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ON-LINE APPLICATION FOR TNPSC REGISTRATION

45041
Registration # : 391565961

Full Name :

M NIRMAL RAJ

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 :

11501610 Group-IV Services NA NO NO --NO Indian

NO FEE 0.00

29/03/1989 MALE No Hindu THANJAVUR Thanjavur R MUTHUMANI Thanjavur Tamil M SHANTHI Backward Class(BC) Agamudayar incl. Thozhu or Thuluva vellala 5839792 20/08/2004 Zonal Deputy Tahsildar Thanjavur Thanjavur 2/545 SAVIER NAGAR VILAR ROAD THANJAVUR

District State : Pin : Permanent Address :

Thanjavur Tamil Nadu 613006 2/545 SAVIER NAGAR VILAR ROAD THANJAVUR

District State :

Thanjavur Tamil Nadu

State : Pin : Contact Details : Email ID : Mobile No : EDUCATIONAL QUALIFICATION PARTICULARS : Exam Passed Year of Publication of Result S.S.L.C : H.S.C : Degree : Diploma : Others : Do you claim reservation for Persons Studied in Tamil Medium (PSTM)? : Are you trained person in Survey in ITI, Tamil Nadu? (Eligible for Field Surveyor and Draughtsman post only)? : 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 : 2004 2006 2011 2008 Medium of Instruction Tamil Tamil English English N/A N/A B.Sc. N/A Degree

Tamil Nadu 613006

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nirmal2255@gmail.com 9952479411

Major Subject

Board / University

N/A N/A MATHEMATICS

STATE BOARD STATE BOARD BHARATHIDASAN UNIVERSITY BHARATHIDASAN UNIVERSITY

DOST -Yes No

SSLC -1431683 2004 STATE BOARD OF TAMILNADU Yes English Type Writing Short hand -Cert. No. Issued by Dir. of Cert. No. Issued by Dir. Tamil Technical Education of Technical Education ----

Type writing / Short hand Qualification

--

--

--

--

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? : Preferential Physical Standards for per notification : Do you claim reservation for Persons Studied in Tamil Medium (PSTM)? : Name of the Examination Centre District: Name of the Examination Centre : Optional Subject (As per Notification) : Do you claim Age Concession? : Do You Claim Fee Exemption? : Under What Category? : No of free Attempts :

Yes Yes Yes Thanjavur Thanjavur General Studies with General Tamil (S.S.L.C Standard) No Yes Backward Class/Backward Class (Muslims) 2 1.Junior Assistant (Security) (Post Code 2400) 2.Junior Assistant (Non-Security) (Post Code 2600) 3.Bill Collector, Grade-I (Post Code 2500) 4.Field Surveyor (Post Code 2800) 5.Draftsman (Post Code 2900) Not Applicable Not Applicable

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

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.

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: 2013-07-13 21:18:07

Signature of Applicant

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