TELANGANA STATE LEVEL POLICE RECRUITMENT BOARD

ONLINE APPLICATION FORM - 2018

Application for the Post(s) of

Name of the Post Registration Number
SCT SI Civil and / or Equivalent 11193686
SCT PC Civil and / or Equivalent 31193686
Basic Details

Aadhaar Number 355203091135

Medium of Written Examination Engilsh

Candidate Surname MADAM

Name of the Candidate (as per
MADAM VISHWANATH
SSC or Equivalent)
Father’s / Husband’s Name M ESWARAIAH

Mother’s Name M NAGAMANI

Gender Male
Date of Birth (as per SSC or
19/11/1994
Equivalent)
Age as on 01-07-2018 23 years 7 months 12 days
Community SC

SSC Roll No 1134129542

Identification Mark 1 A MOLE ON LEFT HAND WRIST

Identification Mark 2 A MOLE ON RIGHT HAND SHOULDER

Nearest CP / SP Office CP Ramagundam

District (Erstwhile) of Local District (New) of Local
KARIMNAGAR Peddapalli
Candidature Candidature
Exam Centre Preference 1 KARIMNAGAR Exam Centre Preference 2 HYDERABAD

Do you belong to State of Telangana ? Yes

Are you an Employee of Telangana State Government ? No

Have you worked as an Instructor in NCC ? No

Are you a Retrenched Temporary Employee in the State

No
Census Department during 1991?

Have you served as an employee in Army / Navy / Air

No
Force ?
Do you claim reservation under Ex-Servicemen Quota
No
(only for Army / Navy / Air Force Personnel)?

Study / Residence Details

Study Passed School Name / Residence District
Class District (New) Mandal (New)
Type Year Address (Erstwhile)
INDIA MISSION SECONDARY
1st Class Regular 2002 KARIMNAGAR PEDDAPALLI PALAKURTHY
SCHOOL
INDIA MISSION SECONDARY
2nd Class Regular 2003 KARIMNAGAR PEDDAPALLI PALAKURTHY
SCHOOL
INDIA MISSION SECONDARY
3rd Class Regular 2004 KARIMNAGAR PEDDAPALLI PALAKURTHY
SCHOOL
INDIA MISSION SECONDARY
4th Class Regular 2005 KARIMNAGAR PEDDAPALLI PALAKURTHY
SCHOOL
INDIA MISSION SECONDARY
5th Class Regular 2006 KARIMNAGAR PEDDAPALLI PALAKURTHY
SCHOOL

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 INDIA MISSION SECONDARY
6th Class Regular 2007 KARIMNAGAR PEDDAPALLI PALAKURTHY
SCHOOL
INDIA MISSION SECONDARY
7th Class Regular 2008 KARIMNAGAR PEDDAPALLI PALAKURTHY
SCHOOL
INDIA MISSION SECONDARY
8th Class Regular 2009 KARIMNAGAR PEDDAPALLI PALAKURTHY
SCHOOL
INDIA MISSION SECONDARY
9th Class Regular 2010 KARIMNAGAR PEDDAPALLI PALAKURTHY
SCHOOL
10th INDIA MISSION SECONDARY
Regular 2011 KARIMNAGAR PEDDAPALLI PALAKURTHY
Class SCHOOL

Post Preferences
Post
Post
Preference Post Name
Code
Order
SCT SI Civil and / or Equivalent

1 11 SCT Sub Inspector of Police (Civil) (Men and Women) in Police Department

Zone in order of Preference

1 Zone VI (Hyderabad Range) 2 Zone V (Warangal Range)

2 12 SCT Reserve Sub Inspector of Police (AR) (Men and Women) in Police Department

Zone in order of Preference

1 Zone V (Warangal Range) 2 Zone VI (Hyderabad Range)

3 17 Station Fire Officer in Telangana State Disaster Response and Fire Services Department

Zone in order of Preference

1 Zone V 2 Zone VI (excluding City of Hyderabad)

3 City of Hyderabad

4 15 SCT Reserve Sub Inspector of Police (TSSP) (Men) in 15th Bn., TSSP in Police Department

5 13 SCT Reserve Sub Inspector of Police (SAR CPL) (Men) in Police Department

6 14 SCT Reserve Sub Inspector of Police (TSSP) (Men) in Police Department

7 18 Deputy Jailors in Prisons & Correctional Services Department

SCT PC Civil and / or Equivalent

1 21 SCT Police Constable (Civil) (Men and Women) in Police Department

Unit in order of Preference

1 Karimnagar 2 Warangal

3 Cyberabad / RR 4 Hyderabad

5 Nizamabad 6 Adilabad

7 Khammam 8 Mahabubnagar

9 Nalgonda 10 Medak

2 22 SCT Police Constable (AR) (Men and Women) in Police Department

Unit in order of Preference

1 Karimnagar 2 Warangal

3 Cyberabad / RR 4 Hyderabad

5 Nizamabad 6 Adilabad

7 Khammam 8 Mahabubnagar

9 Nalgonda 10 Medak

3 26 Firemen in Telangana State Disaster Response and Fire Services Department

Unit in order of Preference

1 Karimnagar 2 Warangal

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 3 Mahabubnagar 4 Nalgonda

5 Nizamabad 6 Khammam

7 Medak 8 Hyderabad
9 Ranga Reddy 10 Adilabad

4 23 SCT Police Constable (SAR CPL) (Men) in Police Department

5 25 Constable (Men) in Special Protection Force (SPF) Department

6 24 SCT Police Constable (TSSP) (Men) in Police Department

7 27 Warders (Male) in Prisons & Correctional Services Department

Special Category Details

Do you claim Reservation under any of the Special Categories? No

Educational Qualification as on 01-07-2018

Post Code Post Qualification

11 SCT SI Civil and / or Equivalent Bachelor's Degree recognized by UGC or any other equivalent examination

21 SCT PC Civil and / or Equivalent Intermediate or its equivalent examination

Other Details
Do you possess Transport Driving license (Either LMV or HMV) ?
No
(for the posts of PC only)

Address for Communication

Name MADAM VISHWANATH

C/o G 32 BASANTHNAGAR

House No. / Colony G 32 WORKERS COLONY

Village BASANTHNAGAR Pincode 505187

District (Erstwhile) KARIMNAGAR Mandal (Erstwhile) Ramagundam

District (New) Peddapalli Mandal (New) Palakurthy

Mobile Number 9052441125

Email Id vishwanathmadam1@gmail.com

Uploaded Documents

Slno Document Name Upload Status

1 Community Certificate Yes

2 SSC or Equivalent Certificate Yes

3 Educational Qualification Certificate for PC Civil Yes

4 Educational Qualification Certificate for SI Civil Yes

5 Study / Bonafide / Residence Certificate 1 Yes

6 Study / Bonafide / Residence Certificate 2 Yes

7 Study / Bonafide / Residence Certificate 3 Yes

8 Study / Bonafide / Residence Certificate 4 Yes

9 Study / Bonafide / Residence Certificate 5 Yes

10 Study / Bonafide / Residence Certificate 6 Yes

Declaration by the Candidate

I hereby declare that I have read all the instructions issued in the Notification(s) carefully and hereby undertake to abide by them. I
am responsible for the correctness of the above details filled in by me. I further declare that I have not been debarred from appearing
in any examination.

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I declare that I fulfill all the conditions of eligibility regarding Age limits, Education qualifications etc., prescribed in the said Notification
(s).
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 is liable to be rejected or cancelled at any stage of selection
and even after appointment my services are liable to be terminated without any notice, besides initiating criminal action.
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 I applied for the Posts after going through about the physical requirement and other qualification and read the
eligibility criteria. 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.
I further declare that, I will not involve in any malpractice or illegal activities in the recruitment tests. In case, it is found that I have
furnished any false information or involved in any malpractice or illegal activities, I am liable for punishment as per the existing rules /
law.
MADAM VISHWANATH
(Candidate Name)

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