District Recruitment Bureau
THIRUVARUR DISTRICT
                                                    Office of the Joint Registrar of cooperative societies
                                                                 SALESMEN /é‰gidahsh¦
Registration Number /                                                           28100594
Name of the Applicant /t¨©z¥gjhuu¨‹ bga® :                                      M RAJESH KANNAN
Personal Details / Ra étu§fŸ :
Date of Birth / g¨wªj njj¨ :                                                    23-06-1993
Father's / Guardian's Name / jªijahh¦ / fh¥ghsh¦ bgah¦                          P MANI
Gender / ghy¨d« :                                                               Male
Marital Status / j¨Ukz« Mdtuh? :                                                Unmarried
Spouse Name / fzt® bga®/kidt¨ bga® :                                            -
Applicant's Native District as: per family card /                               Thiruvarur
Family Card Number/ FL«g ml¦il :                                                PHH-333444108160
Native State /brhªj khãy« :                                                     Tamil Nadu
Native District / brhªj kht£l« :                                                Thiruvarur
Mother Tongue/jhŒ bkhê :                                                        TAMIL
Nationality / njÁa Ïd« :                                                        Indian
Religion / kj« :                                                                Hindu
Certificate Details / rh‹¿jœfë‹             étu§fŸ :
Communal Category / tF¥ò :                                                      Scheduled Caste (SC)
Name of the Sub-Caste /rhj¨ c£g¨u¨t¨‹ bga® :                                    AdiDravida
Certification Number / rh‹¿jœ v© :                                              5216541
Date of Issue / tH§f¥g£l njj¨ :                                                 13-03-2009
Issuing Authority / rh‹¿jœ tH§f¨a mj¨fhu¨ :                                     TALUK TAHSILDAR
Taluk / t£l« :                                                                  Kodavasal
District / kht£l« :                                                             Thiruvarur
Are you a Destitute widow ? /                                                   No
Mjut‰w t¨jitah ? :
Are you Differently Abled Person ? /                                            No
kh‰W¤ j¨wdhs¨ah? :
Are you an Ex-Serviceman ? /                                                    No
K‹dhŸ ÏuhQt¤Âduh? :
Have you been debarred or disqualified by the Public Service Commission or any other recruiting agency from appearing examinations
and selections for specific period or permanently ? / nj®thiza« mšyJ ntW vªj gâ e¨akd Kifikædhnyh nj®ÎfŸ k‰W« bjçÎfëš
fyªJ bfhŸS« cçikæèUªJ j§fis ãuªjukhfnth mšyJ xU F¿¥Ã£l fhy¤Â‰nfh éy¡f¨ it¤njh mšyJ jFj¨a¨‹iknah brŒa¥g£LŸsjh ? :                     No
Are you Employed ? /                                                            No
gâ étu«? :
Do you claim any Priority under G.O.(MS) No 122
Human Resources Management (K2) Department dated 02.11.2021 ? /
(murhiz (ãiy) v© 122, kåj ts nkyh©ik¤ (nf2) Jiw,ehŸ: 02.11.2021 š               No
F¿¥Ã£LŸs Áw¥ò¥ Ãh¨Îfë‹ Ñœ VnjD« K‹Dh¨ik nfhUgtuh?
                                                                        Page 1/2
                                                                                                                 Applied Date : 2024-10-12 08:49 pm
                                                                                       District Recruitment Bureau
                                                                                     THIRUVARUR DISTRICT
                                                                      Office of the Joint Registrar of cooperative societies
Education Qualification Particulars /                             fšé¤ jF F¿j¦j t¨tu§fŸ :
H.S.C OR Diploma                  Registration Number             Month & Year Of Passing                                     H.S.C board                                    H.S.C Certificate Number
        Diploma                        10414249                          Jun 2012                                                DOTE                                                0642240
    Medium of Instruction                    Obtained Mark                          Total Mark                                Mark Percentage
                   Tamil                            460                                600                                           76.67
gŸë ÏW tF¥ò / nkšãiy¤ njh¦éš jäiH xU ghlkhf¥ gæ‹WŸÇuh? :
Whether Studied Tamil as one of the Subjects in S.S.L.C/+2? /                                                                  Yes
mog¦gil fâå fy¦é m¿Î bgw¦WŸÇuh :
Do you have Basic Computer Knowledge ? /                                                                                       Yes
Do you want to claim reservation against Persons Studied the prescribed qualification(s) in Tamil Medium(PSTM) : YES
       Class                        Year of Study   Medium of                                PSTM Cert.                                                                                   Govt / PVT /
                           Mode                                        Issuing Authority                          Name of the Institution / School               District       PinCode
 From       To                      From     To     Instruction                              Issue Date                                                                                        Aided
   1           5       Regular      1999    2004          Tamil               HM             23/04/2022                GOVERNMENT SCHOOL                        Thiruvarur       609501        Govt
   6        10         Regular      2004    2009          Tamil               HM             23/04/2022         GEORGE HIGHER SECONDARY SCHOOL                  Thiruvarur       609501        Govt
Communication Details / bjhlu¦ò                            F¿j¦j t¨tu§fŸ :
       Address of Correspondence / bjhlu¦ò Kftu¨ :                                                            Permanent Address / e¨ue¦ju Kftu¨ :
                     2/4                                                                                                2/4
                     EAST STREET, VILLIYANALLUR                                                                         EAST STREET, VILLIYANALLUR
                     VISHNUPURAM                                                                                        VISHNUPURAM
       District / khtl¦lk¦¦ :          Thiruvarur                                                             District / khtl¦lk¦¦ :         Thiruvarur
       State / khãyk¦ :                Tamil Nadu                                                             State / khãyk¦ :               Tamil Nadu
       Pin / mŠrš Fw¨pL : 609501                                                                              Pin / mŠrš Fw¨pL : 609501
       Email Id / k¨‹dŠrš Kftu¨ :                                                                         rajeshmani.rk81@gmail.com
       Mobile Number / if¥ngÁ v© :                                                                        9585395681
Declaration / cWÂ bkhê :
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,my selection by the
District Recruitment Bureau,is liable for cancellation . /    Ï›é©z¥g¤Âš F¿¥Ã£LŸs étu§fsid¤J« v‹ m¿é‰F v£oatiu c©ik.Ï›é©z¥g¤ij
bghW¤jtiu vJΫ kiw¡f¥gléšiy. nju¦é‰F K‹ngh mšyJ Ãwnfh Ï›étu§fŸ jtW mšyJ c©ik¡F¥ òw«ghdJ mšyJ jFÂæ‹ik vd m¿Í«g£r¤Âš kht£l
MŸnru¦¥ò e¨iya¤jhš eh‹ nj®ªbjL¡f¥g£lJ K‹ mw¨é¥g¨‹w¨ Ïu¤J brŒa¥gLtj‰Fu¨ajhF«.
I accept the above declaration / nk‰Tw¨a cWÂbkhêia V‰W¡ bfhŸ»‹nw‹
Please retain your Application Number and Password emailed to you carefully for further reference.                                                  Signature of Applicant
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                                                                                                                                                                Applied Date : 2024-10-12 08:49 pm