STAFF SELECTION COMMISSION
BLOCK NO. 12, CGO COMPLEX, LODHI ROAD, NEW DELHI
110003
PHASE - XI/ 2023 / SELECTION POSTS
REGISTRATION NO: 81000068759
APPLICATION RECEIVED (CONTENTS NOT VERIFIED)
1. CANDIDATE'S NAME (AS PER 4. MOTHER'S NAME (AS PER
3. FATHER'S NAME (AS PER THE
THE MATRICULATION 2. NEW/ CHANGED NAME THE MATRICULATION
MATRICULATION CERTIFICATE)
CERTIFICATE) CERTIFICATE)
MEGAVATH RAVI - MEGAVATH LAKSHMA MEGAVATH BAJU
5. DATE OF BIRTH (DD/MM/YYYY) (AS PER THE
6. AGE AS ON 01/01/2023 7. GENDER
MATRICULATION CERTIFICATE)
05/06/1998 24.6 MALE
9. WHETHER PERSON WITH
8. CATEGORY BENCHMARK DISABILITY 9.1. IF YES, TYPE OF DISABILITY (OH, HH,VH, OTHERS)
(PwBD) ?
ST NO -
10. NATIONALITY 11. MARK OF VISIBLE IDENTIFICATION
CITIZEN OF INDIA A MOLE ON THE LEFT HAND
13. MATRICULATION (10th 14. MATRICULATION (10th
12. MATRICULATION (10th CLASS) EXAMINATION BOARD
CLASS) ROLL NO. CLASS) YEAR OF PASSING
BOARD OF SECONDARY EDUCATION ANDHRA PRADESH 1427123241 2014
15. REGION TO WHICH THE POST BELONG : EASTERN REGION
16. POST CODE 17. POST NAME 18. LEVEL OF POST
ER13623 MULTI-TASKING STAFF MATRICULATION
LANGUAGE OPTIONS
-
I HAVE READ THE DETAILS viz. ESSENTIAL QUALIFICATIONS/EXPERIENCE ETC RELATED TO THE POST
YES
19. PREFERENCE OF EXAMINATION CENTER
EXAMINATION CENTER EXAMINATION CENTER EXAMINATION CENTER
(FIRST PREFERENCE ) (SECOND PREFERENCE ) (THIRD PREFERENCE )
8601 - HYDERABAD 8008 - VIJAYAWADA 8001 - GUNTUR
20.1. WHETHER YOU ARE AN EX-SERVICEMAN (ESM) OR
20.2. DATE OF JOINING THE ARMED FORCES (DD/MM/YYYY)
SERVING IN THE ARMED FORCES?
NO -
20.3. DATE OF DISCHARGE FROM ARMED FORCES
20.4. LENGTH OF SERVICE IN ARMED FORCES
(DD/MM/YYYY)
- -
20.5. HAVE YOU ALREADY JOINED A CIVIL POST BY
20.6. DATE OF JOINING TO CIVIL POST (DD/MM/YYYY)
AVAILING BENEFIT OF RESERVATION FOR EX-SERVICEMAN (
- -
21.1. WHETHER SUFFERING FROM CEREBRAL-PALSY ?
-
21.2. DO YOU HAVE A PHYSICAL LIMITATION TO WRITE AND SCRIBE IS REQUIRED TO WRITE ON YOUR BEHALF
(CERTIFICATE TO THIS EFFECT FROM THE CHIEF MEDICAL OFFICER/ CIVIL SURGEON & MEDICAL SUPERINTENDENT OF A
GOVERNMENT HEALTH CARE INSTITUTION AS PER NOTICE OF THE EXAMINATION WOULD BE REQUIRED AT THE TIME OF
EXAMINATION) ?
-
21.3. WHETHER SCRIBE 21.4. WILL YOU MAKE YOUR 21.5. IF SCRIBE IS TO BE ARRANGED BY SSC, INDICATE MEDIUM
IS REQUIRED ? OWN ARRANGEMENT OF
SCRIBE ?
- - -
22. WHETHER SKILL TEST REQUIRED?: 23. LANGUAGE/ MEDIUM OF SKILL TEST
NO -
24.1. WHETHER SEEKING AGE RELAXATION ? 24.2. IF YES, AGE RELAXATION CODE
YES 01-SC/ST
25. ESSENTIAL QUALIFICATION RELEVANT TO THE POST OF
SUBJECT
INTEREST
--// MATRICULATION OR EQUIVALENT PASS OR INDUSTRIAL --// MATRICULATION OR EQUIVALENT PASS OR INDUSTRIAL
TRAINING INSTITUTE PASS TRAINING INSTITUTE PASS
25.a. HIGHEST EDUCATIONAL QUALIFICATION (IF ACQUIRED ANY, RELEVANT TO THE POST OF INTEREST)
-
26. DETAILS OF WORK EXPERIENCE
[Link]. NAME OF ORGANIZATION(S) DESIGNATION NATURE OF DUTY PERIOD OF PERIOD OF SERICE
SERVICE FROM TO
(DD/MM/YYYY) (DD/MM/YYYY)
1 - - - - -
ADDRESS DETAIL
27. CORRESPONDENCE ADDRESS 28. PERMANENT ADDRESS
VILLAGE :GURRAMBODU VILLAGE :GURRAMBODU
,MANDAL:MATTAMPALLY,DISTRICT:SURYAPET,STATE:TELAN,MANDAL:MATTAMPALLY,DISTRICT:SURYAPET,STATE:TELAN
GANA,PINCODE:508213 GANA,PINCODE:508213
DISTRICT: SURYAPET DISTRICT: SURYAPET
STATE: TELANGANA STATE: TELANGANA
PIN 508213 PIN: 508213
MOBILE NO : 6300924978 EMAIL: megavathravi141303@[Link]
29. CONTACT DETAILS FOR OTHER NATIONALS
-
30. WHETHER THE PHOTOGRAPH HAS BEEN TAKEN ON OR AFTER 06/12/2022?
YES
FEE PAYMENT AMOUNT TRANSACTION NO TRANSACTION DATE
EXEMPTED - - -
DECLARATION
1. I HAVE READ THE NOTICE OF EXAMINATION AND ACCEPT ALL THE TERMS & CONDITIONS MENTIONED
THEREIN.
2. I HEREBY DECLARE THAT ALL STATEMENTS MADE IN THIS APPLICATION ARE TRUE, COMPLETE AND CORRECT
TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THAT IN THE EVENT OF ANY INFORMATION
BEING FOUND SUPPRESSED/FALSE OR INCORRECT OR INELIGIBILITY BEING DETECTED BEFORE OR AFTER THE
EXAMINATION, MY CANDIDATURE/ APPOINTMENT IS LIABLE TO BE CANCELLED.I AM WILLING TO SERVE
ANYWHERE IN INDIA.
3. I DECLARE THAT THE PHOTOGRAPH UPLOADED IN APPLICATION FORM IS NOT MORE THAN 3 MONTHS OLD.
PRINT TAKEN ON: 05/02/2025 4:05:17 PM IP ADDRESS: [Link]
NUMBER OF ATTEMPT: 1