Direct Recruitment Chargeman APPLICATION FORM Registraon No. : 14EC122098 Registraon Date & Time : 27-07-2014 12:53:01 Trade : Electronics Center Choice 1 : Aruvankadu (near Ooty) Center Choice 2 : Chennai Unit Choice 1 Unit Choice 2 Unit Choice 3 Ammunion Factory Khadki Small Arms Factory Machine Tool Prototype Factory Applicant's Name : (First Name) (Middle Name) (Last Name) DAYANANDHAN Father's Name : SUBRAMANI Mother's Name : VIJAYAKUMARI Spouse's Name : Date of Birth : 20-12-1990 Gender : Male Naonality : 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 Examinaon : English Educaonal Qualicaon (General) : Educaonal Qualicaon School / Inst. Year of Passing SSLC/10th SHRI AMRITHA HIGHER SECONDARY SCHOOL TIRUPATTUR 2007 Technical/Non Technical Qualicaon (General) : Qualicaon Trade/Discipline Instuons Year of Passing Three Years Diploma Electronics IRT POLYTECHNIC COLLEGE BARGUR 2010 Page 1 of 2 Indian Ordnance Factory https://www.i-register.co.in/ioforeg/frmApplicationPrint.aspx 1 of 2 7/31/2014 6:25 PM Address For Correspondence City/Town/Village District State Tel No. : : : : : : : : 15/30-THEN AGARAKARAM STREET TIRUPATTUR VELLORE VELLORE TAMIL NADU - 635601 04179-226401 Email ID : irtdaya@gmail.com Mobile No. : 7708820099 Nearest Railway Staon : JOLARPETTAI Payment Details : Bank Name Branch Code Challan No. Deposit Date Deposit Amount STATE BANK OF INDIA 00934 014950345 30-07-2014 100 Declaraon : I have not submied any other applicaons for this examinaon. I am aware that if I contravene this rule, my applicaon will be rejected summarily by the commision. I have read the provisions in the Noce of the examinaon carefully and i hereby undertake to abide by them. I further declare that I fulll all the condions of eligibility regarding age limits, educaonal qualicaons, and technical qualicaons etc., prescribed for admission to the examinaon. I understand that in the event of ineligibility being detected at any point (before or aer the examinaon), 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 probaon. *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 reservaon in service as per orders contained in Dep. of Personnel and Training oce memorandum No. 36012/22/93- Esst. (SCT) dated 8.9.1993. I also declare that I do not belong to the person/secons(creamy layer) menoned in column 3 of the schedule of the OM menoned above and modied vide Govt. of India DOPT OMs menoned in the noce. I further declare that I am in possession of OBC Cercate in the prescribed format given in the Noce of the examinaon. For all Candidates: I hereby declare that all statements made in this applicaon are true , complete and correct to the best of my knowledge and belief. i understand that in the event of any informaon being found suppressed/false or incorrect ot ineligibility being detected before or aer the examinaon, my candidature/appointment is liable to be cancelled. Please Paste your Color Photograph 3.5 x 3.5 cm not older than 3 months. Registraon No. : ______14EC122098________ 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 Noce. * UR/OBC Candidates, who are eligible to pay fees MUST ENCLOSE Original Bank PAY IN SLIP alongwith the Registraon Slip duly signed and Photo axed. * 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
Indian Ordnance Factory https://www.i-register.co.in/ioforeg/frmApplicationPrint.aspx 2 of 2 7/31/2014 6:25 PM