Group-4

see last page for challan

ANDHRA PRADESH PUBLIC SERVICE COMMISSION :: HYDERABAD APPLICATION FOR GROUP-IV SERVICES (GENERAL RECRUITMENT) NOTIFICATION NO. : 40/2008 Note:'Y'--->Yes ;'N'--->No ;'G' --> State Govt. Employee;'U' --> UnEmployee;'O' --> Others;

Reference Id : 5140447893 Name : Father's/Husband`s name : Date of birth : Gender : Address for communication :

District : Pincode : e-Mail : Mobile : Community you belong : Do you come under Creamy layer : Are you an Ex-Service men : Are you a PH-Person : Visually Handicapped : Visually Handicapped Percentage : Hearing Handicapped : Hearing Handicapped Percentage : Orthopedically Handicapped : Orthopedically Handicapped Percentage :

TEJASWI DARSI BHASKARA RAO 15/5/1988 F H.NO-5-78, BETHAPUDI(POST), REPALLE(MANDAL), GUNTUR 522265 [email protected] 9347216862 SC N N N N 0% N 0% N 0%

Age Relaxation Details

*5140447893*

Fee Relaxation Details

Are you claiming age relaxation : Are you an Ex-Service men : Length of Service as Ex-Service men : Visually Handicapped(VH) : Hearing Handicapped (HH) : Orthopedically Handicapped(OH) : Worked as instructor in NCC : Length of Service in NCC: Employment status : Length of Service in A.P. State Govt: Are you retrenched temporary employee in State Census department : Length of Service in Census Dept:

N N 0 years N N N N 0 years N 0 years N

Are you claiming Fee Relaxation : Y Are you an Ex-Service Men : N Visually Handicapped (VH) : N Hearing Handicapped (HH) : N Orthopedically Handicapped(OH) : N Are you a white card holder : N Employment Status : U Post Preferences Post Preference 1 : Matron Grade -II in A.P.Juvenile Welfare & Correctional Sub -Service Post Preference 2 : - - - -

0 months

Education/Qualification Details District for which applying : HYDERABAD Post Name : 01. Junior Asst. in Various Dept.

03. Matron Grade -II in A.P.Juvenile Welfare & Correctional Sub -Service.

Qualification : Intermediate or its equivalent Do You Possess Physical Measurements for PostCode2 : N Do You Possess Physical Measurements for PostCode2 (Only N ST candidates): Do You Possess Physical Measurements for PostCode3 : Y Date of acquiring : 25/4/2005 Type of Study : R Education Details 4th/Residence 5th/Residence 6th/Residence 7th/Residence 8th/Residence 1st yr 2nd yr 3rd yr 4th yr 5th yr GUNTUR

GUNTUR

GUNTUR

GUNTUR

GUNTUR

DISTRICT YOU BELONG TO : GUNTUR

GENERATED BY APPSC'S WEBSITE www.apspsc.gov.in POWERED BY CGG's RECRUITMENT PROCESSING SYSTEM

9th/Residence 6th yr

SSC/DEGREE

GUNTUR

GUNTUR

CARE : STATE BANK OF INDIA

(a) Credit the Fee to the A/c No. 30597181549 (b) Select Fees/Charges as NF: No Fees (c) Enter Challan No. against Registration Id/Ref. No. (d) Enter Name of the candidate against Name of the Applicant (e) Please write down the Journal Number on both copies of this Challan in the space provided above. GENERATED BY www.apspsc.gov.in POWERED BY CGG's RECRUITMENT PROCESSING SYSTEM

CARE : STATE BANK OF INDIA

(a) Credit the Fee to the A/c No. 30597181549 (b) Select Fees/Charges as NF: No Fees (c) Enter Challan No. against Registration Id/Ref. No. (d) Enter Name of the candidate against Name of the Applicant (e) Please write down the Journal Number on both copies of this Challan in the space provided above.

GENERATED BY www.apspsc.gov.in POWERED BY CGG's RECRUITMENT PROCESSING SYSTEM

Reference Id : 5140447893

Signature of the remitter

Signature of the remitter

Reference Id : 5140447893

Remitters Address : H.NO-5-78, BETHAPUDI(POST), REPALLE(MANDAL), GUNTUR 522265 Purpose : Towards payment of fee for Group-IV Services Inermediate level Date :

Remitters Address : H.NO-5-78, BETHAPUDI(POST), REPALLE(MANDAL), GUNTUR 522265 Purpose : Towards payment of fee for Group-IV Services Inermediate level Date :

---------------------------------------------------Journal No. : ----------------------------------------------------

Fee in Rs. : 25/-

Fee in Rs. : 25/-

---------------------------------------------------Journal No. : ----------------------------------------------------

NOTE 1 : PLEASE PRODUCE THE COPY OF THIS CHALLAN AT THE TIME OF EXAMINATION IF REQUIRED 2 : THIS CHALLAN IS VALID UPTO 05/03/2009. PLEASE PAY THE INDICATED FEE AT ANY SBI ON OR BEFORE 05/03/2009

Fee collection A/C. No : 30597181549 Applicant name : TEJASWI DARSI Post Name : Group-IV Services Inermediate level

NOTE 1 : PLEASE PRODUCE THE COPY OF THIS CHALLAN AT THE TIME OF EXAMINATION IF REQUIRED 2 : THIS CHALLAN IS VALID UPTO 05/03/2009. PLEASE PAY THE INDICATED FEE AT ANY SBI ON OR BEFORE 05/03/2009

Fee collection A/C. No : 30597181549 Applicant name : TEJASWI DARSI Post Name : Group-IV Services Inermediate level

Challan No. : 5140447893

CHALLAN -- Applicant Copy

Challan No. : 5140447893

NOTIFICATION NO. : 40/2008

NOTIFICATION NO. : 40/2008

APPLICATION FOR GROUP-IV SERVICES (GENERAL RECRUITMENT)

APPLICATION FOR GROUP-IV SERVICES (GENERAL RECRUITMENT)

CHALLAN -- State Bank of India Copy

ANDHRA PRADESH PUBLIC SERVICE COMMISSION :: HYDERABAD

ANDHRA PRADESH PUBLIC SERVICE COMMISSION :: HYDERABAD