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Candidate's Name
: LAKSHMEE SOMARAJU
2.
Father's Name
: LAKSHMEE SATYANARAYANA
3.
Mother's Name
4.
Gender
: NOOKARATNAM
: Male
5.
Date Of Birth
6.
Community
: 02-Jul-1987
: OC
7.
: 0221891
8.
: --
: -: --
REGISTRATION NUMBER
4008085
Pass Year :
2002
14.
9.
10.
11.
Highest Qualification
: Intermediate
: HMV
: DLFAP105257482007
Present License
(i) If the candidate posses
HMV,furnish HMV License No.
(ii) Date of issue of LMV License
: --
: --
: 05-Dec-2007
: RTA RAJAHMUNDRY
16.
15.
: Yes
: --
: -1.
2.
17.
: 9490489717
18.
E-mail ID
: meesevagokavaram@gmail.com
19.
: DOOR NO.16-4/9
KOTHAPETA
VEERALANKAPALLI
GOKAVARAM
PIN: 533286
: Yes
: 869629945775
: Yes
: East Godavari
: -: --
: No
: --
: --
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24. Are you an employee of the Army, Naval or Air Force of the Union (for Age relaxation)
: No
: --
: --
: No
: --
: --
26.
Are you retrenched temporary employee in the State Census Department during
1991:(age relaxation)
If yes, Length of Service in Census
: No
: Years: -- Months: -- Days:--
27.
Are you a Home Guard Furnish details if you claim age relaxation under Home
Guard Quota (HG)
If yes,furnish the following
: No
28.
: --
: --
: No
: -: -: --
29.
: --
: --
Furnish details if you claim reservation under Home Guard Quota (HG)
: No
30.
31.
: --
: --
Furnish the details if you claim reservation under NCC ( NCC-A, NCC-B, NCC-C)
quota
If yes,furnish the following
: No
: --
: --
: --
: No
: -: --
: --
: --
: --
: --
: --
If 'Died' or 'Retired'
a) Name of last Post held
: --
: --
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32.
As per the Rule 3 (G) of A.P. (SCT) Rules, 1999, involment in a Criminal case involving moral turpitude (OR) conviction for any offence in
any court of law, is a bar for employment.
Were you involved in any Criminal Case (s) at any time ?
: No
: -- -: --
: --
33.
: No
34.
: No
: --
35.
: No
36.
: 00
37.
: No
: --
: -: --
38.
TransactionId/Reference Id
: -: APMDC8D8B4895E
300
I Certify that I have read the Notification and I am proceeding to submit this application form after having understood
the eligibility and other criteria mentioned in the Notification. I undertake total responsibility for submitting correct
information to the best of my ability.
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