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Personal Information
Applicant’s Place
Date of Birth 05/02/1991 Gender Male MANAPPARAI
of birth
Father's
Father's Name PALANISAMY.P COOL Mother Tongue Tamil
Occupation
Mother's
Mother's Name PAPPTHI.P COOL Marital Status UnMarried
Occupation
Disability
DIFFERENTLY ABLED NO Disability Type
Category
Mobile NO
9790058536
Telephone
Email ID dharmantt@gmail.com 0
Alternate Mobile Number
8056524940
NO
Education Board
Date of Issue of
03/2008 STATE BOARD
Certificate
Medium of
SSLC / SSC / CBSE /
SSLC 5723545 Instruction
Tamil
METRIC / ICSE Certificate NO
School Percentage of 42.80
Mode of Study
Marks
Education Board
Date of Issue of
03/2010 STATE BOARD
Certificate
HSC/INTERMIDATE (OR) Medium of
HSC
EQUIVALENT 5078902 Instruction Tamil
Certificate NO
QUALIFICATION
School Percentage of 46.60
Mode of Study
Marks
Language
To Read
To Write
To Speak
HINDI NO NO NO
Typing Tamil
NO Certificate NO. Certificate Date
(45 words per minute)
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Typing English NO Certificate NO. Certificate Date
(45 words per minute)
Shorthand Tamil
NO Certificate NO. Certificate Date
(90 words per minute)
Shorthand English
NO Certificate NO. Certificate Date
(120 words per minute)
Additional Details
Are you a temporary or discharged state Government employee due to reduction in establishment or for any other
reason but not as disciplinary measure? NO
Have you been debarred or disqualified by the Public Service Commission or any other recruiting agency from appearing
for examinations and selections for a specific period or permanently?
NO
Recruiting Agency :
Peroid :
Are you/were in the Service of Public/Private sector organization or Local Self Financing Institution?
NO
Whether any disciplinary Proceedings/Vigilance Enquiry is/was initiated/ contemplated/ discharged from
service,contemplated?
NO
Was any penalty other than dismissal from service imposed on you during your service?
NO
Have you been arrested/ detained/ released on Bail/ Named in the FIR/ Criminal proceedings pending/ compromised/
Quashed/ Referred by Police/ Charge sheeted/ Prosecuted in any Criminal Case/ Private Complaintant/ Convicted for NO
offence (involving Moral turpitude or any other offence)
Declartion
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 or at any stage,
any action can be taken against me by the Madras High Court including rejection of my application.
I hereby declare that I will not be a party to any kind of canvassing on my behalf.
I further declare that I fulfil all the eligibility conditions prescribed for admission to the examination.
I have gone through the Instructions to the Applicants and the Madras High Court's notification for this Recruitment before filling up the
application form.
I declare that I possess the Physical standards prescribed for the post(s) which I am now applying.
I certify that I have not been debarred / disqualified by the Madras High Court or any other recruiting agency.
.I have verified the correctness of the particulars furnished in the application and taken a print out of the application.
I am fully aware that
NO individual communication regarding the date and time of oral test, certificate verification and counselling (wherever applicable) will be
sent to me. I am also aware that the schedule of oral test/counselling/certificate verification will be made available on the Madras High
Court's website and I have to know the above details on receipt of email/press release/SMS alerts from the Commission to this effect.
I have not suppressed (or) withheld any information relevant for this recruitment.
Payment - YES
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