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ON-LINE APPLICATION FOR TNPSC REGISTRATION

22023
Registration # : 10239700

Full Name :

K KANNATHASAN

One Time ID : Name of The Post Applying for : Are you a Destitute Widow? : Are you a Differently Abled Person? : Are you an Ex-Serviceman ? : PPO No : Date of Discharge / Probable Discharge / Date : Are you a Government Employee? : Nationality / Citizenship : Application Fee / Intimation Charges details: Payment Mode: Amount : Personal Details : Date of Birth : Gender : Married : Religion : Candidate's Place of Birth : Native District : Father's Name : Father's Place of Birth : Mother Tongue : Mother's Name : Spouse's Name : Communal Category : Name of the SubCaste : Certificate No : Date Of Issue : Issuing Authority : Taluk : District : Address for Correspondence :

-Group IV NA NO NO --NO Indian

Net Banking 50.00

02/11/1981 MALE No Hindu NEYVELI Villupuram T KALIYAPPAN Villupuram Tamil K SELVI -Scheduled Caste (SC) HINDU-ADI-DRAVIDA 1388302 25/09/1998 Taluk Tahsildar Panruti Cuddalore C-15 APPAR STREET BLOCK18 NEYVELI

District State : Pin : Permanent Address :

Cuddalore Tamil Nadu 607803 C-15 APPAR STREET BLOCK18 NEYVELI

District

Cuddalore

District State : Pin : Contact Details : Email ID : Mobile No : EDUCATIONAL QUALIFICATION PARTICULARS : Exam Passed S.S.L.C : H.S.C : Degree : Others : Details regarding the prescribed qualification : Qualification Details : Other Equivalent Qualification Details : Certificate No : Year of Passing : Name of the Authority/ University : Preferential qualification for per notification : Year of Passing 1997 1999 2003

Cuddalore Tamil Nadu 607803

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hellobala24@gmail.com 9444943704

Medium of Instruction English English English --

Whether studied Tamil as one of the subject Yes Yes No

SSLC -0138397 1997 CBSE No English Tamil ---

Type writing / Short hand Qualification

Type Writing Short hand

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Name of the Examination Centre District: Name of the Examination Centre : Compulsory Subject (apart from General Knowledge) : Do you claim Age Concession? : Under What Category? : Do You Claim Fee Exemption? : Under What Category? : No of free Attempts :

Cuddalore Neyveli General Knowledge with Tamil Yes Scheduled Castes/(Arunthathiyar) Yes SC/SC(A) 3 1.Junior Assistant - Non Security (Post Code:2600) 2.Draftsman(Post Code:2900) 3.Field Surveyor(Post Code:2800) 4.Junior Assistant - Security (Post Code:2400) 5.Bill Collector (Post Code:2500) Not Applicable Not Applicable

Post Preference :

Criminal Case (Registered/Pending/Punishment awarded) : Participation in Political Activities (In agitation/As a Member of Political Organisation/Candidature in Election) : Post Qualification work experience (Start from present Employer) : Name of the Organisation STATE BANK OF INDI A Previous appearance for Oral Test / Written Test Name of the Post Designation ASSISTANT

From(mm/yyyy) 12/2010

To(mm/yyyy) 03/2012

Nature of Duty SWO

Register No.

Year

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DECLARATION:
1. 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, action can be taken against me by the TNPSC. 2. I hereby declare that I will not be a party to any kind of canvassing on my behalf.

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3. I further declare that I fulfil all the eligibility conditions prescribed for admission to the examination.

4. I have informed my employer in writing that I am applying for this Examination.

5. I have gone through the Instructions etc. to candidates and the Commissions notification for this Recruitment before filling up the application form.

6. I declare that I possess the medical standards prescribed for the post(s) which I am now applying.

7. I certify that I have not been debarred by the TNPSC or any other recruiting agency.

8. I am not a dismissed Government Employee.

I accept the above declaration

Place:

Date: 2012-05-09 07:36:29

Signature of Applicant

Please retain your Registration No. and Password emailed to you carefully for further reference