SERVICE BOON FORM
N.G.O: 15
Nam yanomadala Bhaagai
Designation
Station
resent: Sri K. Chanti Babu,B. Iecn
SERVICE BOOK PART I
(Personal Information required for ESR)
. ofthe Employee :
Mr/MsMrs.:YANAMADALA
Name
BHARGAVI
Designation
VILLAGE SURVE YOR Y-
PHOTOXGRAPIH
(Attcsted by
At the tine of
hcad of ofice Alier completing 12 months
before pasting) appointmcnt 18 years of before the date
Service of retirement
Aadhar Number : OOOOOOODDOO
Father & Mother's Name : Mr. y. SAI PRASAD Mrs. yRATyALAKSHMI
Date of Birth
4. Date of Superannuation
A
:OOODOODO
5. Nationality
6. Whether belongs to SC/ST/OBC illa
Bc- 24
50
Whether differently-abled
(If yes, type of disability)
8. Qualifications [Link] Cal
(At the time of appointment)
9. Subsequently acquired qualification(s):
including Professional &
Technical qualificaitons
10. Marital Status : Single Maried
Divorced/Separated Widow/Widower
if married, Name of the Spouse
I1. Permanent Address
[Link]:-16-2351cHIANAGULA PALEM
kOTHAPETA, EAST GODAVARI
ANDHRA PRADES H,533 223
12. Communication Address
Mobile No.: )
96463355 6a 2
Email bhongavi ganamadala . 62amail-om
13. Home Town at the time of entry into
Govt. Service
a) Nearest Railway Station RAJAMAHENDRA YARAM
b) Nearest Airport RAJAMAHENDRAVARAM
14. Bank Details
3.
A/c No 36818694910
IFSC Code SBT NOoO098
Bank Name State bank of ioolia
Branch Hathapeto:
Sig a n d thumb Signature & Designation of Attesting Office
imp Servant with date along with date and official seal affixed
ASSISTANT DIRECTOR
DISTRICT SURVEY AND LAND RECORDs
.EAST GUDAVARI DISTRICT, KAKINADA
PART 2
CERTIFICATE ATTESTATION
(IMMUTABLE)
No. Subject Certificate Remarks
The employee was medically examined on
Medical and was found fit. The original medical
Medical
Examination
certificate has been kept in safe custody vide SLNo. Certificate
& page No. _of [Link] of the Service book.
His/Her character and antecedents have been verified and| Upload
2 Character &
the verfication report has been kept in safe custody videl Medical
Antecedents
[Link] page No._of [Link] ofthe Service Book. Certificate
He/She has taken oath or allengiance/information to the Upload
Allegiance to the (Police
Constitution Constitution vide [Link] page No. of [Link] of Verification
the Service Book. Report)
He/She has read the Offical Secrets Act& Central Civil Upload
Oath of Secrecy Services (Conduct) Rules and has also taken the oath of (Filled form
duly attested
secrecy vide [Link] page No. of [Link] of thel by Head of
Service Book. Office)
Confirmation in post| 1The employee has been confirmed in the post of
5 after successful
w.e.f. A copy
complection of
ofthe confimation order has been filed at [Link]
probation period
Page [Link] [Link] of the Service Book.
SERVICE BOOK
Name . [Link]
MotherTonguc ELUGU.
1 ct ha.d thumb and finger impressions
, the illiterate CGovermment Servant
AvR SSASTAbinsCTO
GISTI&TSURWErwoUWO O
EAST GOOAVARi UNSTR,
Thumb and finger impression of(Non-gazetted) Government servant
Fourth finger Third finger Second finger First finger Thumb
Certified that the above finger prints have been taken in my presence and under my personal
Superintendence from the left hand of Sri/Smt/Kumari
whose services are entered in the book.
Name of the office . AVIDI-1..SECRETARTAT...
Station
THAPETA...MANDAL.
TRIVJO
ASSISTANT DIRECTOR
DSTRIC SURVEY ANDLANO RECOROS
Síghaiirë alsta«d)enieKMASA
of the Head Otficer or other
Date Attesting Officer
@sroso6so, 3o.
Note (1) The Entries in this page should be renwedor Re-Attested Atleast even F i v eY e a r s , .
And the signatures in olumns 8 and 9 should
be dated. Finger Every
Prints necd not however be taken afresh under this rule.
Years
(2) For additional cntnes in respect to Servantofthe PoliceDepartment please see page (31)
CGovernment Five
s0. (8), (9) áokgod3 s064os
s6 idhsas.
4 0 o s u d s o .
4 ddossa sss0o0
Father's Name and also hushand'sDate ofbirth by the Signature of Signature and desig
Government nation of the bead of
Name in the case of a female Christian era as nearYEducational
Educational
Exact height by the office or other
Name Residenceovemment servant and
residence as can be ascertaincá measurement Personal marks for ldentification serva
attesting Officer
qualifica-
tions r o d s r o s
Sos6
52 Cms
Prosent:Sri . Chanti 8abu.9 fech
officiating state
LEAVE S
(0 Allcation of perieds of lerve on
average pay upto 4 months for
which leave salary is
debitable to mother Gvernment.
(b) Covenmenti
which
(a)Period debitabe
15
11 12
45 6 10
aS
Bhiamgavi seldckedard deainkod
Kun
Im at Avidi- illaçe
vildae Sunteyom Ghade
phogsR.c No A2543|2a
KothapeLa [Link] Dst Diccta uaey
Dtou-10-201 f the Aseiskant
Hakiaada
landmecondS, [Link] biar
at Axidi-1 Sctretamict
The individual joiacd
Jpde
as village SumcNaN
Kothapckal maridal
an the FNO a9-1 2a19
ASSISTANT DIRECTO
OSTRICT SURVEY ANOLAO ECORC
EAST GODAYAA CISTRICT, KAKNA
1
2 6 7 12
AS pd canliçiat e 1ssuad hy the| Amochaylh E DUCATLONAL
Passed
QALLEICATID
secxetaoelAvidi1 viilagThe indiidual Ss Exam. nabion
h
nelicvcd Pejam uillaga susvaya dutirs od the bean Roll Wo 1201ut 121 11 and
0-1-c19 JEN as she ws selocYed ds Cen cata No. LLoi
hSecve,tany Boan k14/1b
Enginecaing Assistont Godc-vide letkca
d -L-20ofihe pandayath secrckary Avidi-s Secondav4 Edut atien AP H dernhred
village kbthapcta mandal
STANT D+RECTOH
aPassed Intar ma dale Pab i
URVEY AND LANO RE(ORO8 fthe
Examn atot had in mavch 3al4 RRD
VARTISTRRT, KAKDA
vSW
A o2 n
and paitlad in A Grade A
beavingRoll Na: 4 o32 42 3St
and endicas iu: Na 15621,
bhaContrala Bcard of
in teemadiak tduation A P
3. Passed Bachelan af echnalag
in CiuilEn inaena4 in irtt ,
clasuith Distinctian daring
APril dcl with Hol46NLAOIS4
Date: 28-o6-2al3 and
Centicate Na koa3 26 á4
Jawaharlal Nehru Technaletal
in
Lnivenity kakinadk Andhra
raoks NDIA
Exeeutve Englheer
P R Dvn., Rajamahendravarp
12
13
14 15
,
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appeinedas Enginkeninhsstant
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[Link] Pator
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i n seaeral hecuitmeot_Conducted
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at
The induidual isplate paife
Sachivalaylam odkokhapeta
Khan iga
stant |
Mand a Enginee4 ur
ReLrul men4219D 30u[2o19
ainee PR_cle kakinada
uperlintending
Executv Engtneer
P R I .Dlvn., Rajamehendraver
11
12
13
14 15
JoNIN4 DETAILS
Jeinina duty on
heFnof
aS
nqintenim, Assutan
at khang rama Jakhivolgyarn
O
klothapela lancaon onspldatd
Pay1seo pemonth videuogs
N AA/canglAui iReailmecal301
D3oil201 oJapeciatendbg
Enginte PR id kakinada
ExecutvsEiginer
PRIDhn., Rajamyhendravarah
13
12 13 15
14
PA5SED APPSCDEPATMENTAL TESTS INTHME SEESION3Pecnt1202
THE ACCDUNTH TEST FOR PUBtic wORKS
DEPARtMENT
OFFICER&SUpjORDItATES (PAPER-1, PAPER COoE-137)
ANDTHEAceUNFS FEST FORPUEAIC WORKS DEPARTMENT
OFFIGERS&SHepRBINAFEST (PAHER-+H, PAPER CODE-142)
VIDEHALL-THCKEJ-BEARINGNG 04ol
HELDFROMDL09:210230921g9UED
BYAPPSC, VHYAWADA. VAEotEttAttont tot
ExeeutvEngineor
RRIL Dlen,Ralamehendravaram
3ild21
THE INDIVMDUAL HAS BEEN VERIFIED ANTICIDENTS
BY
KAKiAOA QdL
SUPERINTENDET POLCE EASIGopANADT
NOTHIJn AOVdSe,
D940222ANDEOUND
Executlve Engineer
PRA-DvRaamahepdrevaram
Seryices Verified with reference to Pay
Bllsand Omce Recorde for the period
from 1.o|3019 to 30ll.202
oy
GRAM PANCHEALKHANORIGA
Kothapeta(M).[Link].
**
Sri K. Chanti Babu,[Link]
15
12
1
13 14 15
DECLARATION OE PROBATION
Theperiod of Probation of the
individual was
declared to have been satistactory completed
W.e.. . in the cadre,
of
Engineering
rule
Assistant (Gr-1), in relaxation of
181a) of the [Link] and Subordinate
Rules, 1996, and also allowed the Pay Stale
of Rs.22460-72810 w.e.f. 1st July, 2022
Vide
Procgs [Link]. A4/575/2022, Dt30.06.2022 of
theCollector&District Magistrate, Kakinad
District.
Executie Enginer
PR Division, Amalapuram
OF EA
FIXATIONOF PAY IN THE CATEGORY
Probation o
Consequent on declaration of
in the categorytheof
the individuat Pay of individual
Engineeaia1Assistant, the 01.07.2022
22460/- w.e.f.
nasbeen fixedatRs.
i n T S P 2 2 4 6 0 - 6 6 0 - 2 3 7 8 0 - 7 2 0 - 2 5 9 4 0 - 7 8 0
28280-8Sp-30830-920-33590-990-36S60.
1080-39800-1170-43310-1260-47090-1350.
51140-1460-55520-1580-60260-1700
65360-1830-70850-1960-72810 Vide Proegs
Dt.30.06.2022 the of
[Link]: A4/575/2022, Kakinada
Magistrate,
Coltector & District
District.
ExecrutiveEngineet
PR Divisipn-Amalapuram
257
