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APPLICATION NO : CCLA-1118108

GOVERNMENT OF ANDHRA PRADESH Chief Commissioner Of Land Administration (CCLA)


APPLICATION FOR THE POST OF VILLAGE REVENUE OFFICERS Circular No.2, Dated 30.11.2011 1. 2. 3. 4. 5. 6. 7. 8. 9. Reference Id : 301210081816718051989
Name : PRATHIPATI RANJIT KUMAR District : WEST GODAVARI Mandal : NIDADAVOLE Village : PURUSHOTHAPALLE Father's/Husband`s name : SESHAGIRI RAO Date of birth : 18/5/1989 Gender : Male Address for communication : MAIN ROAD PURUSHOTHAPALLI NIDADAVOLE MANDAL WEST GODAVARI DISTRIC

9a. 9b. 9c. 10. 11. 12. 13. 14. 15.

District : WEST GODAVARI Mandal : NIDADAVOLE Pincode : 534302 Community you belong : OC e-Mail : p.ranjit.110@gmail.com Mobile : 9705818535 Do you belong to Andhra Pradesh State : Yes Are you an Ex-Service Man : No Are you a PH-Person : No
*301210081816718051989*

PH Details
Visually Handicapped : Visually Handicapped Percentage : Hearing Handicapped : Hearing Handicapped Percentage : Orthopedically Handicapped : Orthopedically Handicapped Percentage : No 0% No 0% No 0%

16. 17. 17a.


Fee Amount
200

Post Name : VILLAGE REVENUE OFFICERS Qualification Details


Qualification : Intermediate or Equivalent Qualification

Payment Details
Journal Number
A96C2C7AF566

Payment Date
17/12/2011

I hereby declare that all information furnished by me in this application is true and correct I undertake to produce the original documents at any moment, failing which my candidature may be cancelled. I am fully aware that furnishing false information will lead to a criminal case against me, apart from cancelling my candidature as it amounts to cheating. I am aloneresponsible if any wrong entries are made by me in the application form.

Sd/PRATHIPATI RANJIT KUMAR Generated for CCLA'S Recruitment Processing: http://ccla.cgg.gov.in/ POWERED BY Governance Centre for Good

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