A P P L I C AT I O N F O R M

1. Name of the Post Applied for: Asst.Accountant/ Accountant

2. Full Name of the Candidate: N.NAGASAMY

3. Date of Birth: 1 7 0 4 1 9 8 6
Day7 Month Year
4. Age: 32

5. Gender: Male

6. Marital Status: Un Married

7. Father Name: P.NAGAPPAN

8. Mailing Address: Muthanaickenpalayam, Thokkavadi(PO), Tiruchengode (TK), Namakkal (DT).

Pin Code: 637215.

Mobile: 9042102428

E.mail ID: nagasamy30@gmail.com

9. Nationality: Indian

10. Whether Physical Handicapped? : YES

11. Community: MBC

12. Education Qualifications:

BOARD/ PERCENTAGE
COURSE INSTITUTION UNIVERSITY DURATION OF MARKS

Sri Ramakrishna Institute of Anna University 76.09

MCA 2009-2012
Technology, Chennai.

Coimbatore.

Arignar Anna Govt.Arts College, Periyar University 2005-2008 51.57

B.Com
Namakkal. Salem.

Govt Higher Secondary School, 2004-2005 70.41

HSC State Board
Vittampalayam

Govt Higher Secondary School,

SSLC State Board 2002-2003 75.60
Vittampalayam

13. Experience:
 Duration Experience
Sl.No. Designation Institution (in years)
From To
Year Month
K.S.R. Educational Institutions
Computer
1. Nov’13 Mar’15 1 4
Operator Tiruchengode.

Assistant Muthayammal Institutions

2. Apr’15 Feb’16 11
Accountant Rasipuram.
Siragugal Financial Service
3. Accountant Mar’16 Oct’16 8
Rasipuram
Vidyaa Vikas Educational Institutions
4. Accountant Nov’16 Till Now 2 1
Tiruchengode.

TOTAL. 5 0

14. Any other relevant information: Tally 9.0 Certificate with First Class from CSC Computer
Education in 2008

I hereby declare that all the statements made in the application are true and complete to the best of my
knowledge and belief. I understand that action can be taken against me by the Commission, if I am declared
by them to be guilty of any type of misconduct mentioned herein. I have informed my Head Office/Deptt, in
writing that I am applying for this selection.

Date: 31.01.2019 Signature of candidate

Place: Tiruchengode.