TELANGANA STATE LEVEL POLICE RECRUITMENT BOARD

PRELIMINARY APPLICATION FORM - 2022

PART- I
Notification Rc No. 41 / Rect. / Admn-1 / 2022 dated 25-04-2022
Post/s Applied for SCT PC CIVIL AND / OR EQUIVALENT

Medium of Written Examination

(Except Technical Papers, which ENGLISH Registration Number
will be in English only)

Name of the Candidate PURRU SOMESH 71365335

Father's Name PURRU GOPAL YADAV

Mother's Name PURRU SHAMANTHA

Gender MALE Community BC-D

Date of Birth 01-01-2001 Age as on 01-07-2022 21 years 6 months 0 days

Aadhaar Number 694474089948 SSC Roll No 1636116015

someshyadav9994@gmail.c
Mobile Number 7989319711 E-mail Id
om
Identification Mark 1 A MOLE ON THE RIGHT HAND RING FINGER

Identification Mark 2

State (Local Candidature) TELANGANA

Local Candidature as per study from 1st Class to 7th Class
MEDCHAL-MALKAJGIRI
(as per new Presidential Order,2018)
Educational Qualification as on 01-07-2022 INTERMEDIATE

District Preference for appearance in Tests / Exams - I MEDCHAL-MALKAJGIRI

District Preference for appearance in Tests / Exams - II HYDERABAD

Note:

1. Candidate will be allotted any town in the Districts selected or any nearby District depending upon the
availability of accommodation for appearance in the Tests / Examinations.
2. In case Candidate submits application for SCT SI (Technical) / SCT PC (Technical), Candidate will be allotted to
any center in Hyderabad city or nearby.

Address for Communication

Name PURRU SOMESH
C/o MALKAJGIRI
H. No. & Colony 9-54/1, VENKATESHWARA NAGAR
Village / Town / City MALKAJGIRI Mandal Malkajgiri
District Medchal-Malkajgiri Pin Code 500047

DECLARATION

I hereby declare that I have read all the instructions mentioned in the Notification(s) carefully and I hereby undertake to
abide by them. I am responsible for the correctness of the above details filled in by me. I further declare that the information
furnished by me is true and correct to the best of my knowledge and is as per the Certificates / Relevant documents.

Signature

22/10/2022 06:47:24 Application Submission Date&Time: 16-05-2022 08:05:28 PM