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

DCA No

Any Degree -SSG 30048753 2010 MADURAI KAMARAJ UNIVERSITY No No Madurai General Studies (Degree Standard) No Yes SC/SC(A) morethan3 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 / disqualified by the TNPSC or any other recruiting agency.

8. I am not a dismissed Government Employee.

I accept the above declaration

Place:

Date: 2014-01-28 15:40:19

Signature of Applicant

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