PROBATION DECALRATION APPROVAL FORM BY DDO AND GSWS EMPLOYEE

1. Name of the District : Sri Sathya Sai

2. Name of the Mandal : Mudigubba
3. Name of the Sachivalayam : Mallepalli-2
4. Department : Revenue
5. Designation : Village Revenue Officer (Grade-II)
6. Name of the Employee : CHERUKUTHOTA PAVAN KUMAR
7. CFMS ID : 14886167
8. Date of Joining : 10-12-2019
9. Mobile No : 8897715573
10. EMAIL ID : cpavanvro.1@gmail.com
11. Is there any Break in the Service period
(Leaves availed other than Casual leaves,
Optional Holidays and Suspension)?
(YES/NO) : NO
12. If YES Nature of Break
(Maternity Leave/Medical Leave) : ---
13. If YES duration of break : ---
14. Date of completion of 2 years of continuous
service (excluding Break if availed) : 09-12-2021
15. Whether All prescribed Departmental
Test Papers Passed?(YES/NO) : YES
16. If YES Paper Name & Code : 1. The Revenue Test, Part - I First Paper (WITH BOOKS) & 18
2. The Revenue Test, Paper - I Second Paper (WITH BOOKS) & 27
3. The Revenue Test, Paper – III (WITH BOOKS) & 62
4. The Revenue Test, Paper – II (WITH BOOKS) & 43
5. Computer Proficiency Test
17. If YES Hall Ticket Number : 11205500, 21202454, 210032455
18. Whether any Disciplinary Cases pending
(YES/NO) : NO
19. Whether Service Register Opened or Not
(YES/NO) : YES
20. Antecedents Verification completed or Not
(YES/NO) : YES
21. If yes, Remarks given by Police department
during Antecedents verification.
(Nothing Adverse/ Adverse) : NOTHING ADVERSE
22. Whether Eligible for Declaration of Probation
(YES/NO) : YES
23. Remarks : ---

I hereby declare that the information furnished as above are correct and I shall liable for punishment
if any wrong information submitted

Signature of the Employee

The above particulars are verified with reference to the original records and Service registers of the individual.

Signature of the DDO and Seal