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ON-LINE APPLICATION FOR TNPSC REGISTRATION
4504
Registration # : 391565961
Full Name : M NIRMAL RAJ
One Time ID : 11501610
Name of The Post Applying for : Group-IV Services
Are you a Destitute Widow? : NA
Are you a Differently Abled Person? : NO
Are you an Ex-Serviceman ? : NO
PPO No : --
Date of Discharge / Probable Discharge / Date : --
Are you a Government Employee? : NO
Nationality / Citizenship : Indian
Application Fee / Intimation Charges details:
Payment Mode: NO FEE
Amount : 0.00
Personal Details :
Date of Birth : 29/03/1989
Gender : MALE
Married : No
Religion : Hindu
Candidate's Place of Birth : THANJAVUR
Native District : Thanjavur
Father's Name : R MUTHUMANI
Father's Place of Birth : Thanjavur
Mother Tongue : Tamil
Mother's Name : M SHANTHI
Communal Category : Backward Class(BC)
Name of the SubCaste : Agamudayar incl. Thozhu or Thuluva
vellala
Certificate No : 5839792
Date Of Issue : 20/08/2004
Issuing Authority : Zonal Deputy Tahsildar
Taluk : Thanjavur
District : Thanjavur
Address for Correspondence : 2/545 SAVIER NAGAR
VILAR ROAD
THANJAVUR
District Thanjavur
State : Tamil Nadu
Pin : 613006
Permanent Address : 2/545 SAVIER NAGAR
VILAR ROAD
THANJAVUR
District Thanjavur
State : Tamil Nadu
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Pin : 613006
Contact Details :
Email ID : [email protected]
Mobile No : 9952479411
EDUCATIONAL QUALIFICATION PARTICULARS :
Exam Passed Year of
Publication of
Result
Medium of
Instruction
Degree Major Subject Board / University
S.S.L.C : 2004 Tamil N/A N/A STATE BOARD
H.S.C : 2006 Tamil N/A N/A STATE BOARD
Degree : 2011 English B.Sc.MATHEMATICS BHARATHIDASAN
UNIVERSITY
Diploma : 2008 English N/A DOSTBHARATHIDASAN
UNIVERSITY
Others : --
Do you claim reservation for Persons Studied in Tamil Medium
(PSTM)? : Yes
Are you trained person in Survey in ITI, Tamil Nadu?
(Eligible for Field Surveyor and Draughtsman post only)? :No
Details regarding the prescribed qualification :
Qualification Details : SSLC
Other Equivalent Qualification Details : --
Certificate No : 1431683
Year of Passing : 2004
Name of the Authority/ University : STATE BOARD OF TAMILNADU
Preferential qualification for per notification : Yes
Type writing / Short hand Qualification
EnglishCert. No. Issued by Dir. of
Technical EducationTamil
Cert. No. Issued by Dir.
of Technical Education
Type
Writing-- -- -- --
Short
hand-- -- -- --
Computer Qualification (for Typist and Steno-Typist, Grade III)
?
Do you possess Certificate Course in Computer on Office
Automationawarded by the Technical Education Department? :
Yes
Preferential Physical Standards for per notification : Yes
Do you claim reservation for Persons Studied in Tamil Medium
(PSTM)? : Yes
Name of the Examination Centre District: Thanjavur
Name of the Examination Centre : Thanjavur
Optional Subject (As per Notification) : General Studies with
General Tamil (S.S.L.C Standard)
Do you claim Age Concession? : No
Do You Claim Fee Exemption? : Yes
Under What Category? : Backward Class/Backward Class
(Muslims)
No of free Attempts : 2
Post Preference :
1.Junior Assistant (Security) (Post Code 2400)
2.Junior Assistant (Non-Security) (Post Code 2600)
3.Bill Collector, Grade-I (Post Code 2500)
4.Field Surveyor (Post Code 2800)
5.Draftsman (Post Code 2900)
Criminal Case (Registered/Pending/Punishment awarded) : Not Appl
icable
Participation in Political Activities (In agitation/As a Member
of Political
Organisation/Candidature in Election) :Not Applicable
Post Qualification work experience (Start from present Employer)
:
Name of the Organisation Designation From(mm/yyyy) To(mm/yyyy)
Nature of Duty
Previous appearance for Oral Test / Written Test
Name of the Post Register No. Year
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DECLARATION:
1. I hereby dec lare that all the particulars furnished in this
application are true, cor rect and c omplete 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.
3. I further declare that I fulfil all the eligibility
conditions presc ribed for admission to the examination.
4. I have informed my employer in wr iting that I am applying
for this Examination.
5. I have gone through the Instruc tions 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 G overnment Employee.
I accept the above declaration
Place:
Date: 2013-07-13 21:18:07 Signature of Applican
Please retain your Registration No. and Password emailed to you
carefully for further reference
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