ON-LINE APPLICATION FOR TNPSC REGISTRATION

28034Registration # : 3766420

Full Name : P KARTHIBAN

One Time ID : 320597 Name of The Post Applying for : Village Administrative Officer Are you a Destitute Widow? : NA Are you a Differently Abled Person? : NO Are you an Ex-Serviceman ? : NOPPO No : --Date of Discharge / Probable Discharge / Date : --Are you a Government Employee? : NO Nationality / Citizenship : IndianApplication Fee / Intimation Charges details: Payment Mode: NO FEEAmount : 0.00Personal Details : Date of Birth : 23/07/1984Gender : MALEMarried : NoReligion : HinduCandidate's Place of Birth : AranthangiNative District : PudukkottaiFather's Name : K PeriyaiahFather's Place of Birth : PudukkottaiMother Tongue : TamilMother's Name : p AmuthaCommunal Category : Backward Class(BC)Name of the SubCaste : YadavCertificate No : 1420558Date Of Issue : 20/02/2000Issuing Authority : Deputy TahsildarTaluk : AranthangiDistrict : PudukkottaiAddress for Correspondence : Door Number:old-48M/3, New-12,

Ezhilnagar First Street,Aranthangi.

District PudukkottaiState : Tamil NaduPin : 614616Permanent Address : Door Number:old-48M/3, New-12,

Ezhilnagar First Street,Aranthangi.

District PudukkottaiState : Tamil Nadu

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State : Tamil NaduPin : 614616Contact Details : Email ID : kaarthipan@yahoo.co.inMobile No : 8015131390EDUCATIONAL QUALIFICATION PARTICULARS :

Exam Passed Year of Passing Medium ofInstruction

Degree Major Subject

S.S.L.C : 2000 English N/A N/AH.S.C : 2002 English N/A N/A

Degree : 2007 English others Civil EngineeringOthers : --Whether studied Tamil as one of the subject : hscDetails regarding the prescribed qualification : Qualification Details : Other Equivalent QualificationOther Equivalent Qualification Details : B.ECertificate No : 353472Year of Passing : 2007Name of the Authority/ University : AnnaPreferential qualification for per notification : YesPreferential Physical Standards for per notification : Yes

Type writing / Short hand Qualification English Tamil

Type Writing -- --

Short hand -- --

Name of the Examination Centre District: Chennai-SouthName of the Examination Centre : SaidapetCompulsory Subject : General Knowledge with EnglishDo you claim Age Concession? : NoDo You Claim Fee Exemption? : YesUnder What Category? : Backward Class/Backward Class (Muslims)No of free Attempts : 3Post Preference : 1.Village Administrative Officer (Post Code:2025)Criminal Case (Registered/Pending/Punishment awarded) : Not ApplicableParticipation in Political Activities (In agitation/As a Member of PoliticalOrganisation/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

Petronash Engineer -Design 03/2011 03/2012 Structural DesignDharani Constructi

onAssistant Engineer 07/2007 02/2011 Construction

Previous appearance for Oral Test / Written Test

Name of the Post Register No. Year

-- -- --

-- -- --

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 orincorrect 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: 2012-08-10 12:21:04 Signature of Applicant

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

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