1

TELANGANA RESEDENTIAL EDUCATIONAL INSTITUTIONS RECRUITMENT BOARD.

HYDERABAD

BASIC INFORMATION DATA

(CHECK LIST)
(To be filled by the candidate)

HALL TICKET NO Paper – I :

Paper – II :
PHOTO OF THE
CANDIDATE
DATE OF VERIFICATION:

Signature of Candidate
Name of the
01 Candidate
( as per SSC)
02 Father’s Name

Mother’s
03
Name

04 Gender Male Female Others

Date of Birth D D M M Y Y Y Y
05
( as per SSC)

Years Months days

(Age as on
06 01/07/2023)

1 2 3 4 5
Name of the University
Date of
Qualifi acquiring Max Marks % of
cation qualificat Marks Secured Marks
ion

Degree
(as on 05.04.2023)
Qualification

Notification
As per

07 PG

Ph.D

NET

SET
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Official use:

OC EWS SC ST BC

A B C D E

Community
(Integrated 1. Caste certificate issued by Telangana Govt. Yes/No
Community
08 Certificate
issued by the 2. Certificate No Dt:
Telangana
Govt.)
3. Official use:

BC Candidates Whether non-creamy layer YES NO

shall submit certificate produced
Non Creamy
Layer
Certificate as
per 1. Date of issue of Non-Creamy Layer Certificate:
G.O.Ms.No:8 2. Certificate No Dt:
of 2014
09
& 3. Official use:

Govt.
Memo.No.3009
/BCW/
OP/2011,
Dt:18-12-2015.

VH HH OH

PH –Category
1. Percentage of Disability %.
2. Certificate No Dt:
10

3. Official use:
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If age
relaxation is Whether relevant Certificate
claimed, Years Produced
specify
(No. of years claimed for YES NO
1) Retrenched relaxation)
Census
Employee
2) Telangana
State
11 Govt. Official use:
Employee
3) N.C.C
4) Ex-Service
Men
5) SC/ST and
BC

District
Class Year State
Indicate the
evidence I
(Original Study
Certificate to
be produced) II
OR
12
Residence III
Certificate for
7 yrs. prior to IV
SSC if private
Study. V

VI

VII
District, Zone
and Multi Zone
13
you belong to.

Present
Employment
details
Official use:
14 (Government
Employees
should submit
NOC)

Details of
15 Sports
Certificates
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Declaration

I hereby declare that

i) All the columns filled in by me containing my biodata and other particulars are true to
the best of my knowledge.

ii) The Certificates such as, my Educational Qualification, Community Certificate, Date
of Birth (SSC), Study/Residence in support of my claim for local candidature are
genuine.

iii) I did not resort to any irregular or improper means in connection with my candidature
for selection.

iv) I am liable for permanent debarment from appearing for the recruitment to be
conducted by TREIRB and other PSCs and also criminal prosecution, if I am found
15 involved in any unfair means / malpractice.

v) I further declare that the information furnished by me is correct and my candidature

shall be cancelled at any stage if it is found incorrect.

Address.

………………………………………………….

…………………………………………………

…………………………………………………..

Mobile No…………………………………

Place:
Date: Signature of the candidate.

TO BE USED FOR ADMISSION (OFFICIAL USE)

The Candidate Provisionally Admitted for further process for selection.

Verification Chief Verification Camp Officer

Officer Officer

TO BE USED FOR REJECTION

The Candidate Rejected for further process of selection with the following reason.

Suptd. Camp Officer EO (Convenor)

CHAIRMAN