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ON-LINE APPLICATION FOR TNPSC REGISTRATION

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

33036Registration # : 11690448

Full Name :

K MANGAYARKARASI

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 NO NO NO --NO Indian

Post Office 50.00

28/05/1983 FEMALE No Hindu VELLORE Vellore K KATHAVARAYAN Vellore Tamil K KANTHA -Scheduled Caste (SC) PUTHIRAI VANNAN 2782917 30/06/2003 Taluk Tahsildar Vellore Vellore NO.895 BAJANAI KOVIL STREET KARUGAMBATHUR

District State : Pin : Permanent Address :

Vellore Tamil Nadu 632013 NO.895 BAJANAI KOVIL STREET KARUGAMBATHUR

2/3District State : Pin : Contact Details : Email ID : Mobile No : EDUCATIONAL QUALIFICATION PARTICULARS : Exam Passed S.S.L.C : H.S.C : Degree : Post Graduate 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 : Other Equivalent Qualification M.Sc 2311226 2005 THIRUVALLUVAR UNIVERSITY No English Type writing / Short hand Qualification Type Writing Short hand Name of the Examination Centre District: Name of the Examination Centre : Compulsory Subject (apart from General Knowledge) : Do you claim Age Concession? : Do You Claim Fee Exemption? : Under What Category? : No of free Attempts : 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 Previous appearance for Oral Test / Written Test Name of the Post Register No. Year Designation From(mm/yyyy) To(mm/yyyy) Nature of Duty Vellore Vellore General Knowledge with Tamil No Yes SC/SC(A) 0 1.Junior Assistant - Non Security (Post Code:2600) 2.Junior Assistant - Security (Post Code:2400) 3.Bill Collector (Post Code:2500) Not Applicable Not Applicable --Tamil --Year of Passing 1998 2000 2003 2005 Medium of Instruction Tamil Tamil English English -Whether studied Tamil as one of the subject Yes Yes Yes N/A [email protected] 8870901096 Vellore Tamil Nadu 632013

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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.

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

3/34. 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: 2012-06-04 19:06:13

Signature of Applicant

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