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ON-LINE APPLICATION FOR TNPSC REGISTRATION

This online application is provisional subject to payment of application fees/ intimation charges

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Registration # : 341107537

Full Name : P GAUTHAM

One Time ID : 13106316

Name of The Post Applying for :Combined Civil Services Exam - II

(Group II) - (Interview - Posts)

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 date of Discharge : --

Are you a Government Employee? : NO

Nationality / Citizenship : Indian

Application Fee / Intimation Charges details:

Payment Mode: Post Office

Amount : 75.00

Personal Details :

Date of Birth : 24/04/1991

Gender : MALE

Married : No

Religion : Hindu

Candidate's Place of Birth : VRIDDHACHALAM

Native District : Perambalur

Father's Name : T PANDIYAN

Father's Place of Birth : Perambalur

Mother Tongue : Tamil

Mother's Name : P AMUDHA

Communal Category : Backward Class(BC)

Name of the SubCaste :Kammalar or Viswakarma/Viswakarmala incl. Thattar / Porkollar / Kannar / Karumar /

Kollar / Thachar / Kalthachar / Kamsala & Viswabrahmin

Certificate No : 6912861

Date Of Issue : 13/05/2008

Issuing Authority : Deputy Tahsildar (Certificates)

Taluk : Perambalur

District : Perambalur

Address for Correspondence : 5A/68 A7 BHARATHIDASAN STREET

7TH CROSS

PERAMBALUR

District Perambalur

State : Tamil Nadu

Pin : 621212

Permanent Address : 5A/68 A7 BHARATHIDASAN STREET

7TH CROSS

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PERAMBALUR

District Perambalur

State : Tamil Nadu

Pin : 621212

Contact Details :

Email ID : gauthaaa@gmail.com

Mobile No : 7598335265

EDUCATIONAL QUALIFICATION PARTICULARS :

Exam Passed Date of

Publication of

Results

Medium of

Instruction

Degree Major Subject Board / University

S.S.L.C : 05/06/2006 English N/A N/A MATRICULATION

H.S.C or Equivalent

Qualification :

09/05/2008English H.S.C

N/ASTATE BOARD

Degree : 01/08/2012 English B.E. AERONAUTICAL ANNA UNIVERSITY

Others : --

Do you claim reservation for Persons Studied in Tami l Medium (PSTM)? : No

Details regarding the prescribed qualification :

Qualification Details : Any Degree

Other Equivalent Qualification Details : --

Certificate No : CBEA000130

Year of Passing : 2012

Name of the Authority/ University : ANNA UNIVERSITY

Do you have the preferential qualification as per notification? : No

Physical Standards as per notification : Yes

Type writing English Tamil

Type Writing -- --

Name of the Examination Centre District: Perambalur

Name of the Examination Centre : Perambalur

Optional Subject (As per Notification) : General Studies (Degree Standard) with General English (S.S.L.C Standard)

Do you claim Age Concession? : No

Do You Claim Fee Exemption? : No

Criminal Case (Registered/Pending/Punishment awarded) : Not Applicable

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

-- -- --

-- -- --

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.

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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 / disqualified by the TNPSC or any other recruiting agency.

8. I am not a dismissed G overnment Employee.

I accept the above declaration

Place:

Date: 2013-09-12 17:16:55 Signature of Applican

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

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