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GROUP II SERVICES
(GENERAL RECRUITMENT)
NOTIFICATION NO: 17/2016 TO 20/2015
DATE OF VERIFICATION:
Signature
Name of the Candidate
01
( as per SSC)
02 Father’s Name
03 Mother’s Name
05 Religion
Date of Birth D D M M Y Y Y Y
06
( as per SSC)
2) Retrenched
Census Employee
5) Ex-Service Men
09 Qualification As per Quali Date of Name of the
( For Post code 12: Notification ficati acquiring University
Degree with Maths , on qualification
Economics, Commerce
candidates Only eligible)
(For Post Code 13:
Degree with Law
candidates Only Eligible)
10 Community(integrated
Community Certificate OC SC ST BC
Issued by M.R.O for
SC/ST/BC from A B C D E
Telangana State Govt)
Official use :
11 BC Candidates should
Submit Non Creamy Whether non-creamy layer
Layer certificate as per certificate produced Yes No
G.O.Ms.No:8 of 2014
Official use :
&
MemoNo.3009/BCW/
OP/2011, Dt:18-12-2015.
12 PH –Category VH HH OH
Percentage of Disability
VII
VIII
IX
16 Present Employment
details
(Government Employees
should submit NOC)
Declaration
i) All the columns filled in by me containing my biodata and other particulars, are true to the best of
my Knowledge.
ii) The certificates such as, my educational qualification, community certificate, date of birth (SSC),
study/residence in support of my claim for local candidature is genuine.
iii) I did not resort to any irregular or improper means in connection with my candidature for
selection.
iv) I am liable for permanent debarment from appearing for the recruitment to be conducted by
TSPSC and other PSCs and also criminal prosecution, if I am found involved in any unfair means
/ malpractice.
15
v) I further declare that the information furnished by me is correct and my candidature shall be
cancelled at any stage if it is found incorrect.
Address.
………………………………………………….
…………………………………………………
…………………………………………………..
Mobile No…………………………………
Place:
Date: Signature of the candidate.
SECRETARY