ox, tas NAVODAYA VIDYALAYA SAMITI Ministry of Education, Deptt. of School Education & Literacy, Government of India ‘TRANSFER DRIVE 2022 - Phase-1 SHALA DARPAN (PIS)ID : 2012110013 APP NO: 136537 FULLNAME: — Mr, MENTEY SRIRAJ PRESENT PLACE/SCHOOL : Srikakulam. DESIGNATION PGT-Computer Science APPOINTMENT MODE AT PRESENT POST : Direct recruitment EMAIL stiraj.mentey@gmail.com NPS NO. : 110003022436 CPF NO. : RETIREMENT DATE: 31-07-2045, NVS JOINING DATE: 22-08-2012 GENDER : MALE, CATEGORY: Scheduled Caste BIRTHDATE: 04-07-1985 RELIGION: Hinduism AADHAR CARD NO. : 8697xxxxxxxx HOME DISTRICT: — West Godavari HOME STATE: Andhra Pradesh (AP) WHETHER JOINED AGAINST Spl. Rectt. Drive: NO YEAR: Spl. Rectt. Drive Region : Date of joining (Spec. Req. Drive) : SERVICE RECORDS School Designation From To Reason Srikakulam, PGT-Computer 22-08-2012 Present Initial Posting on Recruitment Science DISABILITY DETAILS DISABLED CATEGORY: NO. WHO IS DISABLED? DISABILITY : DISABILITY % : CERTIFICATE ISSUE DATE : PRINT DATE: 02-05-2022 an‘SERIOUS AILMENT DETAILS ‘SUFFERING FROM DISEASES IF ANY : NO WHO IS SUFFERING : DISEASE : Disease Detection/Surgery DATE : CERTIFICATE ISSUE DATE: Cert. issued/ countersigned by CHO/CMSICS? SINGLE LADY DETAILS: SINGLE LADY CATEGORY : SINGLE LADY TYPE: ‘SPOUSE DETAILS (If NVS): EMAIL : SERVICE TYPE : CERTIFICATE ISSUE DATE: ‘SPOUSE DETAILS (If Out Of NVS): SPOUSE NAME: BIRTHDATE : DESIGNATION : EMAIL : PLACE TYPE: SERVICE TYPE : STATE: DISTRICT: CERTIFICATE ISSUE DATE: ‘TRANSFER REQUEST DETAILS DO YOU WISH TO PARTICIPATE TRANSFER DRIVE? NO WILLINGNESS TO SERVE AT HARD STATIONS (For Plain Station Employee) PROFILE APPROVED BY: Principal Approve No. CLAIMED TRANSFER CATEGORY : APPROVED TRANSFER CATEGORY : (Principal Approve) Disclosure: | here by deciare that above mentioned information is true to the best of my knowledge and | understand that any misleading information may lead to rejection of application and panalty. (Signature. of Applicant) (02-05-2022 ) PRINT DATE: 02-05-2022 212