APPLICATION NO : CCLA-2671270

GOVERNMENT OF ANDHRA PRADESH Chief Commissioner Of Land Administration (CCLA)

APPLICATION FOR THE POST OF VILLAGE REVENUE OFFICERS CCLA`s Ref. No. A2 /2059/2013, dated: 26.12.2013. 1. 2. 3. 4. 5. 6. 7. 8. 9. Reference Id : 4012100671270
Name : T PADMA District : GUNTUR Mandal : PIDUGURALLA Village : THUMMALACHERUVU Father's/Husband`s name : T RAMANA REDDY Date of birth : 11/5/1992 Gender : Female Address for communication : 2-127 THUMMALACHERUVU PIDUGURALLA GUNTUR

9a. 9b. 9c. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 21a. 22. 22a.

District : GUNTUR Mandal : PIDUGURALLA Pincode : 522437 Community you belong : OC e-Mail : padmathalakola@gmail.com Mobile : 7799436563 Do you belong to Andhra Pradesh State : Yes Are you an Ex-Service Man : No Are you an A.P.State Govt. Employee : No Are you a retrenched temporary employee in No State Census Department : Aadhaar No. 986840243734 Reference Number of VILLAGE REVENUE ASSISTANTS Are you a PH-Person : No

Post Name : VILLAGE REVENUE OFFICERS Qualification Details

Qualification : Intermediate or Equivalent Qualification

Written Examination Language

Choosen Written Examination language: ENGLISH/TELUGU

Payment Details
Fee Amount
300

Journal Number
A3C94DFE5C2987

Payment Date
07/01/2014

I hereby declare that all information furnished by me in this application is true and correct I undertake to produce the original documents at any moment, failing which my candidature may be cancelled. I am fully aware that furnishing false information will lead to a criminal case against me, apart from cancelling my candidature as it amounts to cheating. I am aloneresponsible if any wrong entries are made by me in the application form.

Sd/T PADMA ( 07-Jan-2014 08:00:54 PM ) Generated for CCLA'S Recruitment Processing: http://ccla.cgg.gov.in/ POWERED BY Governance Centre for Good