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Annexure-I: Maritial Status (Married/Unmarried)

This document contains an application form for the position of Telecom Technical Assistant in 2012 with BSNL Kerala Telecom Circle. The 16-question form requests information such as name, date of birth, address, educational qualifications, and employment history. It includes declarations for OBC candidates regarding creamy layer status and a signature section where applicants declare that their application details are true and correct.

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Joemon John Kurishumootill
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87 views2 pages

Annexure-I: Maritial Status (Married/Unmarried)

This document contains an application form for the position of Telecom Technical Assistant in 2012 with BSNL Kerala Telecom Circle. The 16-question form requests information such as name, date of birth, address, educational qualifications, and employment history. It includes declarations for OBC candidates regarding creamy layer status and a signature section where applicants declare that their application details are true and correct.

Uploaded by

Joemon John Kurishumootill
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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ANNEXURE-I APPLICATION FOR DIRECT RECRUITMENT OF TELECOM TECHNICAL ASSISTANT-2012 IN BSNL KERALA TELECOM CIRCLE IMPORTANT NOTES :

(i) Before filling this form, Read detailed advertisement (ii) All entries should be made in capital letters

Name of recruitment Unit(SSA)

Name (for Sl No. 2 & 3 please keep one box blank between first name, middle name & last)

Father's/Husband's Name

Date of Birth(ddmmyyyy)

Age on 13.05.2013(ddmmyyyy)

Whether claiming age relaxation

Write: Yes/No

Gender (Male/Female)

Maritial Status (Married/Unmarried)

Nationality

10

Community (OC/OBC/SC/ST)

11

Category (write as applicable)


Whether registered under Employment Exchange of the respective SSA (Yes/No). If Yes Reg.No. If Physically Handi capped (attach Medical Certificate ) Locomotive or % of Hearing Disabilit Impairment y Whether Govt employee (Yes/No) Whether belongs to Ex Servicemen /J&K - Please specify

Whether BSNL employee(Yes/No ) If yes mention HRMS No

Address for correspondence (in capital 12 letters) Name : Address : Please affix one recent passport size photograph without attestation

Pincode e-mail address Mobile No Tele No : 0 Signature of the Candidate

13

Educational Qualification (Diploma in Engg & Above) Name of the Engg University/Institute Diploma/Degree with Discipline

Month & Year of Passing

As per the Advertisement whether eligible (Yes/No)

14 Permanent Address (in Capital letters) Name Father's/Husband's Name Address Please affix one recent passport size photograph without attestation

PIN Code

15.Details of application fee particulars IPO/Bank Draft No. & Date Amount

Issuing Bank/Post Office

Payable in favour of

16. Declaration to be given by OBC candidate only, eligible to avail reservation applicable to OBC: I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . son/daughter of Shri . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . resident of village/town/city . . . . . . . . . . . . . . . Dist. . . . . . . . . . . . . . . . . . . State . . . . . . . . . . . . . hereby declare that I belongs to the . . . . . . . . . . . . community which is recognized as a backward class by the Government of India for the purpose of reservation in services as per orders contained in Department of Personnel and Training Office Memorandum No 36012/22/93-Estt(SCT) Dtd 8.9.1993. It is also declared that I do not belong to persons/sections (Creamy Layer) mentioned in column 3 of the Scheduled to the above referred office Memorandum dated 8.9.1993 and amended vide OM No 36033/3/2004-Estt.(Res.) Dtd 14.10.2008.

DECLARATION TO BE SIGNED BY THE APPLICANT


I do hereby declare that all the statements made in the application are true, complete and correct to the best of my knowledge and belief. I understand that in the event of any particular information given above being found false or incorrect, my candidature for the post of Telecom Technical Assistant is liable to be rejected or cancelled and in the event of any mis-statement or discrepancy in the particulars being detected after my appointment, my services are liable to be terminated forthwith without any notice to me. I also understand that if appointed, I would rank junior to any TTA who had been appointed earlier by the erstwhile DoT/DTS/DTO or BSNL or any other candidate who had already qualified in the TTA examination but not appointed as TTA by BSNL so far, Similarly, candidates of TTA examination held prior to my appointment will also rank en-bloc senior to me.

Place

(Signature of the Applicant)

Date

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