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Gramin Dak
Sevak
Engagement
Candidate Applica on Form
Registra on
CR1D574F534F7C
Number
Father/Husband
Name JEEVARATHINAM P S SELVAM T
Name
email ID psjeevagovt@gmail.com Mobile 9080455217
Present
FARMER Aadhar Number 880990225696
Occupa on
Can You ride a Whether Employer
Yes No
bicycle NOC is available
PH :
Address Details
Present Address Permanent Address
Door No. 492442 Door No. 492442
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4/2/2019 Print Application
Marks
Secondary
School Leaving
Cer ficate upto
State of Passing 10thclass Tamilnadu Board
September
2011,
Tamilnadu
10thclass
Result Type Marks 2675898
Cer ficate No.
Compartmental/Supplementary/Trail No
Tamil 63
English 48
Mathema cs 68
Science 46
Social Science 48
Documents Uploaded:
10thclass Supplementary-I Supplementary-II Computer Caste
Cer ficate Marks Memo Marks Memo Cer ficate Cer ficate
10TH.jpg - - - OBC.jpg
I hereby declare that the informa on furnished above is true and correct to the best of
my knowledge and that if the informa on proved to be false at a later date, I am liable
for such ac on that may be taken by the department
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4/2/2019 Print Application
I have studied and understood the no fica on and found myself eligible for applying to
this post. This is not a duplicate Registra on. If found duplicate my en re candidature
will be cancelled
I hereby undertake to declare that I will reside in the Branch Post Office village within
one month from selec on but before engagement as Gramin Dak Sevak Branch,
Postmaster in the event of selec on to the post.
I hereby undertake to declare that I have other sources of income besides the
allowances to be paid by the Government for adequate means of livelihood for myself
and my family, in the event of my engagement to the post of Gramin Dak Sevak Branch
Postmaster. self and my family, in the event of my engagement to the post of Gramin
Dak Sevak Branch Postmaster.
I hereby undertake to declare that my candidature will be cancelled If I failed to produce
computer cer ficate at the me of appointment, if i got selected.
I have passed all the subjects in the qualifying exam and uploaded the copy of original
cer ficates.
I have submi ed genuine cer ficates only and I know my candidature will be
disqualified in case the cer ficate found fake/ingenuine at any later point of me.
Date: 26/03/2019
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