Ordinary Elections to Localbodies - Tamil Nadu - 2019

Registration of polling personal for local body election duty

Staff Details

1. CPS or GPF Number (If CPS/GPF Number no available, enter Mobile CPS Number GPF Number Mobile Number
Number) Number : _____________________

2. Name of the Staff

Govt PSU College Aided School

3. Working Office Type
Other Organization Private

4. Name of the Department / Organization

5. Name of the Office

6. Drawing and Disbursing Officer(DDO)

7. Designation

8. Gender Male Female Trans Gender

9. Type of Pay Special Pay Regular pay Consolidated pay

10. Level of Pay (As per 7th Pay Commission)

11. Cell of Pay (Level) / Current Basic Pay

12. Mobile Number

13. Email ID

14. Place of Working District

TownPanchayat Municipality Corporation

14(a) Place of work located in Localbody Type
Panchayat Union

14(b) Name of Localbody / Zone Code

15. Residence District

TownPanchayat Municipality Corporation

15(a) Residence District Localbody Type
Panchayat Union

15(b) Name Localbody / Zone Code

16. Native District

TownPanchayat Municipality Corporation

16(a) Native District Localbody Type
Panchayat Union

16(b) Name Localbody / Zone Code

17. Name of Police Station for Residential Area

18. EPIC Number

19. Previous Experience

19(a). Previously worked in L B Election ? Yes No

19(b). Previously Handled EVM ? Yes No

19(c). Any Punishment awarded for Assembly/Localbody Yes No

Official use Only : Polling Official Category for Consolidated pay Employee : Category - 2 (3,4,5) Category - 3 (2,6)

Polling Official Category fixation has to be done by PA Election office Only