5/22/2017 TNPSC

TamilNaduPublicServiceCommission

COMB INE DCIVIL SE RVICE SE XAMINAT IONII(NON

Name o f th e P o st Ap p l yi n g fo r / :
INT E RVIE WPOST S)(GROUPIIASE RVICE S)

No ti fi c ati o n No . / : 10/2017

Ap p l i c ati o n No . / : 710479523

Reg i strati o n Date :/ : 2 2 0 5 2 0 1 7

In i ti al s Name
Name o f th e Ap p l i c an t/ :
R SANT HIL AKSHMI

Gen d er/ : FE MAL E

Date o f Bi rth / : 0 5 0 2 1 9 9 2

In i ti al s Name
Fath er' s Name/ :
S RAMAMOORT HY

In i ti al s Name
Mo th er' s Name/ :
R MANIMOZ HI

Mari tal S tatu s/ ? MARRIE D

S p o u se' s Name/ / : MUNIYASAMYK
Ap p l i c an t' s P l ac e o f Bi rth / : VAL AVANT HAL PURAM

Nati ve Di stri c t/ : T HIRUNE LVE L I

Fath er' s P l ac e o f Bi rth / : T HIRUNE LVE L I

Mo th er To n g u e/ : TAMIL

Nati o n al i ty/ : INDIAN

Rel i g i o n / : HINDU

CertificateDetails /

Co mmu n al Categ o ry/ : DE NOT IFIE DCOMMUNIT Y(DC)

Name o f th e S u b Caste/
MARAVARS
:
Certi fi c ate No / : 0935305
Date o f Issu e/ : 2 2 0 9 2 0 0 5
Issu i n g Au th o ri ty/ Z ONAL DE PUT Y
: TAHSIL DAR
Di stri c t/ : T HIRUNE LVE L I
Tal u k/ : SANKARANKOIL

Are yo u a Desti tu te Wi d o w? / ? NO

Are yo u a Di fferen tl y Ab l ed P erso n / ? NO

Are yo u a Go vern men t E mp l o yee/ ? NO
*Have yo u b een d eb arred o r d i sq u al i fi ed b y th e P u b l i c S ervi c e
Co mmi ssi o n o r an y o th er rec ru i ti n g ag en c y fro m ap p eari n g fo r
exami n ati o n s an d sel ec ti o n s fo r a sp ec i fi c p eri o d o r p erman en tl y? /

NO



?

Are yo u an E xS ervi c emen / ? NO

Cri mi n al Case Reg i stered / ? NO

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5/22/2017 TNPSC
P arti c i p ati o n i n P o l i ti c al Ac ti vi ti es / ? NO

CommunicationDetails /

Co rresp o n d en c e Ad d ress/ P erman en t Ad d ress/

NUMB E R5 2 0 7 ANAL L AMMAL NUMB E R5 2 0 7 A

Ad d ress Li n e 1 / Ad d ress Li n e 1 /
NAGAR NAL L AMMAL NAGAR
Ad d ress Li n e 2 / SPUDHUPAT T IROAD Ad d ress Li n e 2 / SPUDHUPAT T IROAD
Ad d ress Li n e 3 / SIVAKASIWE ST Ad d ress Li n e 3 / SIVAKASIWE ST
S tate/ : TAMIL NADU S tate/ : TAMIL NADU
Di stri c t/ : VIRUDHUNAGAR Di stri c t/ : VIRUDHUNAGAR
P i n c o d e/ : 626124 P i n c o d e/ : 626124

E mai l ID/ : rsa nthi l a kshmi 9 2 @g ma i l .co m

Mo b i l e No / : 8 0 5 6 7 3 111 4

EducationalQualificationParticulars /

S S LC / :
Date o f P u b l i c ati o n o f Resu l t / : 3 1 0 5 2 0 0 7
Med i u m o f In stru c ti o n / : TAMIL
Name o f th e Bo ard / Un i versi ty / / : STAT E B OARD
Certi fi c ate Nu mb er/ : 4330771
Wh eth er stu d i ed Tami l as o n e o f th e su b jec t/
YE S


?

HS C / :
Date o f P u b l i c ati o n o f Resu l t / : 1 4 0 5 2 0 0 9
Med i u m o f In stru c ti o n / : TAMIL
Name o f th e Bo ard / Un i versi ty / / : STAT E B OARD
Certi fi c ate Nu mb er/ : 4 2 1 0 2 11
Wh eth er stu d i ed Tami l as o n e o f th e su b jec t/
YE S


?

D egreeQu alification (Oth erth an Law )/ ( ):

Date o f P u b l i c ati o n o f Resu l t/ : 3 0 0 6 2 0 1 2
Name o f th e Deg ree / : OT HE RT HANAB OVE DE GRE E S
Name o f th e Bo ard / Un i versi ty / / : MADURAIKAMARAJ UNIVE RSIT Y
Certi fi c ate Nu mb er/ : 0 9 UA0 4 0
Wh eth er stu d i ed Tami l as o n e o f th e su b jec t/
NO


?

Med i u m o f In stru c ti o n / : E NGL ISH

TECHNICALEDUCATIONALQUALIFICATIONS /

*Have yo u p assed th e Certi fi c ate c o u rse i n Co mp u ter o n Offi c e

Au to mati o n award ed b y th e Di rec to rate o f Tec h n i c al E d u c ati o n ? /

' '
? :
Not e: : F or P ers onal C l erk pos t , candi dat es s houl d have p as s ed t h e C ert i fi cat e C ours e i n
C om p ut er on Offi ce Aut om at i on award ed by t he Tech ni cal Educat i on Depart m ent .
C andi d at es who do n ot pos s es s t he s ai d qual i fi cat i o n m ay al s o ap pl y. If s el ect ed, for
s uch po s t t hey s h oul d acqui re C ert i fi cat e C ours e i n C om p ut er on Offi ce Aut om at i on
qual i fi cat i o n wi t h i n t he peri od of t hei r p robat i o n. : YE S


(C ert i fi cat e C o urs e i n C om pu t er on Offi ce
Aut o m at i on ) .
.



.

Certi fi c ate Nu mb er : 000098324

Date o f Issu e o f Certi fi c ate : 0 4 0 1 2 0 1 2

Do yo u h ave th e P h ysi c al S tan d ard s as p er n o ti fi c ati o n ? /

YE S

? :

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5/22/2017 TNPSC

ExaminationParticulars /

Name o f th e E xami n ati o n Cen tre / : VIRUDHUNAGAR SIVAKASI

GE NE RAL ST UDIE S(DE GRE E STANDARD)+APT IT UDE T E ST

ANDGE NE RAL TAMIL (S.S.L .CSTANDARD)
S u b jec t( s) fo r E xami n ati o n / :
+
( )

RegistrationFees

* P aymen t Mo d e ONL INE T RANSACT IONID:CP8 5 7 6 2 9 1 6 FE E SAMOUNT :1 0 0

FeeConcession /

Do yo u c l ai m exami n ati o n fee c o n c essi o n ? /

? :
INS TRUCTIONS FOR AVAILING E XAMINATION FE E CONCE S S ION/

. Not e: If an y o f t he can di dat es who have al ready avai l ed Two free
chances i n cas e of ExS ervi cem en cat egory o r Three free ch ances i n cas e of Degree hol ders
of B C / B C M / M B C / DC cat egory or t hos e who want s t o pay t he exam i n at i on fee s houl d
ch oos e t h e op t i on < No/ > an d pay t he exam i nat i on fee. The appl i cat i on of
candi d at es wh o m akes a fal s e cl ai m for ex em pt i on from p aym ent of exam i nat i on fee wi l l
be rej ect ed at an y s t age of s el ect i on. Th e opt i on (Yes / No) for fee conces s i on i s not
al l owed t o edi t aft er s ubm i t t i ng app l i cat i on
NO

B C / B C M / M B C / DC


< No/ >
.


. ( /
)
.

Declaration /

I h ereb y d ec l are th at al l th e p arti c u l ars fu rn i sh ed i n th i s ap p l i c ati o n are tru e, c o rrec t an d c o mp l ete to th e b est o f my kn o wl ed g e an d b el i ef.
In th e even t o f an y i n fo rmati o n b ei n g fo u n d fal se o r i n c o rrec t o r i n el i g i b i l i ty b ei n g d etec ted b efo re o r after th e exami n ati o n o r at an y
stag e, an y ac ti o n c an b e taken ag ai n st me b y th e TNP S C i n c l u d i n g rejec ti o n o f my ap p l i c ati o n .

.
, .
,

.

I h ereb y d ec l are th at I wi l l n o t b e a p arty to an y ki n d o f c an vassi n g o n my b eh al f.

.

I fu rth er d ec l are th at I fu l fi l al l th e el i g i b i l i ty c o n d i ti o n s p resc ri b ed fo r ad mi ssi o n to th e exami n ati o n .

.

I h ave g o n e th ro u g h th e In stru c ti o n s to th e Ap p l i c an ts an d th e Co mmi ssi o n ' s n o ti fi c ati o n fo r th i s Rec ru i tmen t b efo re fi l l i n g u p th e

ap p l i c ati o n fo rm.

"
"

.

I d ec l are th at I p o ssess th e P h ysi c al stan d ard s p resc ri b ed fo r th e p o st( s) wh i c h I am n o w ap p l yi n g .

/ .

I c erti fy th at I h ave n o t b een d eb arred / d i sq u al i fi ed b y th e TNP S C o r an y o th er rec ru i ti n g ag en c y.

.

I am n o t a d i smi ssed Go vern men t E mp l o yee.

.

I h ave veri fi ed th e c o rrec tn ess o f th e p arti c u l ars fu rn i sh ed i n th e ap p l i c ati o n an d taken a p ri n t o u t o f th e ap p l i c ati o n .

.

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