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7/21/2019 Karthik tnpsc
http://slidepdf.com/reader/full/karthik-tnpsc 1/3
12/10/2015 TNPSC
http://182.18.164.63/tnpscen192015/tfrmAcknowledgement.aspx 1/3
Tamil Nadu Public Service Commission
Name of the Post Applying for / :VILLAGE ADMINISTRATIVE OFFICER IN THE TAMIL NADUMINISTERIAL SERVICE
Notif ica t ion No. / : 19 /2015
Ap pl ic at io n No . / : 519569746
Registration Date : / : 10-12-201 5 04:59:57
Name of the Candidate / Ṉ :
Initials Name
S KART HIKE YAN
Gender / : MALE
Date of Birth / : 15-03-1980
Father's Name / :
Initials Name
K SRINIVASAN
Mother's Name / :
Initials Name
R VANIT HAMANI
Marital Status / ? MARRIED
Spouse's Name / / : INDUMATHI
Candidate's Place of Birth / : TIRUVANNAMALAI
Native District / : THIRUVANNAMALAI
Father's Place of Birth / : THIRUVANNAMALAI
Mother Tongue / : TAMIL
Nationality / : INDIAN
Religion / : HINDU
Certificate Details /
Communal Category / : SCHEDULED CASTE-ARUNTHATHIAR(SCA)
Name of the Sub - Caste / Ṉ
:ARUNTHATHIYAR
Certificate No / : 2759902
Date of Issue / : 22 - 06- 2001
Issuing Authority /
Ṉ :TAHSILDAR
District / : THIRUVANNAMALAI
Taluk / : THIRUVANNAMALAI
Are yo u a Di ff eren tl y Ab le d Pe rso n / ? NO
Are yo u a Go ve rn men t Em pl o yee / ? NO
Have you been debarred or disqualified by the Public ServiceCommission or any other recruiting agency from appearing
examinations and selections for specific period or permanently? /
Ṉ Ṉ
?
NO
Are yo u an Ex -S erv ic eme n / ? NO
Criminal Case Registered / ? NO
Partic ipat ion in Poli t ica l Activ i t ies / ? NO
Communication Details /
7/21/2019 Karthik tnpsc
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12/10/2015 TNPSC
http://182.18.164.63/tnpscen192015/tfrmAcknowledgement.aspx 2/3
Correspondence Address / Ṉ Permanent Address / Ṉ
Ad dr ess Li n e 1 / Ṉ 1 : 1 22
Ad dr ess Li n e 2 / Ṉ 2 : INDIRA NAGAR
Ad dr ess Li n e 3 / Ṉ 3 : NALLAVAN PALAYAM
State / : TAMIL NADU
District / : THIRUVANNAMALAI
Pin co d e / : 606603
Ad dr ess Li ne 1 / Ṉ 1 : 1 22
Ad dr ess Li ne 2 / Ṉ 2 : INDIRA NAGAR
Ad dr ess Li ne 3 / Ṉ 3 : NALLAVAN PALAYAM
State / : TAMIL NADU
District / : THIRUVANNAMALAI
Pin co d e / : 606603
Email ID / Ṉ : kar [email protected]
Mobile No / : 9952742885
Educational Qualification Particulars /
SSLC
Date of Result Published / : 17-06-1996
Name of the Board / University / / : STATE BOARD
Certificate Number / : 4036152
Whether studied Tamil as one of the subject /
?YE S
Medium of Instruction / : TAMIL
Select the evidence for Persons Studied in Tamil Medium (PSTM) with a recording
that he/she studied the Prescribed orEquivalent Qualification inTamil Medium /
(Tamil Medium)
:
PSTM CERTIFICATE IN PRESCRIBED FORMAT
Certificate of Evidence for PSTM issued on / : 30-09-2013
Certificate of Evidence for PSTM issued by (Issuing authority) /
Ṉ :PRINCIPAL
HS C
Date of Result Published / : 05-06-1998
Medium of Instruction / : TAMIL
Name of the Board / University / / : STATE BOARD
Certificate Number / : 2534295
Whether studied Tamil as one of the subject /
? YE S
Under Graduate
Date of Result Published / : 03-07-2003
Name of the Degree / : B.SC
Major Subject / CHEMISTRY
Name of the Board / University / / : UNIVERSITY OF MADRAS
Certificate Number / : 01757
Whether studied Tamil as one of the subject /
?YE S
Medium of Instruction / : TAMIL
Do you have the Physical Standards as per notification? /
? :YE S
Examination Particulars /
Name of the Examination Centre / : KANCHEEPURAM
Subject(s) for Examination / :GENERAL STUDIES WITH BASICS OF VILLAGE ADMN. ANDGENERAL TAMIL (SSLC STD.)
Registration Fees
*Payment Mode NI L
Declaration /
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, action can betaken against me by the TNPSC.
, Ṉ .
.
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12/10/2015 TNPSC
http://182.18.164.63/tnpscen192015/tfrmAcknowledgement.aspx 3/3
I hereby declare that I will not be a party to any kind of canvassing on my behalf. .
I further declare that I fulfil all the eligibility conditions prescribed for admission to the examination. .
I have gone through the instructions to the candidates and the Commission's notification for this Recruitment before filling up theapplica t ion form.
" "
.
I declare that I possess the Physical standards prescribed for the post(s) which I am now applying. .
I Certify that I have not been debarred / disqualified by the TNPSC or any other recruiting agency.
.
I am not a dismissed Government Employee. .
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