3/6/2019 KPTCL

Application for the Post of Junior Assistant

Application Id / ಅ ಸಂ ೆ CEJA104070
Applicant's Full Name(as in SSLC/10th Certificate) /ಆಭ ಯಪ ಣ ೆಸರು Prathvi M D
Mother's Name / ಾ ಯ ೆಸರು Vanajakshi M T
Father's Name /ತಂ ೆಯ ೆಸರು Devaiah A M
Date of Birth /ಜನ ಾಂಕ 09/03/1993
Applied category/ ೋ ರುವ ವಗ ST/ಪ.ಪಂ
ROHINI NILAYA
Address for communication/ SEEGETHODU
ಪ ಣ ಾಸ DEVARAPURA POST
GONIKOPPAL
Taluk/ ಾಲೂಕು Virajpet
District / ೆ MADIKERI
State/ ಾಜ Karnataka
PIN/ 571213
Email Address /ಇ- ೕ ಾಸ prathviprathvi97[at]gmail[dot]com
Mobile / ೈ 9482236458
Gender Male
Are You married No
Date of submission 06/03/2019
Qualification PUC
Name of the College/Institution and University Cauvery College Gonikoppal
Maximum Marks : 600
Marks obtained 290
SSLC Registration Number 20090538504
State/Central Government Servant N
Presently working N
Test Centre Mysuru
Ever been dismissed from your services? No
Percentage 48.33330
Selected Company CESC Only
Rural Yes
KMS No
PDP No
Ex-Military person No
Physically Handicapped(PH) No
**You are excempted from Application Fee as per Notification and your claim**
Do you claim age relaxation? No
Inservice No No. of Years 0
Ex-Military person/ No No. of Years
Physically Handicapped(PH) /
ಅಂಗ ಕಲ ಅಭ ೕ No

ಅಭ ಯ ೂೕಷ ೆ : I declare that I have gone through this recruitment notification carefully and that to the best of my knowledge and
belief the information furnished by me in the application form are true and correct. I Agree that, if the information furnished by me is
found to be not true, I will not only be disqualified from further stages of recruitment but also liable for appropriate legal action./ ಾನು
ೇಮ ಾ ೆ ಸಂಬಂಧಪಟ ಪ ಕಟ ೆಯನು ಗಮನ ಟು ಓ ರು ೇ ೆ ಮತು ಈ ಅ ಯ ಾನು ಒದ ರುವ ಾ ಯು ನನ ಳವ ೆ ೆ ಅನು ಾರ ಸತ ಾ ಯೂ ಮತು ಸ ಾ ಯೂ
ಇರುತ ೆ ಎಂದು ಪ ಾ ೕಕ ೂೕ ಸು ೇ ೆ. ಈ ಅ ಯ ಒದ ರುವ ವರಗಳ ಸುಳ ಅಥ ಾ ತ ೆ ಂದು ಕಂಡುಬಂದ ೇಮ ಾ ಯು ಮುಂ ನ ಹಂತಗ ೆ ಾನು ಅನಹ ೊಳ ವ ದರ
ೊ ೆ ೆ ಾನು ಸೂಕ ಾನೂನು ಕ ಮ ೆ ಒಳಪಡು ೆ ೆಂಬು ಾ ಒ ರು ೇ ೆ.

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