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ON-LINE APPLICATION FOR TNPSC REGISTRATION

27028
Registration # : 391234113

Full Name :

V SELVAKUMAR

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 :

-Group-IV Services NO NO NO --NO Indian

Net Banking 125.00

02/06/1991 MALE No Hindu ILAYANKUDI Sivaganga K VELU Sivaganga Tamil V AMUTHA Denotified Community(DC) Maravars 0925941 15/06/2007 Zonal Deputy Tahsildar Ilayankudi Sivaganga 213/2, CHITHAMBAL, NORTH ANDAKKUDI (POST) ILAYANKUDI(T K)

District State : Pin : Permanent Address :

Sivaganga Tamil Nadu 630702 213/2, CHITHAMBAL, NORTH ANDAKKUDI (POST) ILAYANKUDI(T K)

District State :

Sivaganga Tamil Nadu

State : Pin : Contact Details : Email ID : Mobile No : EDUCATIONAL QUALIFICATION PARTICULARS : Exam Passed Year of Publication of Result S.S.L.C : 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 : 2007 2009 Medium of Instruction Tamil Tamil N/A N/A Degree

Tamil Nadu 630702

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selvakumar.sn@gmail.com 8754660088

Major Subject

Board / University

N/A ITI MECHANIC MOTOR VEHICLE -Yes No

TAMIL NADU NCVT

SSLC -4266596 2007 TAMIL NADU SSLC 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

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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? : 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

No Yes Yes Chennai-Central Nungambakkam General Studies with General Tamil (S.S.L.C Standard) No No -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.

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.

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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: 2013-07-09 16:38:51

Signature of Applicant

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