APPLICATION FORM

To,

1 POST CODE:

The Chief General Manager (H.R.)

POST
APPLIED FOR:

Maharashtra State Power Generation Company Ltd., 2nd Floor, Prakashgad, Anant Kanekar
Marg, Bandra (East), Mumbai 400051

Affix your
recognizable
recent Passport
size photograph

Name in full (Surname first) (IN CAPITAL LETTER)

Full Address
a) Residence: (with Telephone No., Mobile No., e-mail address etc.)

P I N
Mobile No.
email ID
b) Office: (with Telephone No., Mobile No., e-mail address etc.)
email ID

P I N
Telephone No.

Domicile of Maharashtra,

Mobile No.

Indicate by ( )

Yes
No

5
Date of Birth:

5(a) Age as on 03rd February 2016:_______Years_______Months_______Days_______

6
Gender:

Male

Female

7
Marital status :

Married
Unmarried
Widow
Divorcee

8
Category: Applied for ( )

SC
ST
NT(B)
SBC
OBC
OPEN

9
Category: Indicate your category by a ( )

SC
ST
VJ(A)
NT(B)
NT(C)
NT(D)
SBC
OBC
OPEN

Are you applying under women reservation:

(Before ticking yes, Ensure that you posses Non-Creamy Layer
Certificate valid as on 3rd Feb 2016) (except women candidates
applying under SC & ST category)

Do you have Non-Creamy Layer

A

certificate (valid as on 3rd Feb 2016):

Are you a meritorious Sports person:

(Before ticking Yes, kindly read the GR. Of Govt. of Maharashtra related to
Sports as mentioned in the Advertisement)

12 If Yes, details of Sports:

Date of Issue of Non-Creamy B Layer Certificate:

13 Are you applyig under Handicap

DD

MM YY

Yes

No

Reservation:
(Before ticking Yes, kindly read the nature of Handicap as
mentioned in the Advertisement for the post you are applying
for)

Yes

No

Yes

No

13
Nature of Permanent Disability

B
& Percentage:
Nature of Permanent Disability
(Minimum should be 40%)

Level (International) Sports Type

Yes

No

Rank / Medal

14
Are you an employee of MAHAGENCO?:

Yes
No

If, Yes, CPF Number :

(Maximum 10 characters)

Current Job Location:

Last Job Location for Retired

MAHAGENCO employee:

15
Present/Retired Designation:

16
Present/Retired Office/Department:

17 Scale of Pay:
Present Gross Emoluments OR last emoluments in case of retired person (Specify Basic Pay, D.A., Other Allowances etc): - COMPULSORY FOR
ALL CANDIDATES

Demand Draft / Pay Order Details: (Drawn in favour of MAHARASHTRA STATE POWER GENERATION CO. LTD., MUMBAI, payable at
Mumbai)
Name of the
Branch
Demand Draft No(6
MICR No. (9 Digits)
Amount
Bank

Digits)

Qualification Details: As on 03rd February 2016:

Educational / Professional Qualification:
Exam Passed (Degree
College / Institute / University
Year of Passing
Percentage of Marks &
and onwards)

Class

21 Details of affiliation with Professional Bodies / Institution / Society:

Name of the Body

Membership No
Since When

22 Experience:
Details of posts held from time to time: As on 03rd February 2016: (If required plese attach seprate sheet)

Name of the
Scale of Pay
Period
Total Experience
Nature of Job

Organization with

Sr. No
Position Held
& Gross
From
To
Year
Month
(Responsibilities

No. of employees &

Emoluments

handled) *

Annual Turnover

23 List of Publications/academic honors received:

24 Proven achievements:

25 Any other information:

I declare that all the above information and particulars are correct and that I will stand disqualified if any information is found to be incorrect at
any stage.
I declare that I have _____(Number) living children as on today, out of which no. of children borne after 28/03/2005 is _____. I am aware that if
any total number of living children are more than two due to children borne after 20/03/2006, I am liable to be disqualified for the post applied.
I declare that I am ready to serve any where in the Company.
I undertake to abide by all the conditions and General conditions mentioned in the advertisement given by the Company.
Place:
Date:
Signature
Note: Copies of Testimonials in support of age, category, qualifications, experience etc. may be furnished, wherever necessary.
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