Indian Ordnance Factories

Advertisement No. 10201/11/0567/1415

Direct Recruitment Chargeman
APPLICATION FORM
Registration No.

: 14CV118046

Registration Date & Time

: 28-07-2014 22:53:23

Trade

: Civil
Center Choice 1 : Kolkata

Center Choice 2 : Kanpur

Unit Choice 1

Unit Choice 2

Unit Choice 3

Heavy Vehicle Factory

Ordnance Clothing Factory Avadi

Cordite Factory Aruvankadu

(First Name)
SURESH KRISHNAN J

Applicant's Name

Father's Name

: JANARTHANAN S

Mother's Name

: SENTHAMIZH SELVI J

Spouse's Name

: UNMARRIED

Date of Birth

: 17-10-1992

Gender

: Male

Nationality

: Indian

Category

: OBC

Whether Departmental Candidate

: No

Whether Ex-Servicemen

: No

Physically Handicapped

: No

Candidates who had ordinarily been domiciled in the

State of Jammu & Kashmir during period from 1st Jan
1980 to 31st Dec 1989

: No

Whether belong to Minority Community

: No

Medium of Examination

: English

(Middle Name)

(Last Name)

Educational Qualification (General) :

Educational Qualification

School / Inst.

Year of Passing

SSLC/10th

G B H S SCHOOL

2007

Technical/Non Technical Qualification (General) :

Qualification

Trade/Discipline

Institutions

Year of Passing

Three Years Diploma

Civil

SRINIVASA SUBBARAY GOVT POLYTECHNIC COLLEGE

2010

Page 1 of 2
Address For Correspondence

City/Town/Village
District
State
Tel No.
Email ID

:
:
:
:
:
:
:
:

NO.2/259/221
ANAIGOUNDAMPATTI
OPP TO GOVT ENGG COLLEGE
OMALUR
SALEM
SALEM
TAMIL NADU - 636011
-

: jskrish565@gmail.com

Mobile No.

: 8409393479

Nearest Railway Station

: SALEM

Payment Details :
Bank Name

Branch Code

Challan No.

Deposit Date

Deposit Amount

STATE BANK OF INDIA

12549

022600073

05-08-2014

100

Declaration :
I have not submitted any other applications for this examination. I am aware that if I contravene this rule, my application will be rejected summarily by the
commision.
I have read the provisions in the Notice of the examination carefully and i hereby undertake to abide by them.
I further declare that I fulfill all the conditions of eligibility regarding age limits, educational qualifications, and technical qualifications etc., prescribed for
admission to the examination. I understand that in the event of ineligibility being detected at any point (before or after the examination), may
candidature/appointment is liable to be cancelled.
I also declare that I do not stand debarred by any of the Ordance Factories as on date and have never been convicted by any court of law. I also declare that no
charge sheet is pending against me in any court of law. Further declare that I have never been dismissed or removed from Govt. Service or my service been
terminated during probation.
*For Candidate belonging to OBC:
I declare that I belong to the community which is recognized as a backward class by Govt. of India for the purpose of reservation in service as per orders contained in
Deptt. of Personnel and Training office memorandum No. 36012/22/93- Esst. (SCT) dated 8.9.1993. I also declare that I do not belong to the person/sections(creamy
layer) mentioned in column 3 of the schedule of the OM mentioned above and modified vide Govt. of India DOPT OMs mentioned in the notice. I further declare that I
am in possession of OBC Certificate in the prescribed format given in the Notice of the examination.
For all Candidates:
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 ot ineligibility being detected before or after the examination, my candidature/appointment is liable
to be cancelled.

Please Paste your Color

Photograph 3.5 x 3.5 cm
not older than 3 months.

Registration No. :

______14CV118046________

Name :

_________________________

Date :

_________________________

Place :

_________________________

________________________________________________
Signature of the Candidate
Note To Candidates :
* Please keep one photocopy of the Acknowledgement Slip for future reference.
* OBC Candidates MUST ENCLOSE the Photo Copy of Non CREAMY LAYER CERTIFICATE as prescribed in Annexure III given in Full Notice.
* UR/OBC Candidates, who are eligible to pay fees MUST ENCLOSE Original Bank PAY IN SLIP alongwith the Registration Slip duly signed and
Photo affixed.
* The Envelope must be sent by Ordinary Post to the below address.
* Do not write 'Indian Ordnance Factories' in the Postal Address.

Post Box No. 2091

Chennai 600020.
Page 2 of 2

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