TELANGANA STATE LEVEL POLICE RECRUITMENT BOARD :: TEST 2015

Filled In Online Application

for the posts of SCT PC (Civil) (Men & Women), SCT PC (AR) (Men & Women), SCT PC (SAR CPL) (Men); SCT PC
(TSSP) (Men) in Police Dept., Constable (Men) in SPF Dept., Firemen in Telangana State Disaster Response & Fire
Services Dept
Basic Details
Medium of Written Examination :
Name of the Candidate(as per ssc or equivalent) :
Father/Husbands Name :
Mothers Name :
Gender :
Date of Birth(as per ssc or equivalent) :
Age as on 01-07-2015 :
Community
(For BC Candidates Only)Do you belong to Creamy
Layer/Non-Creamy Layer
Do you belong to ST and Aboriginal Tribe domiciled In
the agency areas of Adilabad / Khammam / Warangal /
Mahabboobnagar districts
Identification Marks1 :
Identification Marks2 :
Do you belong to State of Telangana :
If No, Which State :

TELUGU
P CHENNAIAH
P POSAIAH
P BUGGAMMA
Male
10-05-1989
26 years 1 months 21 days
BC-D
Non-CreamyLayer

Registration No
477455

NA

A MOLE ON THE STOMCK

A MOLE ON THE STOMCK
Yes
NA

Post(s) applied for

1st preference
2nd preference
3rd preference
4th preference
5th preference
6th preference

21-SCT Police Constable (Civil) (Men and Women) in Police Department

22-SCT Police Constable (AR) (Men and Women) in Police Department
23-SCT Police Constable (SAR CPL) (Men) in Police Department
24-SCT Police Constable (TSSP) (Men) in Police Department
25-Constable (Men) in Special Protection Force (SPF) Department
26-Firemen in Telangana State Disaster Response and Fire Services Department

Unit Preferences for Post Code NO.21

1st preference
3rd preference
5th preference
7th preference
9th preference
11th preference

Cyberabad
Hyderabad
Warangal Rural
Karimnagar
Warangal Commissionerate
Nizamabad

2nd preference
4th preference
6th preference
8th preference
10th preference
12th preference

Ranga Reddy
Mahaboobnagar
Khammam
Nalgonda
Medak
Adilabad

Unit Preferences for Post Code NO.22

1st preference
3rd preference
5th preference
7th preference
9th preference
11th preference

Cyberabad
Hyderabad
Mahaboobnagar
Warangal Rural
Karimnagar
Nizamabad

2nd preference
4th preference
6th preference
8th preference
10th preference
12th preference

Unit Preferences for Post Code NO.24

1st preference
2nd preference
3rd preference
4th preference
5th preference
6th preference
7th preference
8th preference
9th preference
10th preference
11th preference
12th preference

3rd Bn, TSSP (IR), Ranga Reddy(New)

8th Bn., TSSP, Kondapur, Ranga Reddy district
1st Bn., TSSP, Yousufguda, Hyderabad
10th Bn., TSSP, Beechpally, Mahaboobnagar district
6 th Bn, TSSP (IR), Khammam district(New)
7th Bn., TSSP, Dichpally, Nizamabad district
5th Bn., TSSP (IR), Warangal(New)
12th Bn., TSSP, Anneparthy, Nalgonda district
4th Bn., TSSP, Mamnoor, Warangal district
17th Bn., TSSP, Rukmapur, Karimnagar district
13th Bn., TSSP (IR), Mancherial, Adilabad district
2nd Bn., TSSP (IR), Adilabad(New)

Ranga Reddy
Nalgonda
Warangal Commissionerate
Khammam
Medak
Adilabad

Unit Preferences for Post Code NO.26

1st preference
3rd preference
5th preference
7th preference
9th preference

Ranga Reddy
Mahaboobnagar
Warangal
Khammam
Adilabad

2nd preference
4th preference
6th preference
8th preference
10th preference

Hyderabad
Nalgonda
Karimnagar
Medak
Nizamabad

Educational Details
Educational Qualifications as on 01-07-2015
Furnish to which District of Telangana State you are local

M.A
RANGA REDDY

Study details from 4th class to 10th class

Class
4
5
6
7
8
9
10

Month
April
April
April
April
April
April
April

Year
1999
2000
2001
2002
2003
2004
2005

SchoolName
ZPHS IPPAIPALLY
ZPHS IPPAIPALLY
ZPHS IPPAIPALLY
ZPHS IPPAIPALLY
ZPHS IPPAIPALLY
ZPHS DOMA
ZPHS B KULAKCHERLA

District
RANGA REDDY
RANGA REDDY
RANGA REDDY
RANGA REDDY
RANGA REDDY
RANGA REDDY
RANGA REDDY

Residence details
Year
1

Address
SRI RAMALINGESHWARA JUNIOR
COLLEGE KULAKCHERLA
SRI RAMALINGESHWARA JUNIOR
COLLEGE KULAKCHERLA
SRI RAMALINGESHWARA DEGREE
COLLEGE KULAKCHERLA
SRI RAMALINGESHWARA DEGREE
COLLEGE KULAKCHERLA
SRI RAMALINGESHWARA DEGREE
COLLEGE KULAKCHERLA
PGRRDC COLLEGE HYDRABAD
PGRRDC COLLEGE HYDRABAD

2
3
4
5
6
7

District
RANGA REDDY
RANGA REDDY
RANGA REDDY
RANGA REDDY
RANGA REDDY
HYDERABAD
HYDERABAD

State Government Employee

Are you an employee of Telangana State Government
Date of joining service
Length of service as on 01-07-2015
Are you still in service

No
NA
NA
NA

Army/Navy/Air Force
Have you served as an employee in Army/Navy/Air Force
Date of entry
Date of discharge
Total service rendered
Do you claim reservation under Ex-Servicemen Quota
Have you been discharged as on date of notification(31-12-2015)

No
NA
NA
NA
No
NA

If still serving and yet to be discharged after the date of notification (31-12-2015)
Date of entry :
Date of discharge :

NA
NA

NCC
Have you worked as an instructor in NCC
Date of entry
Date of discharge
Total service rendered

No
NA
NA
NA

Retrenched employee/widow
Do you a Retrenched temporary employee in the state Census
Department during 1991
Length of service in census department
Do you a widow, divorcee/judicially separated women

No
NA
No

Special Category
Do you come under any of the Special Category :
Applicable Category :

No

Meritorious Sports Person quota

Name of the Sport

Category

NCC quota
Certificate

NCC Certificate Issued Date

Home Guard quota

Date of enrollment
Home Guard Number
Name of the Unit
No.of days worked as Home Guard
Are you still working as Home Guard as on date of notification (31-12-2015)

NA
NA
NA
NA

For Children of Police Personnel (CPP) quota

Date of enrollment of your parent
Name of the Post
Name of the Unit
Is your parent working (or) retired (or) died as on date of notification (31-12-2015)

NA

NA

CDI quota
Date of enrollment of your parent :
NA
Name of the Post :
Name of the Unit :
Is your parent died (or) retired on medical invalidation as on 31-12-2015: NA

CSPF quota
Date of enrollment of your parent :
Name of the Post :
Name of the Unit :
Is your parent Working (or) retired (or) died as on 31-12-2015 :

NA

NA

Driving License(etc.,)
Do you have minimum Physical measurements as per Notification :
Do you possess Driving license :
Type of license :
Date of issue of license :
Date of validity :
Period of Driving license as on date of notification :
Examination Centre applied for :

Yes
No
NA
NA
NA
NA
RANGA REDDY

NOTE: The applicant will be allotted to any town in the selected district. In case if the capacity of the Test Centres located in a particular district is not sufficient, the
Test Centres of the adjacent district may be allotted. No further communication in this regard will be entertained.

Criminal Case Details(etc.,)

Were you involved in any criminal case (s) at any time :
Crime No. & Year :
Name of the PS :
Name of the Dist :
Were you ever arrested by the Police :
If you were prosecuted by the Police Convicted stage of the case :
Were you involved in more than one Criminal case :
Total No. of Criminal cases involved :
Were you at any time employed and discharged/
terminated/removed/dismissed from service of the government (whether
during training or later) :
Name of the Post :
Name of the Department :
Date of Discharge/terminated/removal/ Dismissal :
Office address :

No
NA
NA
NA
NA
NA
No

NA
NA
NA
NA

Address for Communication

Name :
C/o :
H.No./colony :
Village :
Mandal :
District :
PinCode :
Mobile No :

P CHENNAIAH
P POSAIAH
3-12/A IPPAIPALLY
IPPAIPALLY VILLAGE KULAKCHERLA MANDAL
Kulkacharla
RANGA REDDY
509335
9542869025

Email Id :
SSC RollNo :

chinnamudhiraj9p@gmail.com
1042123

Payment Details
Transaction id./Reference Id :
Payment Through:
Amount (in Rs.)
Date and Time of Submission :

TSPR62B9774F3
TS Online
400
2/1/2016 1:51:43 PM

1) I have read all the instructions carefully and I am conversant with the instructions. I shall abide by the eligibility conditions and other regulations to be satisfied for
appearing at the recruitment test. Further, I assure that, I will not involve in any malpractice or illegal activities in the recruitment test. In case, I have furnished any
false information or involved in any malpractice or illegal activities, I am liable for punishment as per the existing law.
2) I am responsible for the correctness of the above details filled in by me and the COORDINATOR, TSLPRB is not responsible in any way.

SIGNATURE and LEFT HAND THUMB Impression of the candidate to be done in the presence of the
Invigilator on the day of Examination in the Examination Hall
SIGNATURE OF THE CANDIDATE
in the presence of the Invigilator

Note: The candidates are required to take two print outs of this Filled in Online application form. One copy has to be submitted in the
Exam Hall to the Invigilator and the other has to be retained with the candidate. 2) Candidates are not allowed into the Exam Hall even
if they are LATE BY A MINUTE. 3) This is a Computer Generated sheet and does not require the Signature of the COORDINATOR,
TSLPRB.

I hereby declare that I have read the instructions issued in the notification dated 31-12-2015 of the Telangana State Level Police Recruitment
Board carefully and hereby undertake to abide by them. I further declare that I have not been debarred from appearing in any examination.
I declare that I fulfill all the conditions of eligibility regarding Age limits, Education qualifications etc., prescribed in the said notification.
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 to be false or incorrect or incomplete and that I have suppressed any information or that I do not
satisfy the eligibility criteria,my candidature for the selection is liable to be rejected or cancelled and even after appointment my services are liable
to be terminated without any notice. Iam willing to serve the department anywhere in the State/India if selected.
I declare that I am fully fit to compete in the PMT and PET and other Physical tests and my fitness is certified by the medical practitioner and as I
applied for the posts of Police Constable and other equivalent posts after going through about the physical requirement and other qualification and
read the eligibility criteria.I further declare that I have got myself medically checked up by a certified doctor in this regard, and that if any untoward
incident occurs during the course of PMT,PET or tests I shall be solely responsible and I declare that I am participating in all the above tests on
my own accord and on my own, without any coercion from anybody.