ANDHRA PRADESH PUBLIC SERVICE COMMISSION # VIJAYAWADA

ASSISTANT EXECUTIVE ENGINEERS IN VARIOUS DEPARTMENTS

NOTIFICATION NO: 09/2018, dt: 29/11/2018.
CHECK LIST

(To be filled by the candidate)

DATE OF VERIFICATION:

SUBJECT :

REGISTER NO : PHOTO OF THE

CANDIDATE

01.
Name of the Candidate
( as per SSC)

02. Father’s Name

Male / Female
03. Gender
D D M M Y Y Y Y
Date of Birth
04.
( as per SSC)
Years Months Days
05. (Age as on 01/07/2018)

If age relaxation is claimed, specify. Whether relevant

1) Retrenched Census Employee Certificate
2) A.P. State Govt. Employee Years Produced
06. 3) N.C.C
4) PH persons YES NO
(No. of years claimed for relaxation)
5) BC,SC,ST
6) Ex-Service Men
Qualification Branch Date of acquiring qualification
Qualification
07. As per
(as on 29/11/2018)
Notification
Community(integrated
community Issued by OC SC ST BC
08. Competent authority
/M.R.O for SC/ST/BC) A B C D E
BC Candidates should Whether non-creamy layer
Submit Non Creamy certificate YES NO
Layer certificate as produced
09.
per G.O.Ms.No:3 of
2006 & G.O.Ms.No:26
of 09/12/2013.
Local Zone to which Zone
belong.
Class Year District State
IV
Indicate the evidence V
(Original Study
10. Certificate to be VI
produced) OR VII
Residence certificate
for 7 yrs. Prior to SSC VIII
if private Study. IX
X
PH (Disability)
11.
Percentage VH………..…% HH……………% OH…………..%
 Details of posts for information of candidates:
PC No. Name of the Post
01 AEE (Civil) in A.P. Rural Water Supply and Sanitation Department.
02 AEE (Civil) in Roads & Buildings Engineering Service.
12. AEE (Electrical) in Roads & Buildings Engineering Service. (State wide
03
post)
04 AEE (Civil) in A.P. Water Resources Department.
05 AEE (Mechanical) in A.P. Water Resources Department.
06 AEE (Civil) in A.P. Panchayat Raj & RD Engineering Service.
AEE (Civil/Mechanical) in A.P. Tribal Welfare Engineering
07
Department.
08 AEE (Civil) in A.P. Public Health & Municipal Engineering Department.
13. Details, if employed
1. All the above columns are filled in by me, for consideration to final admission and
subsequent selection. 2. The original certificates produced by me have been verified and
returned to me.
Permanent Address:- Correspondence Address:- Same address 
mark 
…………………………………………………. ………………………………………………….

14. …………………………………………………. ……………………………………………….…

………………………………………………….. …………………………………………………..

Mobile No…………………………………… Email Id……..………………………………….

Place:
Date: Signature of the candidate.
-------------------------------------------------------------------------------------------------------------------------------

TO BE USED FOR ADMISSION (OFFICIAL USE)

The candidate may be admitted for verification of Original Certificates Finally.

JR. ASST./A.S.O SECTION OFFICER ASST. SECRETARY

TO BE USED FOR PROVISIONAL ADMISSION

The candidate may be admitted, on verification of Original Certificates provisionally, as he/she

has to submit the following documents.
 The candidate may be admitted for verification of Original Certificates
provisionally as he/she has to submit the following / Receipt of prescribed deformity
under P.H. Category.

A. S.S.C. (D.O.B)
B. Original Degree Certificate
C. Study / Residence Certificate for Zone
D. Community Certificate
E. Non-Creamy Layer Certificate
F. Experience Certificate
G. Recognization of University / Equivalency

Signature of the candidate.

JR. ASST./A.S.O. SECTION OFFICER ASST. SECRETARY DY.SECRETARY

TO BE USED FOR REJECTION

JR. ASST./A.S.O. SECTION OFFICER ASST. SECRETARY DY.SECRETARY

SECRETARY

MEMBER

CHAIRMAN