ar016 ‘TNPSC Tamil Nadu Public Service Commission SUL HIG sat owen} CH TourromssowiLd Name of the Post Applying for /eilawaai Ab upsises Quusp : POSTS INCLUDED IN GROUP - IV SERVICES. Notification No, / atghedsene ae: 15/2016 Application No. /eSweanuu eae: 616120315 Registration Date: / wiley Gaus pret + 09-09-2016 12:10:42 Inivals Name Name of the Condidete ctenamaugengiér Quug , BMELGUEGHgIeG — Cuts} Gender /ureSena; MALE Date of Birth / DAB CRA: 24-06-1986 Initials Name Fother's Name/ spmpung Que, BMe@LOUCSgIec — CULT a DEVARAS Inivats Name Mother's Name snug Que; BMOLOUEAgES — CUS Marital Status / Sgwemd ajeraupe? MARRIED Spouse's Name /sameu} / weneredutds Quy: DEVE Candidate's Pace of Birth /sinseLusny? UipBs @Lb: DHARMAPURT Father's Place of Birth /shensusrd pie BLO: DHARMAPURE Mother Tongue / gid) Quay: TAMIL Nationality /@5éu @on - INDIAN Religion ‘pio: HINDU sale ae rtificate Details gm 5 Communal Category /eway SC caste so) Name of the Sub = Caste / engi aciieiée cus centifcat No onesie Date of Issue / aipmauuce Ga@ Issuing Authority onde expres sand ‘re you a Differently Abled Person / mbps Speerehur > NO Are you a Government Employee /aigaiuerutersr * NO Have you bean departed or caguaifed by the Pull Service examinations and selections for specific period ar permanently? eaianeneud avo g Cag BE UMM Buloe Wamoercor No Cpyoieu wg Ophase ahs) OancresD AoE SG shiamm SrSBTUraGan RONG GG GHUICL stossipCan sinad maigcgs alias] S@suDetonICuT GewUILUL Gsterse * re you an Ex-Servicemen /qneeenrst Batgpe.ssange? NO Criminal Case Registered / GhmetuK apsg uUuULLA? NO apie. 1, 168 62:8080IsisnctrmAcknawledgement aspx ADIDRAVIDA saszos2 09-07-2004 TALUK TAHSILDAR 48ar016 ‘TNPSC Participation in Political Activities / aipAweSes uieabu? NO Communication Details QSL fu Gis aeutiie st Emall 10/ Rererge0 wand Mobile No! macual ast, o99466se18 bate of Result Published / Gayay (oaoj Gaieful-UULL aA) Mediom of Instruction uta on Name of the Board / Univesity /CphqaSeQUUUdSMOdaysd Certificate Number / eres som Whether studied Tamil as one of the subject / siliny Go UNLOrs TeBBI CREA cubperetyn Select the evidence for Persons Studied In Tamil Mesium (PSTH) with 2 recording that he/she studied the Prescribed orEquivatent Qualification inTemil Mediom SUMO UPA Puree OarwteG Nacassucr avery Perseus ee SHS SGSOU KUN APM (raail NecamULdeDENg UEY Geuigieter seaigmp C500 Sua Certificate of Evidence for PSTM Issued on / exons aupmmuucs Gag) Certificate of Evidence for PSTM Issued by (Issuing authority) / erekipp apsisis smart Diploma Date of Result Published / ¢asay (ago GeisMuML UCL oo—) Medium of Instruction / wip) ony Major Subject / qageten usb Nome of the Board / University /@ppeidecgunbudamerdape Certificate Number / evens) som Degree Date of Result Published / Gaay waxoj GeiofuBL ULL oA Name of the Degree (uti uae Que Major Subject / qagetrana unLwb Name of the Board / University /@ppadecguibudsmedayard Certificate Number | eres som Medium of Instruction wis om ‘Have you passed the Certiicate coutse In Computer on office ‘Automation awarded by the Directorate of Technical Education ? 278 OST GLUS SOG Quageyasars G-AsUOUpD Ne signee sreusiaurbad eneiiiap URIde Cate up gieratyn? ‘Mlitaies she the pedo th probetion BUN BELPOD DDD SOROS WEE SLLET - DHO-I UBC GEG sDerarluprIyce ‘27a OBR PUpLUs AMES SIMD aipwaduod aowahudKs Spiaieon prow muéac ardepDsip (Centeate Coarse tn Computer ox Offer Atematon) CUD AHKE CASO. gs genau eraidsy UNS Slereriusnsieesh Givsciaesae slewantiAeaerr cap EPUALL snaiDiey CupTsAjsct BLUsAlsEsse Osha, No apie. 1, 168 62:8080IsisnctrmAcknawledgement aspx Comrespondence Address /Opntu greed Permanent Addrest Srbsr cae Address Line 1 / qpasulf 1: NO:3/1700,NEW COLONY Address Line 1 / (pseugh 1 - NO:3/1700,NEW COLONY Adores ine 2 qpasif + VENNAMPATTY(ROAD) Agcress Line 2 aa? VENNAMPATTY(ROAD) Adres Line 3 cosas 3: DHARMAPURT Agcres Line 3 @aauf) DHARMAPURL State ose TAMIL NADU State one TAMIL NADU ovstiet rast DHARSAPURL Disc ri. DHARMAPURL Pincode 9s 5380 «36701 Pincode ages @i99 636701 Hayaraja6@emait.com . é ved 24-03-1999) TAMIL, STATE BOARD 06224360 ves MARK SHEET 14-04-1999 SECRETORY 25.04.2007 TAMIL, MECHANICAL ENGINEERING 034000 21-04-2010 MECHANICAL ENGINEERING ANNA UNIVERSITY 60606114307RG ENGLISHar016 ‘TNPSC eUUICUCLEE SAHA SEDAN UBOE HIE “ae abur6 AgANE STeUMELULTEEE" eTEDED URUIE Capea Cup eae. *Do you possess the Survey Trade in 1.71, Tamil Nadu? / S186" siAp Bicigg a6 Op BID UDA BeroUpgle Bo steraip URANO ‘Gubpsuer” Do you have the Physical Standards as per notification? apfslameds guide Gem aupses Cupgiertya: » YES xamination Particulars GajjaNlein oNeuprivescit Name of the Examination Centre / Gsay inusp eH Quip + DHARMAPURI -DHARMAPURI GENERAL STUDIES + APTITUDE TEST AND GENERAL TAMIL Subject(s) for Examination /Gpclparer un (SS-L-C STANDARD ) GUIgiaiBalS Dera’ Cia, WHpNb GUTBE SBD UsET ABN SHON 591) Registration Fees Declaration 2 gy Quon. 1 hereby dectare that all the particulars furished in this application are true, correct and complete to the best of my knowledge and belie. In the event of any Information being found false ar Incorrect or inligibiley being detected before or after the exemination oF at any Slage, any action can be (aken against me by the TNPSC including rejection af my appliestion. Bashoraiugee GGUILGea saguermegeOpul UgsgU LAACRE alma Te BAG aieuarny Larmourerena, Murame VPGO WHMouAME CHAMPS wa sHOg DPA AHOg MHSGuasHCon Halaywade ga —id SSIDTHOA, LEMOEGL YPUUTEME 1G SELB cee si TUbULTsHO Aeraxiu DyraPly LLU conbpy CRFosvaTub AQKGD F605 HLousmaaen a CUUGACDEL 1 hereby declare that twill not be a party to any kind of canvassing on my behalf. far ergDO che csr aenmauulo br gre cL pwsuNe Beare cox Lturther declare that I {uli all the eligibility coneitions prescribes for admission to the examination BSEsjale sipiaslaes Comaluner anatsH Seslawoauld Cup pieces coe a pHs) aplaleya 1 have gone through the instructions to the candidates and the Commission's no {application form grarmarusder “cAoreLUSTpaEsere SAG YODSE Upp BUURAAETE aHorbupLUGABLULG KE aedéseauoreesd Unbe aiiibp Dace Beietelomaupens Woe Oeiigierceren, ication for this Recruitment before filing up the 1 declare that 1 possess the Physical standards prescribed for the post(s) which 1 am now applying Slaroniagn Lgl sop UsMeGees CamauTeN LUD se waccn QupgMemer TaD epPUEREEEDE. Lcestfy that Ihave not been debarred / disqualified by the TNPSC or any other recruiting agency. Ascslarmaussrtor goog Cup hs Ue Pluu Poowamrcor pa AAAs wos SEPFE CoLwUULadlomes send orsnpenasien es, 1am not 9 dismissed Government Employee brat Uesflupey Geuwouce aysuueusend aided 1 have verified the correctness of the particulars furnished in the application and taken 2 printout of the application Daca cUsse SUCH shaywancmpwsus ehinbpy aeenaiey AOeGhg map paced fongp26)- Print Home | Logout ep. 1,168 62:8080IsisnctrmAcknawledgement aspx