You are on page 1of 3

1/3

ON-LINE APPLICATION FOR TNPSC REGISTRATION

37028
Registration # :

419356108

Notification. No. :

18/2014

Full Name :

M VIGNESH

Do you have One Time Registration ID? :

NO

Name of The Post Applying for :

Junior Assistant/Bill Collector/Field Surveyor/Draughtsman

Are you a Destitute Widow? :

NA

Are you a Differently Abled Person? :

NO

Are you an Ex-Serviceman ? :

NO

PPO No :

--

Date of Discharge / Probable date of Discharge :

--

Are you a Government Employee? :

NO

Nationality :

Indian

Application Fee / Intimation Charges details:


Payment Mode:

Net Banking

Amount :

125.00

Personal Details :
Date of Birth :

31/03/1992

Gender :

MALE

Marital Status :

UnMarried

Religion :

Hindu

Candidate's Place of Birth :

mannargudi

Native District :

Tiruvarur

Father's Name :

R Mathavan

Father's Place of Birth :

Tiruvarur

Mother Tongue :

Tamil

Mother's Name :

M Santhi

Communal Category :

Backward Class(BC)

Name of the SubCaste :

ThuluvaVellala

Certificate No :

7020118

Date Of Issue :

08/07/2008

Issuing Authority :

Zonal Deputy Tahsildar

Taluk :

Mannargudi

District :

Tiruvarur

Address for Correspondence :

1/293, Keelamaruthur
60, Panayiur
Mannargudi

District

Tiruvarur

State :

Tamil Nadu

Pin :

614717

Permanent Address :

1/293, Keelamaruthur
60, Panayiur
Mannargudi

District

Tiruvarur

2/3

District

Tiruvarur

State :

Tamil Nadu

Pin :

614717

Contact Details :
Email ID :

ms.vignesh31@gmail.com

Mobile No :

9994064601

EDUCATIONAL QUALIFICATION PARTICULARS :


Exam Passed

Date of
Publication of

Medium of
Instruction

Degree

Tamil

N/A

Tamil

H.S.C

Major Subject

Board / University

N/A

Tamilnadu State
Board

N/A

Tamilnadu State
Board

Results
S.S.L.C :
H.S.C or Equivalent
Qualification :

31/05/2007
14/05/2009

Others :

--

Do you claim reservation for Persons Studied in Tamil Medium (PSTM)? :

No

Are you trained person in Survey in ITI, Tamil Nadu?


(Eligible for Field Surveyor and Draughtsman post only)? :

No

Whether you are applying with the Educational Qualification as Prescribed in


Prescribed Qualification
the notification or with an equivalent qualification :
Details regarding the prescribed qualification :
Qualification Details :

SSLC

Certificate No :

4668854

Year of Passing :

2007

Name of the Authority/ University :

Tamilnadu State Board

Preferential qualification for per notification :

No
English

Type writing / Short hand Qualification

Cert. No. Issued by Dir. of


Cert. No. Issued by Dir.
Tamil
Technical Education
of Technical Education

Type
Writing

--

--

--

--

Short
hand

--

--

--

--

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? :

No

Physical Standards as per notification :

Yes

Name of the Examination Centre District:

Thiruvarur

Name of the Examination Centre :

Mannargudi

Optional Subject :

General Studies with General Tamil (S.S.L.C Standard)

Do you claim Age Concession? :

No

Do You Claim Fee Exemption? :

No

Criminal Case (Registered/Pending/Punishment awarded) :

Not Applicable

Participation in Political Activities (In agitation/As a Member of Political


Organisation/Candidature in Election) :

Not Applicable

Experience Details :
Name of the Organisation

Designation

From(mm/yyyy)

To(mm/yyyy)

Nature of Duty

Previous appearance for Oral Test / Written Test


Name of the Post

Register No.

Year

--

--

--

--

--

--

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.

3/3

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 / disqualified by the TNPSC or any other recruiting agency.

8. I am not a dismissed Government Employee.

I accept the above declaration

Place:

Date: 2014-11-12 10:25:03

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

Signature of Applicant