STATE LEVEL POLICE RECRUITMENT BOARD, ANDHRA PRADESH - 2016

FILLED IN ONLINE APPLICATION FORM

1.

Candidate's Name

: KOWLU RAMBABU

2.

Father's Name

: NAGARAJU

3.

Mother's Name

4.

Gender

: PADMA
: Male

5.

Date Of Birth

: 18-Jun-1994

6.

Community

7.

: SC
SSC Or Equivalent Roll No.(Hall Ticket No.) : 1106113422

8.

Highest Qualification

9.

Upload Community Certificate(BC/SC/ST)

12.

1.

Identification Marks (as per

SSC or Equivalent)

13.

Candidate Mobile No.

14.

E-mail ID

15.

Address for Communication

2.

Preserve the REGISTRATION NUMBER

for all your future correspondence.

REGISTRATION NUMBER

1354230
Pass Year :

2011
10.

: B.Tech.
: Uploaded
: A MOLE ON LEFT HAND MIDDLE FINGER
: A MOLE ON LEFT SIDE OF THE CHEAST
: 9701443513
: krambabu1430@gmail.com
: TUNIVADA
REGIDI
SRIKAKULAM
AP
PIN: 532122
: Yes

16. Do you have an Aadhar Card

: 418589640132

Aadhar Card No.

17. What is your preferred medium of Exam
18. Which is your preferred place for
writing Preliminary Written Exam
19. Select Post Preference

11.

: English

1st : Visakhapatnam
2nd : Bobbili
1st : 21 - SCT PC (Civil) (Men & Women)
2nd : 22 - SCT PC (AR) (Men & Women)
3rd : 53 - Warder (Male)

20. Which is preferred place for appearing in PM/PET after you qualify
Preliminary Written Exam

1st

: Visakhapatnam

2nd

: Vizianagarm
: Yes
: Srikakulam
: --

21. Are you presently a local of State of Andhra Pradesh

If Yes, What is your Local District
If No, Which State you belong to
If you have selected 'Telangana' as State to which you belong, as per GSR 591E of Govt. of
India, Candidates who migrate from Telangana to Andhra Pradesh with in a period of 3 years
from the 2nd Day of June, 2014 shall be regarded as local candidate in Andhra Prades. Do
you belong to this Category ?

: --

22. Are you an Employee of Govt. of Andhra Pradesh.

: No

23. Do you claim benefit of Age relaxation / Reservation / Physical Events / Under
Ex-Servicemen Quota

: Yes

24. If you are BC Candidate, you are eligible for reservation quota, if you do not
belong to Creamy Layer

: I do not belong to Creamy Layer

25. Do you claim benefit of Physical Measurement under ABO-ST

(i) If Yes, What is your Native District
(ii) What is your Native Scheduled Area
26. Do you claim benefit of Special Reservation under any one or more of the
following categories (for Post Code 21 and 22)
27. Do you claim benefit of special reservation under CJP for Post Code No. 53 (Male)
28. Do you claim benefit of Age-relaxation under Home Guard
If Yes, which is your present Unit in State of Andhra Pradesh
29. Do you claim benefit of Age-relaxation under NCC (Worked as Instructor)
30. Do you claim benefit of Age-relaxation under temporary employee in the State Census
with a minimum service of 6 months during 1991.

31. Do you claim benefit of Age-relaxation under an employee of A.P. State Government
(Employees of APTRANSCO, Discoms, APGENCO, APSRTC, Corporations,
Municipalities,Local Bodies etc., are not entitled for Age relaxation)

32. Do you claim benefit of Age-relaxation under a widow, a divorced woman or a

woman judicially separated from her husband, and who is not remarried.
33. Do you claim benefit of Age-relaxation under Army, Naval or Air Force of the Union.
34. Fee Paid through : Mee Seva

Transaction Id./Reference Id.

: No
: -: -:

NCC : No
CPP : No

CDI : No
MSP : No

HG

: No

: No
: No
: -: No
: No
: No
: No
: No
: 03PTNLP00046470

Amount (in Rs.) : 150

I Certify that I have read the Notification and I am proceeding to submit this application form after having understood
the eligibility and other criteria mentioned in the Notification. I undertake total responsibility for submitting correct
information to the best of my ability.
Date: 09-Sep-2016 20:36 PM