Job Verification_Department Admin

Personal Details

Sur Name

Reddy

Full Name

Kiran Kumar

Appointed by direct recruitment

abcd.pdf

Designation Applying for

Lorem Ipsum

Place of working

Hyderabad

Date of entry into service

12-02-2017

Present Address

House Number

1703 Apple Lane

Name of the Apartment

Hyderabad

Street & Road

39 Peachfield Road

State

Telangana

Village (optional)

Peoria

Mandal/Taluk

Peoria

Town/City

Peoria

District

Hyderabad

Pin code

500027

Phone numbers

+91-9632587412

Particulars of the Places

Particulars of the places where you have resided during the preceding five years from the date of filling up attestation form

Year 1

Father’s Name

[Father Name Here]

To (Month/Year)

[Date Here]

Residential Address in full

House Number

12-1-1289/109

Name of the Apartment

[Apartment Name Here]

Lane Name

[Lane Name Here]

Street & Road

[Street & Road Here]

State

Telangana

District

Hyderabad

Mandal/Taluk

Peoria

Town/City/Village

Peoria

Pin code

500027

Nearby Police Station

Nampally

Other Personal Details

Father’s Details

From (Month/Year)

January 2019

Profession

Bussiness man

If in service, give father’s designation and official address

Designation

DieSachbearbeiter Choriner Straße 4910435 Berlin

Official Address

DieSachbearbeiter Choriner Straße 4910435 Berlin

Present postal address

902 Cambridge Street Westfield, MA 01085

Permanent House Address

The Bridge Integrated Learning Space1 Dowrey Street N1 0HY London

Nationality

Nationality of father

Indian

Nationality of mother

Indian

Nationality of wife/husband

Indian

Place of birth of wife

Nizambad

Date of Birth of the Applicant

Present Age

2/4/1983

Age at SSC/matriculation

18 Years

Place of birth of applicant, district and state

District and state to which you belong

Telangana Hyderabad

Religion

Are you a member of Backward Class

Specify the Class/Tribe Grade A

Educational Details

Educational qualifications showing places of education with years in schools and colleges since 15th year of age (upload certified copies of Study certificates for the below)

SSC/Matriculation

Name of the school

The Bridge Integrated Learning Space

School full address

1 Dowrey St, London N1 0HY, UK

State

Telangana

District

Hyderabad

Mandal/Taluk

Peoria

Town/City/Village

Peoria

Date of entering (month and year)

[Date Here]

Date of leaving (month and year)

[Date Here]

Examination passed

[Date Here]

Registration Number

[Registration Number Here]

Nearby Police Station

Nampally

Employment Details

Educational qualifications showing places of education with years in schools and colleges since 15th year of age (upload certified copies of Study certificates for the below)

Designation of the post held or description of work

Period From

January 2019

Period To

April 2020

Full address of the office

Vidya Poshak B.L.D.E. Association's Shri Siddeshwar Art Institue Maddinkhani, BLDE hosplital Road, Vijayapur-586101

Institution

Lorem Company

Have you been at any time dismissed

No

Removed from service

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book. It has survived not only five centuries, but also the leap into electronic typesetting, remaining essentially unchanged.

Resigned to the post

No

View Experience Certificate

Legal Terms

Have you ever been arrested by the police, convicted by a court of law or detained under any state/central preventive detention laws for any offence? Whether such conviction sustained in the court of appeal or set aside by the appellant court if applied against.

No

Note:

If detained, convicted, debarred etc. subsequent to completion and submission of this form, the details should be communicated immediately to the concerned department of the authority to whom the attestation form has been sent earlier failing which it will be deemed to be suppression of information)

References

Name and complete address of two responsible persons of your locality to whom you are known or two references to whom you are known. (persons shall not be blood relatives)

Reference 1

Name

Suresh Kumar

House number

12-1-1289/109

Name of the apartment

Galada Towers

Lane name

Abc street

Street name and road

Abc street

State

Telangana

District

Warangal

Mandal/Taluk

Nampally

Town/City/Village

Hyderabad

Pin code

500021

Mobile Number

+91-9632587412

ID Proof No.

123569854

Reference 2

Name

Suresh Kumar

House number

12-1-1289/109

Name of the apartment

Galada Towers

Lane name

Abc street

Street name and road

Abc street

State

Telangana

District

Warangal

Mandal/Taluk

Nampally

Town/City/Village

Hyderabad

Pin code

500021

Mobile Number

+91-9632587412

ID Proof No.

123569854

Declaration

I hereby declare that the statements made in this form are true to the best of my knowledge and belief.
I am married/unmarried and having only one wife living (delete which is not applicable)
I am fully aware that furnishing of false information or suppression of any information in the attestation form would be a disqualification and is likely to render me unfit for employment under the government.
I am also fully aware that if it comes to notice at any time during my service that false information has been furnished or that there has been suppression of information in the attestation form, my services would be liable to be terminatedsolely on this ground

Signature of the candidate

Date

12-02-2018

Place

Hyderabad

CERTIFICATE TO BE SIGNED BY A GAZETTED OFFICER OR MEMBER OF LEGISLATURE OR OTHER AUTHORITY AS PRESCRIBED BY THE APPOINTING AUTHORITY.

Download Signed Certificate

Candidate Endorsement

Generate Covering Letter