ACK Slip

http://www.recruitment.kar.nic.in/rdpr/AckSlip.aspx?RefNo=289402&&...

Zilla Panchayath, BAGALKOTE
Rural Development and Panchayath Raj Department

Government of Karnataka Acknowledgement Slip 289402 PANCHAYATH DEVELOPMENT OFFICER

Reference No Post applied for District opted for BAGALKOTE appointment Place of Examination BAGALKOTE Full Name( as in GIRIJA BIDARIMATH SSLC/10th Cert) Mother's Name SHANTA Father's Name CHANDRASHEKARAYYA Gender Female Date of Birth 19/01/1982 Applied Category 3B Do you come under KMS these groups? Are you in Govt. No Service? Do you claim age Not Applicable relaxation? Are you a Graduate? Yes C S BIDARIMATH, VIDYACHETAN , RAMDEV Address for GALLI, communication JAMKHANDI District BAGALKOTE PIN 587301 Email address girija.bidarimath@gmail.com Landline Phone No 221267 Mobile Phone No 9986158495 Medium of writing English test
I hereby declare that all contents made in this application are true, complete and correct to the best of my knowledge and belief. I have read the rules and understand that in the event of any information being found false or ineligibility being detected before or after the selection ,action can be taken against me by the Government under rule 20 of Karnataka Civil Services(General Recruitment) rules 1977 as amended from time to time. I have read the rules and instructions carefully and hereby undertake to abide by them. I further declare that, I fulfill all the eligibility conditions regarding age, education qualifications, reservations etc., wherever applicable,prescribed for the post. Place :BAGALKOTE Date :06/08/2009 Signature of the Candidate

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10/7/2009 12:03 PM

bank use only Bank Copy Challan Zilla Panchayath. LAST DATE OF CHALLAN PAYMENT AT BANK: 11..BAGALKOTE the Credit of Secretary RDPR 64044930154 . BAGALKOTE Rural Development & Panchayat Raj Dept.in/rdpr/AckSlip. Government Of Karnataka Candidate Copy Bank and Branch Name bank use only Bank Journal No Bank Journal Date Post Applied For District opted for appointment Ref No Name PANCHAYATH DEVELOPMENT OFFICER BAGALKOTE Post Applied For District opted for appointment Ref No Name Address Paid into A/C No Soudha. Address RAMDEV GALLI. B'lore Sl No Particulars 1 Application Fee Total Amount in Words: Five hundred only Amount 500.BAGALKOTE Paid into the Credit of Secretary RDPR A/C No 64044930154 . State Bank of Mysore .08.00 GIRIJA BIDARIMATH C S BIDARIMATH. State Bank of Mysore . Vidhana Soudha . BAGALKOTE Rural Development & Panchayat Raj Dept.kar. JAMKHANDI. (In case of non availability of SBM then SBI or SBH) No bank charges to be collected from the remitter/applicant Accepted at all the Branches of SBM. RAMDEV GALLI.00 500. Government Of Karnataka Bank and Branch Name Bank Journal No Bank Journal Date PANCHAYATH DEVELOPMENT OFFICER BAGALKOTE 289402 289402 GIRIJA BIDARIMATH C S BIDARIMATH. (In case of non availability of SBM then SBI or SBH) No bank charges to be collected from the remitter/applicant Print Back 2 of 2 10/7/2009 12:03 PM .2009 Challan Zilla Panchayath..00 Sl No Particulars 1 Application Fee Total Amount in Words: Five hundred only Signature of Remitter/Applicant Received the above amount in Rs(in words) Five hundred only Signature of Remitter/Applicant Received the above amount in Rs(in words) Five hundred only Date : Signature of Receiving authority Date : Signature of Receiving authority Accepted at all the Branches of SBM.ACK Slip http://www. VIDYACHETAN .recruitment.00 500.aspx?RefNo=289402&&. JAMKHANDI. VIDYACHETAN .nic. Vidhana B'lore Amount 500.