TELANGANA STATE PUBLIC SERVICE COMMISSION::HYDERABAD

GROUP II SERVICES
(GENERAL RECRUITMENT)
NOTIFICATION NO: 17/2016 TO 20/2015

BASIC INFORMATION DATA

(CHECK LIST)

(To be filled by the candidate)

TSPSC ID :

Ref ID : PHOTO OF THE

CANDIDATE
HALL TICKET NO :

VENUE: : TSPSC- OFFICE,Nampally-Hyderabad.

DATE OF VERIFICATION:

Signature
Name of the Candidate
01
( as per SSC)

02 Father’s Name

03 Mother’s Name

04 Gender Male Female

05 Religion

Date of Birth D D M M Y Y Y Y
06
( as per SSC)

Years Months days

(Age as on 01/07/2016)
07

If age relaxation is Put ( ) in (No. of years claimed for relaxation)

claimed, specify appropriate box

1) SC/ST and BC Years Months Days

2) Retrenched
Census Employee

3) Telangana State Whether relevant Certificate Produced

Govt. Employee
08 YES NO
4) N.C.C
Official Use

5) Ex-Service Men
09 Qualification As per Quali Date of Name of the
( For Post code 12: Notification ficati acquiring University
Degree with Maths , on qualification
Economics, Commerce
candidates Only eligible)
(For Post Code 13:
Degree with Law
candidates Only Eligible)

(as on 30/12/2015 for the

Notification No. 20/2015
& 17/2016)

(as on 01/09/2016 for the

Notification No. 17/2016
only)

a) Are you eligible for the If yes write your optional

post of Asst.Section YES NO Subjects in Degree level
Officer in Finance Dept
(Post Code No.12)
b) Are you eligible for the YES NO If Yes, Degree in Law certificate
post of Asst.Section must be produced
Officer in Law Dept.
(Post Code No.13)
c)Are you eligible for the YES NO If yes, Physical requirements
post of Prohibition required as per Notification
&Excise Sub-Inspector
(Post Code No.5)
Official use :

10 Community(integrated
Community Certificate OC SC ST BC
Issued by M.R.O for
SC/ST/BC from A B C D E
Telangana State Govt)

Official use :

11 BC Candidates should
Submit Non Creamy Whether non-creamy layer
Layer certificate as per certificate produced Yes No
G.O.Ms.No:8 of 2014
 Official use :
&

MemoNo.3009/BCW/
OP/2011, Dt:18-12-2015.

12 PH –Category VH HH OH

Percentage of Disability

13 Indicate the evidence Class Year District State

(Original Study
Certificate to be
IV
produced) OR
Residence certificate for
7 yrs. Prior to SSC if V
private Study.
VI

VII

VIII

IX

Local Zone to which

14 5th Zone 6th Zone
Belongs.

15 Are you eligible for City

Cadre Post
YES NO
(Asst. Labour Officer)

16 Present Employment
details
(Government Employees
should submit NOC)
 Declaration

I hereby declare that

i) All the columns filled in by me containing my biodata and other particulars, are true to the best of
my Knowledge.

ii) The certificates such as, my educational qualification, community certificate, date of birth (SSC),
study/residence in support of my claim for local candidature is genuine.

iii) I did not resort to any irregular or improper means in connection with my candidature for
selection.

iv) I am liable for permanent debarment from appearing for the recruitment to be conducted by
TSPSC and other PSCs and also criminal prosecution, if I am found involved in any unfair means
/ malpractice.

15
v) I further declare that the information furnished by me is correct and my candidature shall be
cancelled at any stage if it is found incorrect.

Address.

………………………………………………….

…………………………………………………

…………………………………………………..

Mobile No…………………………………

Place:
Date: Signature of the candidate.

TO BE USED FOR ADMISSION (OFFICIAL USE)

The Candidate Admitted for further process.

Jr. ASST./A.S.O SECTION OFFICER ASST. SECRETARY/DY SECRETARY

TO BE USED FOR REJECTION

Jr. ASST./A.S.O SECTION OFFICER ASST. SECRETARY/DY.SECRETARY

SECRETARY