Government of Karnataka

Department of Public Instruction

O/o Commissioner for Public Instruction
Nrupathunga Road, Bangalore - 01

REQUEST TEACHER TRANSFER APPLICATION -2016

(APPLICANT COPY )
First KGID No. :

1211225

Application No. :

Applicant Name :

P M SANGLIKAR

Designation :

Assistant Master ( AM )

Subject while appointed :

KANNADA - GENERAL

Present working place :

GLPS KONDIKOPPA

010558

Applied date :

07/08/2016

School / Office category : Primary

Zone : C

KONDIKOPPA
Taluk Name :

SHIRHATTI

District Name :

Date of birth :

18/06/1966

Gender :

Female

Date of entry into joining service:

04/04/1996

Marital Status :

Married

Date of probationary declared :

03/04/1998

Mobile No :

9448783550

Mode of entry into Group B:

Telephone No. :

Is applicant as an excess teacher :

NO

Date of Entry into present school /office 05/06/2002

Transfer Sought for:

Is out of unit
Transfer taken
earlier :

Within Unit

Willing to attend counselling division at:

Grounds for Priority :
Total completed years :

GADAG

Excess & Redeployed during 2016

NO

Date of entry into present cadre:

05/06/2002

Spouse working/residential Address:

WIDOWS
20

Total weightage :40

Pincode:

EXPERIENCE DETAILS
Sl.No. Designation

Places where applicant

worked in present cadre

Taluk

District

Date from

Date to

Zone

Completed Weightage
years

ASSISTANT
MASTER

LPS MAJJUR TANDA

SHIRAHATTI

GADAG

04/04/1996

04/06/2002

12

ASSISTANT
MASTER

GLPS KONDIKOPPA

SHIRAHATTI

GADAG

05/06/2002

07/08/2016

14

28

Declaration : This is to certify that, all the above information furnished by me is true and correct to the best of my knowledge
Candidate Signature
Note: Total weightage will be considered with reference to the last date of the application submission subject to condition.

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8/7/2016-17:26:17

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