TAMIL NADU PUBLIC SERVICE COMMISSION

FORM-1
Page 1 of 2
ANSWER SHEETS PACKING REPORT
(To Be Filled in and RETURNED to TNPSC)
Combined Civil Services Examination – 4
1. Name of the Examination :
(Group – IV Services)

2. Name of the Centre : 1807-Kalayarkovil

3. Venue Name and Number : 09- Suthanthira Polytechnic College

4. Date of Examination : 11.02.2018

5. Time of Examination : 10.00am to 01.00pm

Total Number of Candidates actually allotted to this

6. : 200
venue ( As per the Nominal List/Attendance Sheet)
Register Numbers of the candidates admitted in addition
7. : Nil
to the actually allotted candidates.
No. of Presentees (i.e. Total Number of used OMR
8. :
answer sheets.)

9. No. of Absentees ( total Number alone) :

Register Numbers of the candidates who have returned
10. the OMR Answer sheet as Blank(without shading any of : Nil
the answers field)
Register Numbers of the candidates who have used
11. pencil for answering in the OMR answer sheets given to : Nil
them
Specify the Number printed on the Barcode Sticker (
12. Ensure that barcode Stickers have been stuck on the : 1203H031
inner brown cover as per the instructions)
Time of packing of USED OMR answer sheets by the
13. : 01.40pm
Chief Invigilator
Number of seals affixed by the Chief Invigilator on the
14. : 10
outer cloth cover
Name of the Commission’s Staff/Officer deputed for
15. Inspection duty. (Name the senior most official, if more : Nil
than one.)
Time of handing over of used OMR answer sheets Nil
16. :
(Bundle-I) to the staff / Officer of the commission. (for Chennai Centre Only)
Time of handing over of used OMR answer
17. : Nil
sheets(Bundle-I) to the Treasury Staff
(Mofussil Centres)
I was personally present during counting and packing of used OMR Sheets and while affixing Barcode Sticker on the Pocket. The
Bundle contains 224numbers of used OMR Sheets

Signature of the Chief Signature of the TNPSC Signature of the Treasury Staff
Invigilator Staff

Signature of the ED wing Staff TNPSC

 TAMIL NADU PUBLIC SERVICE COMMISSION
Page 2 of 2
FORM-1
CERTIFY BY THE CHIEF INVIGILATOR
Strikeout whichever is not applicable

Certified the no other candidates except those given in the attendance sheets have appeared in this
examination

Or
Certified that the following candidate(s) has/ have been provisionally admitted to this examination
based on the information furnished by the candidate(s) with Application Registration ID number allotted as
Register Numbers and that the photos and undertaking in the prescribed format (Annexure- VI) obtained from
them are enclosed in Bundle-III.
Register No Register No
Sl.No Name of the Candidate Sl.No Name of the Candidate
Allotted Allotted
1

NIL
8

10

11

12

13

14

15

16

Signature of the Chief Invigilator

(With Designation Seal)
 TAMIL NADU PUBLIC SERVICE COMMISSION

FORM-2
Page1 of 2
(To Be Filled in and RETURNED to TNPSC)

RûXûUd LiLô¦lTô[¬u A±dûL

úRo®u ùTVo : Combined Civil Services Examination – 4 (Group – IV Services)

úRoÜ Sôs : 11.02.2018
úRoÜ ûUVm : 1807-Kalayarkovil
úRoÜ áPm Gi. ùTVo : 09- Suthanthira Polytechnic College

§Ú. T. NWYQi
1 RûXûUd LiLô¦lTô[¬u ùTVo Utßm AYo Y¡dÏm TR® : ØRpYo

úRoÜ LiLô¦lTô[oL°u ùTVoLs Utßm AYoLs Y¡dÏm TR®Lu Tt±V ®YWeLs

2 : Bm, CûQdLlThÓs[Õ
CQdLlThÓs[]Yô?

A) CkR úRoÜ áPj§p LiTôoûYVt\/ûLLs

CVXôR Uôtß §\]ô°LÞdLôL úRoÜ GÝÕm ùTôÚhÓ ER®Vô[o(Scribe) GYúWàm
¨VªdLlThP]Wô?
3 : CpûX
B) Bm G²p GjRû] STo? AYoL[Õ ùTVoLs Utßm AYoLs Y¡dÏm TR®Ls Tt±V
®YWeLû[ ϱl©ÓL.

A) úRoÜ Sô[uß ReLÞdÏ ER®VôL ReL[Õ Aû\«p úRoÜl T¦Vôt±V

LiLô¦lTô[oL°u(Invigilators to Assist Chief Invigilator) ùTVoLs Utßm AYoLs
4 : 1. §Ú. Gm.úLô©Sôj ®¬ÜûWVô[o
Y¡dÏm TR®Ls Tt±V ®YWeLû[ ϱl©ÓL.

Bm, 1 STo,
5 LôYp T¦dÏ LôYXo YÚûL ׬kR]Wô? Bm G²p GjRû] úTo? LôYXo Gi(PC No) : 1. Grade1. No:1065

®]ôjRôsLs APe¡V LhÓLs N¬TôodLl ThP]Yô? AûY úNRm Cu± ØÝûUVôL

6 : Bm
CÚkR]Yô?

®]ôjRôsLs APe¡V Es Eû\Ls N¬ TôodLlThP]Yô? AYt±u U¥l×Ls KWeLs Utßm

7 : Bm
Øj§ûWLs ØÝûUúVôÓ CÚkR]Yô?

®]ôjRôsL°u Gi¦dûL Utßm úRoÜdLô] TôPj§u ùTVo KqùYôußm ùY° Eû\«p

8 : Bm
ϱl©h¥ÚkRT¥ N¬VôL CÚkR]Yô?

JqùYôÚ úRoÜl TôPj§tϬV ®]ôjRôsLs ϱl©hP úRoÜ Sôs Utßm úSWj§p

9 : Bm
®iQlTRôWoLÞdÏd ùLôÓdLlThP]Yô?

JqùYôÚ TôPj§Ûm ùT\lThP ®]ôjRôhL°u Gi¦dûLÙm ®iQlTRôoLÞdÏd ùLôÓdLlThP

10 : Bm
®]ôjRôsLs Tt±V ®YWeLÞm úRoYôûQVj§tÏ AàlTlThÓs[]Yô?

EeLÞdÏ AàlTlThP ùTVol Th¥V-p úRoÜdÏ YWôRYoL°u T§Ü GiLs ϱdLlThÓ

11 : Bm
úRoYôûQV AÛYXLj§tÏ §Úl© AàlTlThÓs[Rô?

§Úl×L.....
 TAMIL NADU PUBLIC SERVICE COMMISSION

Form-2
Page 2 of 2
-2-

12 ®iQlTRôWoLÞdLô] ®§ûV Á±VRtLôL/ KÝe¸]f ùNVpLs LôWQUôL GkR :

CpûX
®iQlTRôWúWàm úRoÜd áPjûR ®hÓ ùY°úVt\lThP]Wô? AlT¥Vô«u AYoLÞûPV
ùTVo, T§Ü Gi JqùYôÚYÚm ùNnR Ït\j§u ®YWm B«VYtû\d ϱl©PÜm.

13 GkR ®iQlTRôúWàm NkúR¡dÏmT¥ CÚkRôWô? AlT¥Vô«u AYoLÞûPV ùTVo, T§Ü :

Gi, úUÛm AYoLs ÁÕ GÓdLlThP SPY¥dûLûVd ϱl©PÜm CpûX

14 RûXûUd LiLô¦lTô[o / LiLô¦lTô[o GYÚûPV AàU§«u± ®iQlTRôWoLs GkR :

úSWj§XôYÕ ùY°«p ùNu\]Wô? CpûX

15 úRoÜ ûUVj§p GjRû] áPeLs ApXÕ Aû\L°p úRoÜ SPjRÕ AkRkR Aû\LÞdÏl :
ùTôßlúTtßl T¦Vôt±V LiLô¦l Tô[oL°u ùTVoLs TR® ØRXô] ®YWeLs APe¡V
Bm
úRoÜdáP YûWTPeLs AàlTlThÓs[]Yô?

16. ØuTQUôL YôeLlThP ùRôûL GqY[Ü? GqY[Ü TQm ùNXT¯dLlThPÕ? Á§ HúRàm :

§Úl©d ùLôÓdLlThPRô? CpûX

17 LiLô¦l× T¦dLôL úRoYôûQVj§-ÚkR YkR AÛYXo Utßm UôYhP Bh£VWôp :

T¦VUojRlThP AÛYX¬u ùTVo Utßm TR®. Gu. TôXNk§Wu
Nôo T§Yô[o, úNkRUeL[m

18 RtLô-L AàU§f ºhÓ(Temporary Hall Ticket) Utßm Uôtß AàU§f ºhÓ :

(Duplicate Hall Ticket) L°u A¥lTûP«p úRoÜ GݧVYoL°PªÚkÕ ùT\lThP BYQeLs
CpûX
úRoYôûQVj§tÏ AàlTlThÓs[]Yô?

19 ®ûPjRôsLs ûYdLlThÓ AàlTlThP Eû\«u úUp úRoÜdÏ YWôRYoL°u T§Ü GiLs :

ϱdLlThÓs[]Yô? ( Õû\j úRoÜLÞdÏ UhÓm) Bm

RûXûUd LiLô¦lTô[¬u ûLùVôlTm

CPm: B«pTh¥

úR§: 11.02.2018

Name of the Examination
Centre Name
Date of Examination
TAMIL NADU PUBLIC SERVICE COMMISSION
FORM-3
(To be filled in and Returned to TNPC)
Combined Civil Services Examination
:
– 4 (Group – IV Services) Venue
09- Suthanthira
: Suthanthira Polytechnic College number &
Polytechnic college
name
: 11.02.2018 & 10.00 am to 1.00pm

NO RELATION CERTIFICATE FROM CHIEF INVIGILATOR AND ALL INVIGILATORS INCLUDING INVIGILATORS
TO ASSIST CHIEF INVIGILATOR ANS SCRIBE(S) IF APPOINTED IF ANY

Certified that none of my relative or person known to me has appeared for the above said examination
in this Venue.
Chief Invigilator /
S.No Name & Designation Room No. Signature
Hall Invigilator
P. SARAVANAN
1. Chief Invigilator
Principal

M.Durairaj Asst. to Chief

2.
Lecturer Invigilator

K.Arivazhagan
3. Hall Invigilator
Head of Department

D.Rajakumaran
4. Hall Invigilator
Lecturer

K.Rajesh Kannnan
5. Hall Invigilator
Lecturer

K. Vidhya
6. Hall Invigilator
Lecturer

K. Kathirvel
7. Hall Invigilator
Lecturer

C.Palanimuthu
8. Hall Invigilator
Lecturer

M.Nizarudeen
9. Hall Invigilator
Lecturer

A.Suganya Christy
10. Hall Invigilator
Lecturer

K. Selvameenal
11. Hall Invigilator
Lecturer

K. Anitta
12. Hall Invigilator
Lecturer

Signature of the Chief Invigilator

(Name in block letter with Designation & Address)
P.SARAVANAN
Suthanthira Nagar, Kalakanmai,
Kalayarkovil, Sivagangai-630555
 TAMIL NADU PUBLIC SERVICE COMMISSION

FORM- 4
(To be filled in and RETURNED to TNPSC)
[Two Copies one for Bundle-II and another for Bundle-III]

Name of the Examination : Combined Civil Services Examination

– 4 (Group – IV Services)
Venue Number 09-Suthanthira
Centre Name :
1807-Kalayarkovil and Name Polytechnic
College
Date of Examination :
11.02.2018

OMR ANSWER SHEETS ACCOUNT

No. of OMR answer No. of OMR answer

No. of OMR answer No. of OMR answer sheets returned ( sheets damaged/
sheets received sheets distributed Number wise statement cancelled ( with serial
to be attached) number)

220 224 96 Nil

CERTIFICATE

Certified that no used or unused OMR answer sheets are kept with me.

Signature of the Chief Invigilator

[P.SARAVANAN/Principal
Suthanthira Nagar, Kalakanmai,
Kalayarkovil, Sivagangai-630555]
 TAMIL NADU PUBLIC SERVICE COMMISSION
FORM- 5
(To be filled in and RETURNED to TNPSC)

Combined Civil Services Examination

Name of the Examination :
– 4 (Group – IV Services) Venue Number 09-Suthanthira
and Name Polytechnic
Centre Name : 1807-Kalayarkovil
College

Date of Examination : 11.02.2018

Session : FN
QUESTION BOOKLETS ACCOUNT
Total number of Total number of
Question Booklet Balance Question
Subject question booklet question booklets
code Booklets
received issued
001-General Studies with
General Tamil
GRFT3 220 224 96

001-General Studies with

General English
20 0 20
GRFE0

Total 240 224 116

CERTIFICATE REGARDING THE OPENING OF QUESTION BOOKLET PACKETS

Time of
Question Total number of question
opening of Total number of
Subject Paper paper packets opened for
question paper packet received
Code no. distribution
packet
10 X 10 X
001-General Studies 20 X16 20 X15
GRFT3 9.40AM
with General Tamil
= 320 Nos. = 300 Nos.
10 X 10 X
001-General Studies -
GRFE0 20 X 1 20 X ---
with General English
= 20 Nos. = --- Nos.

Total 340 300

1. Certified that the seals on the Question Paper Cover have not been tampered.
2. Certified that all the unused question papers and wrappers of question paper booklets have been
returned in a sealed bundle to the TNPSC.
Signature of the Invigilator
1.

2. Signature of the TNPSC Staff

(if available in your Hall)

Signature of the Chief Invigilator

[P.SARAVANAN/Principal
Suthanthira Nagar, Kalakanmai,
Kalayarkovil, Sivagangai-630555]
 TAMIL NADU PUBLIC SERVICE COMMISSION
FORM- 7
(To be filled in and RETURNED to Tamil Nadu Public Service Commission in duplicate)
Combined Civil Services Examination
Name of the Examination :
– 4 (Group – IV Services)
Venue Number 09-Suthanthira
Centre Name : 1807-Kalayarkovil and Name Polytechnic
College
Date of Examination : 11.02.2018
UTILISATION CERTIFICATE
Certified that the advance amount of Rs.13000/- ( Rupees Thirty Thousand Only) received from The
Secretary, Tamil Nadu Public Service Commission, Chennai, for the conduct fo written Examination relating to
the post of TNPSC Group-IV Service Exam held on 11.02.2018 at Suthanthira Polytechnic College
centres was utilized in full/ part towards conduct of the above said Examination. Necessary list of expenditure
for the amount Utilized is enclosed. The unspent amount of advance of Rs. ----– (Rupees ---- only) is
returned.

Encl: List of the expenditure incurred. Signature of the Chief Invigilator

[P.SARAVANAN/Principal
Suthanthira Nagar, Kalakanmai,
Kalayarkovil, Sivagangai-630555]

TAMIL NADU PUBLIC SERVICE COMMISSION

Combined Civil Services Examination
Name of the Examination :
– 4 (Group – IV Services)
Venue Number 09-Suthanthira
Centre Name : 1807-Kalayarkovil and Name Polytechnic
College
Date of Examination : 11.02.2018
UTILISATION CERTIFICATE
Certified that the advance amount of Rs.10300/- ( Rupees Ten Thousand Three hundred Only)
received from The Secretary, Tamil Nadu Public Service Commission, Chennai, for the conduct fo written
Examination relating to the post of Combined Civil Services Examination – 4 (Group – IV Services)held on
11.02.2018 at 09- Suthanthira Polytechnic College centres was utilized in full/ part towards conduct of the
above said Examination. Necessary list of expenditure for the amount Utilized is enclosed. The unspent
amount of advance of Rs. ---– (Rupees ---- only) is returned.

Encl: List of the expenditure incurred. Signature of the Chief Invigilator

[P.SARAVANAN/Principal
Suthanthira Nagar, Kalakanmai,
Kalayarkovil, Sivagangai-630555]
 TAMIL NADU PUBLIC SERVICE COMMISSION
FORM- 8
(To be filled in and RETURNED to TNPSC)
Combined Civil Services Examination
Name of the Examination :
– 4 (Group – IV Services)
Venue Number 09-Suthanthira
Centre Name : 1807-Kalayarkovil and Name Polytechnic
College
Date of Examination : 11.02.2018

LIST OF THE EXPENDITURE INCURRED

Total
Sl.No. Description
Rs. Ps.
1. Remuneration to Chief Invigilators, Invigilators & OA 10000.00

2. Remuneration to Sweeper, Scavenger & Waterman 300.00

3. Remuneration to Police 200.00

4 Stationery 600.00

5 Hall Rent 1500.00

6. Remuneration to Inspection Staff deputed by DRO/ Collector 400.00

Total amount received : Rs.13000.00

Total amount spent : Rs. 13000.00
Balance amount Rs : Nil

(Rupees
_____________________________________________________________________________
Only)
Signature of the Chief Invigilator
[P.SARAVANAN/Principal
Suthanthira Nagar, Kalakanmai,
Kalayarkovil, Sivagangai-630555]
 TAMIL NADU PUBLIC SERVICE COMMISSION
FORM- 9
úRoÜ BnÜl T¦dÏ UôYhP Bh£Vo AYoL[ôp ¨VªdLlTÓm AÛYXo, úRoÜd LhÓlTôÓ AÛYXÚdÏ NUol©dLlTP úYi¥V
A±dûL T¥Ym.
(ØRuûU LiLô¦lTô[o êXUôL NUol©dLlTP úYiÓm)

úRo®u ùTVo: Combined Civil Services Examination – 4 (Group – IV Services)

úRoÜ Sôs/úSWm: 11.02.2018/ úRoÜdáP Gi(Venue No.): 09

10.00am to 01.00pm
úRoÜ ûUVm: 09-Suthanthira úRoÜdáP ØLY¬: Suthanthira Nagar, Kalakanmai,
Polytechnic College Kalayarkovil, Sivagangai-630555

1. úRoÜd áPj§tÏ ùNu\ úSWm : 07.00am

Aû]jÕd LiLô¦lTô[oLÞm ϱjR úSWj§p YÚûL ׬kRôoL[ô?

2 : Bm

®]ôj RôhLs APe¡V Eû\Ls ©¬dLlTÓm úTôÕ EPu CÚk¾oL[ô?

3 : Bm

®]ôj RôhLs APe¡V Eû\L°p Øj§ûWLs(Seals) ØÝûUVôL CÚkR]Yô?

4 : Bm

5 ®]ôj RôhLs APe¡V Eû\Ls ©¬dLlThP úSWm? : 9.40am

6 ARtϬV T¥Yj§p ûLùVÝj§h¼oL[ô? : Bm

ÁRØs[ ®]ôj RôPLs úNL¬dLlThÓ N¬TôodLlThÓ LôûX 10.45 U¦dÏs

7 Øj§ûW«PThÓ Tj§WUôL ûYdLlThP]Yô? : Bm

Bm, 1 STo
LôYp T¦dÏ LôYXo YÚûL ׬kRôWô? Bm G²p GjRû] úTo? LôYXo Gi(PC.No.) 1. Grade1 No1065/
8 :
A.Mayakannan

®iQlTRôWoLs HúRàm KÝe¸]f ùNVpL°p DÓThPôoL[ô? Bm G²p ®TWm RÚL

9 : CpûX

ReL[Õ E\®]o / ùR¬kRYo GYúWàm CkRj úRoÜd áPj§p úRoÜ Gݧ]ôoL[ô?

10 : CpûX

Aû\d LiLô¦lTô[oLs / ®iQlTRôWoLs úRoÜ SûPùTt\ NUVj§p ûLúT£Lû[l

TVuTÓj§]Wô? Bm G²p úRoYû\ Gi/ ®iQlTRôWoL°u T§Ü Gi. B¡VYtû\d
11 : CpûX
ϱl©ÓL.

úRoÜ Ø¥kR©u ®ûPjRôhLû[d Lh¥ Øj§ûW«Óm úTôÕ EPu CÚk¾oL[ô? Bm

12 G²p úSWm ϱl©ÓL : Bm

úRo®u úTôÕ úRoÜdÏ NmUkRªpXôR úRoÜdÏ Tô§l× HtTÓm YûL«p, HRôYÕ

13 ¨LrÜ SPkRRô? CÚkRo AÕ Ï±jÕd ùR¬®dLÜm : CpûX

14 úRoÜ SPkRÕ Ï±jÕ HRôYÕ LÚjÕ ApXÕ T¬kÕûW ùNn¡ÈoL[ô? CpûX

BnÜ AÛYX¬u ûLùVÝjÕ

ùTVo: Gu. TôXNk§Wu
TR®: Nôo T§Yô[o,

RûXûU LiLô¦lTô[o ûLùVôlTm AÛYXL ØLY¬:

Lôû[Vôo úLô®p, ÑRk§Wô SLo, Lô[dLiUôn, £YLeûL

TAMIL NADU PUBLIC SERVICE COMMISSION

 FORM-10
Page 1 of 2

(To be filled in and RETURNED to TNPSC)

Check List for Chief Invigilator
úRo®u ùTVo: Combined Civil Services Examination – 4 (Group – IV Services)
úRoÜ Sôs/ úSWm: 11.02.2018/10.00am to 01.00pm
úRoÜ ûUVm: ÑRk§Wô Tô-ùPd²d Lpí¬ úRoÜ áP Gi Utßm ùTVo: 1807-Suthanthira Polytechnic
College

úRoÜdÏ Øu]o UôYhP Bh£Vo AÛYXLj§p SPkR LXkRônÜ áhPj§p LXkÕ ùLôiÓ ReLÞdϬV CûQl×LÞPu á¥V RûXûU
1 LiLô¦lTô[o ¨VU] BûQ ReL°u úRoÜdáPj§tϬV úRoYô[¬u ×ûLlTPjÕPu á¥V Attendance Sheets Utßm Number Bm
Statements B¡VYtû\ ùTtßd ùLôi¼oL[ô?

2 Attendance Sheet L°p ReL°u úRoÜd áPj§u ùT\o Utßm ®XôNm N¬TôodLThPRô? Bm

úRoÜdÏ ØkûRV Sôs ®]ôjRôsLs Utßm ®ûPjRôsL°u Gi¦dûLûV ARu LhÓdLû[(Bundles) ©¬dLTPôR ¨ûX«úXúV
3 Bm
LÚîXj§p N¬TôodLlThPRô?

úRoÜdÏ ØkûRV Sôs ReL°u úRoÜd áPj§p AàU§dLlThP úRoYoL°u Gi¦dûL«u A¥lTûP«p úRoÜ Aû\L°p T§ùYiLs
4 Bm
ϱl©hÓ RÏkR Øu HtTôÓLs ùNnVlThP]Yô?

úRoÜ Sô[uß LôûX 7.00 U¦V[®p ®]ôjRôsLs Utßm ®ûPjRôsLû[ ùTtß ùLôsYRtÏ ReLs úRoÜd áPj§p RVôWôL
5 Bm
CÚk¾oL[ô? AûYLû[ ùUôûTp ë²h AÛYXo AYoL°PªÚkÕ ùTtßd ùLôiÓ Jl×ûL A°j¾oL[ô?

LôYp T¦dÏ LôYXÚm, Å¥úVô TPm GÓdL Å¥úVô¡WôTÚm ReL°u úRoÜdáPj§tÏ YÚûL ׬kRôoL[ô? CpûXùV²p
6 Bm
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7 Bm
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Aû\dLôiLô¦dTô[o AkRkR Aû\LÞdϬV ®ûPjRôsLs, T¥Ym-5, T¥Ym -6 Utßm Attendance Sheets B¡VûYLÞPu
8 úRoÜ ùRôPeÏm AûW U¦dÏ Øu AkRkR úRoÜ Aû\LÞdÏ ùNuß ®ûPjRôsLû[ úRoYoLÞdÏ YZe¡ A§p Es[ ®YWeLû[ Bm
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9 Bm
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Aû\dLiLô¦lTô[oLs ®]ôjRôsLs APe¡V Eû\Lû[(Packets) úRoÜ ùRôPeÏm 10 ¨ªPj§tÏ Øu]o úRoYoL°u Øu²ûX«p
10 CWiÓ úRoYoL°PªÚkÕ Eû\«u úUÛm Utßm T¥Ym-6 Ûm Nôuù\ôlTm ùTtß Eû\Lû[l ©¬jÕ úRoYoLÞdÏ ®]ôj Bm
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Page 2 of 2

TAMIL NADU PUBLIC SERVICE COMMISSION

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