District Recruitment Bureau - 2023

CUDDALORE

(01-2023)Assistant/Junior Assistant in Cooperative Institutions

Registration Number / gÂÎ v© : 03101056

Name of the Applicant / t¨©z¥gjhuu¨‹ bga® : A NIDHANAM
Personal Details / Ra étu§fŸ :
Date of Birth / g¨wªj njj¨ : 03-03-2000
Father`s Name / jªija¨‹ bga® : D ARULANANDHAM
Mother`s Name / jhah® bga® : A ARASILAN KUMARI
Guardian`s Name / fh¥ghs® bga® : -
Gender / ghy¨d« : Female
Marital Status / j¨Ukz« Mdtuh? : Unmarried
Spouce Name / fzt® bga®/kidt¨ bga® : -
Applicant`s Place of Birth / t¨©z¥gjhu® g¨wªj Ïl« : KURINJIPADI
Native State /brhªj khãy« : Tamil Nadu
Native District / brhªj kht£l« : Cuddalore
Mother Tongue/jhŒ bkhê : TAMIL
Nationality / njÁa Ïd« : Indian
Religion / kj« : Hindu
Certificate Details / rh‹¿jœfë‹ étu§fŸ :
Communal Category / tF¥ò : Most Backward Class(MBC)
Name of the Sub-Caste /rhj¨ c£g¨u¨t¨‹ bga® : Vanniyar
Certification Number / rh‹¿jœ v© : 7734920
Date of Issue / tH§f¥g£l njj¨ : 22-12-2014
Issuing Authority / rh‹¿jœ tH§f¨a mj¨fhu¨ : ZONAL DEPUTY TAHSILDAR
Taluk / t£l« : Bhuvanagiri
District / kht£l« : Cuddalore
Are you a Destitute widow ? / No
Mjut‰w t¨jitah ? :

Are you Differently Abled Person ? / No

kh‰W¤ j¨wdhs¨ah? :

Are you an Ex-Serviceman ? / No

K‹dhŸ ÏuhQt¤Âduh? :

Have you been debarred or disqualified by the Public Service Commission or any other recruiting agency from appearing examinations
and selections for specific period or permanently ? / nj®thiza« mšyJ ntW vªj gâ e¨akd Kifikædhnyh nj®ÎfŸ k‰W« bjçÎfëš
fyªJ bfhŸS« cçikæèUªJ j§fis ãuªjukhfnth mšyJ xU F¿¥Ã£l fhy¤Â‰nfh éy¡f¨ it¤njh mšyJ jFj¨a¨‹iknah brŒa¥g£LŸsjh ? : No

Are you Employed ? / No

gâ étu«? :

Co-Operative Training Qualifications Particulars / Tl¦LwÎ¥ gæ‰Á jF F¿j¦j t¨tu§fŸ :

Are you currently undergoing Diploma in cooperative training by regular or correspondence course in Institute of cooperative management? No

Have you Passed any one of the courses mentioned below ? :

P.G Degree in Cooperation in any University recognized by UGC

Name of the Cooperative Training Institute Or College / University : ANNAMALAI UNIVERSITY

Certificate Number / Registration Number /Bonafied Number : 20250033

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Applied Date : 2023-11-27 07:55 pm
 District Recruitment Bureau - 2023
CUDDALORE

Education Qualification Particulars / fšé¤ jF F¿j¦j t¨tu§fŸ :

S.S.L.C. Register S.S.L.C. Certification
Month & Year Of Passing Medium of Instruction S.S.L.C. Education Board
Number Number

5090073 Mar 2015 English STATE BOARD 5389280

H.S.C OR Diploma Month & Year Of Passing Medium of Instruction H.S.C board H.S.C Certificate Number

HSC Mar 2017 English STATE BOARD 1265410

Month & Year Of Medium of

Qualification Name Of Degree Major Subject Name of the Board/ University Certification Number
Passing Instruction
Bachelor of Science
Degree MATHEMATICS Apr 2020 English Thiruvalluvar University 20606293
(B.Sc)

Integrated 5 year PG - - - - - -

Do you want to claim reservation against Persons Studied the prescribed qualification(s) in Tamil Medium(PSTM) : NO

Communication Details / bjhlu¦ò F¿j¦j t¨tu§fŸ :

Address of Correspondence / bjhlu¦ò Kftu¨ : Permanent Address / e¨ue¦ju Kftu¨ :

116 116

SOUTH STREET, VADAKUTHITTAI SOUTH STREET, VADAKUTHITTAI

MELAMANAKUDI PO BHUVANAGIRI TK MELAMANAKUDI PO BHUVANAGIRI TK

District / khtl¦lk¦¦ : Cuddalore District / khtl¦lk¦¦ : Cuddalore

State / khãyk¦ : Tamil Nadu State / khãyk¦ : Tamil Nadu

Pin / mŠrš Fw¨pL : 608601 Pin / mŠrš Fw¨pL : 608601

Email Id / k¨‹dŠrš Kftu¨ : nidhaarul33@gmail.com Mobile Number / if¥ngÁ v© : 6369896366

Application Fee Paid Details/ é©z¥g f£lz« brY¤j¥g£l étu§fŸ :

Transaction Id : ZIC51564584778 Date of Fee Paid / f£lz« brY¤Âa ehŸ : 2023-11-27 Amount Paid / brY¤Âa bjhif : Rs. 500

Declaration / cWÂ bkhê :

I hereby declare that all the particulars furnished in this application are true, correct and complete to the best of my knowledge and belief. In the event
of any information being found false or incorrect or ineligibility being detected before or after the examination,my selection by the
District Recruitment Bureau,is liable for cancellation . / Ï›é©z¥g¤Âš F¿¥Ã£LŸs étu§fsid¤J« v‹ m¿é‰F v£oatiu c©ik.Ï›é©z¥g¤ij
bghW¤jtiu vJΫ kiw¡f¥gléšiy. nju¦é‰F K‹ngh mšyJ Ãwnfh Ï›étu§fŸ jtW mšyJ c©ik¡F¥ òw«ghdJ mšyJ jFÂæ‹ik vd m¿Í«g£r¤Âš khtl¦l
MŸnru¦¥ò e¨iya¤jhš eh‹ nj®ªbjL¡f¥g£lJ K‹ mw¨é¥g¨‹w¨ Ïu¤J brŒa¥gLtj‰Fu¨ajhF «.

I accept the above declaration / nk‰Tw¨a cWÂbkhêia V‰W¡ bfhŸ»‹nw‹

Please retain your Application Number and Password emailed to you carefully for further reference. Signature of Applicant

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Applied Date : 2023-11-27 07:55 pm