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RLT Data Sheet

The document is a data sheet for recruitment of assistants in 2023. It requests information such as personal details, education qualifications, work experience, language skills, and a declaration. The data sheet is to be submitted in three copies including an original and two photocopies along with a recent passport photo.

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60 views

RLT Data Sheet

The document is a data sheet for recruitment of assistants in 2023. It requests information such as personal details, education qualifications, work experience, language skills, and a declaration. The data sheet is to be submitted in three copies including an original and two photocopies along with a recent passport photo.

Uploaded by

gozmcdwlveopgwifyr
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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DATA SHEET—RECRUITMENT OF ASSISTANTS—2023

AFFIX RECENT
(TO BE BROUGHT IN 3 COPIES—1 ORIGINAL +2 COPIES) PASSPORT SIZE
COLOUR
VENUE OF RLT:
PHOTOGRAPH
& SIGN ACROSS

Post Applied for : ASSISTANT


State Applied for :
Roll No :
Name in Full (In CAPITAL : SHRI/SMT/KUM
LETTERS)

(First Name) (Middle Name) (Last Name)


Father’s/Husband’s Name & :
Occupation

Present Address in full for :


Correspondence

Pin
E-mail :
Phone / Mobile :
Alternate Mobile no. :
Nearest Railway Station :
Permanent Address :

Pin

Category : SC ( ) ST ( ) OBC ( ) EWS ( ) Unreserved ( )

Change of category from that Domiciled :


furnished in the application form Caste Cert. Ref. No.
will disqualify the candidate from
Date of Issuance :
recruitment process
Issuing Authority:

*Whether Ex-Serviceman/ Disabled Ex-S/Dependent Ex-S( please specify) Yes /No

*Whether PWD(VI/HI/OC/ID)(please Specify with percentage of disability)

*certificates/documents copy in prescribed format to be attached and original produced


1
*Whether existing confirmed Yes ( ) / No ( )
Employees of Public Sector General
Insurance Companies (including GIC If Yes, S.R.No.__________________Designation_________________
and Agriculture Insurance Co. of Name of the Company/Corporation _______________________
India Ltd.) Place of Posting _______________________________________
*certificates/documents copy in Date of Confirmation ___________________________________
prescribed format to be attached and
original produced

Date of Birth ______/________/_______________(dd/mm/yyyy)

Age as on 30-09-2023 ___________years

Place of Birth ________________________

State of Domicile _________________________

Gender Male ( ) / Female ( )

Religion __________________________

Marital Status __________________________

Languages (1)___________________(2)__________________(3)______________
Known(Read,Write,Speak)
(4)___________________(5)__________________(6)______________

Qualifications as on 30.09.2023
Date of Aggregate Class /
Exam Subjects
Name of University / Institution passing marks Division
Passed Offered
Exam (%)* or Rank
SSC
HSC
Graduation
Post Graduation
Any Other
*Conversion of CGPA(Practice as adopted by University) Proof to be attached .
*Marks Calculation method, if specific, adopted by the University, proof to be attached.

Separate Sheet may be enclosed if space not sufficient.

Are You pursuing further studies (if yes, give details )_______________________________________________

Preferred Places of posting in the state 1. 2. 3.

Please provide three different options.Note: These preferences are not binding on the Company. Candidate may be posted to any
location other than the preferred ones mentioned here

2
Insurance Qualification, if any
Examination passed Year of passing Name of Institution

Past and Present Employment (To be furnished in detail)


Name and Full address of Employer Designation / Period Scales & Reason(s)
(s) Post held From To Pay drawn for leaving

Experience certificate to be enclosed.

Candidates serving in Government / Quasi govt. offices/Public Sector Undertakings (including Nationalized Banks and
Financial Institutions)/ Others are required to produce a “No Objection Certificate” from their employer at the time of
Regional Language Test, in the absence of which their candidature will not be considered. The candidates selected will have
to serve a minimum period of 5 years in the posted location. Appearing for the RLT will not automatically confer any right
of being selected for the said post. The decision of the Company will be final and binding in all matters
Separate sheet may be enclosed if space not sufficient.
The candidates are advised to satisfy themselves before their appearance in the Regional Language Test that they fulfill the
requirement as to age, qualification, etc. and if found ineligible their candidature will be cancelled at any stage of
recruitment. Appearing for the Regional Language Test will not automatically confer any right of being selected for the said
post. The decision of the Company will be final and binding in all matters.

I hereby declare that :


1. I have carefully read and understood the instructions given in the advertisement and all statements made in the
application are true and correct to the best of my knowledge and belief and no relevant information has been concealed.
I am not aware of any circumstances which might impair my fitness for employment under Government/PSU.
2. Mere submission of application for this post will not entail right for claiming appointment.
3. In the event of any information being found false or incorrect, and in the event of any misrepresentation, mis-statement
or discrepancy in the particulars being detected prior to or after my appointment, my candidature / services for the post
applied is liable to be cancelled / rejected / terminated forthwith at any stage without giving any notice to me.
4. I am willing to serve the Company anywhere in India. During the tenure of my service, I shall be liable to be transferred
to any place in India and/or outside India, within or across the Public Sector Non-Life Insurance Companies / General
Insurance Corporation of India (GIC) or from one department to another or to be deputed to any organization /
institution / entity / department associated with and/ or affiliated to the Companies / GIC or with whom they have any
official relation or business link as may be deemed from time to time.
5. I agree that the Company has the right to transfer me to any part of the Country at its discretion.
6. I have never been debarred / disqualified / restricted from appearing in any examination, selection, interviews, etc.,
conducted by any institution, board, Public Service Commission, Staff Selection Commission or instrumentality of the
State.
7. I have never been arrested, prosecuted, convicted, fined, or any case is pending in any Court of Law or involved in any
other case registered by Police at the time of submitting this application for the post applied.
8. I have never been expelled /withdrawn/discharged from any training Institution of Government or others.
9. If detained, arrested, prosecuted, bound down, fined, convicted, debarred etc. subsequent to the completion and
submission of this application, the details will be communicated immediately in writing to the Company, failing which it
will be deemed to be suppression of factual information.
10. The information provided by me is complete and correct and if found false, suppressed or incomplete, either at the
recruitment stage or at any time during the course of employment, I may be disqualified and my services would be liable
to be terminated forthwith without any notice.

Date:

Place : *(SIGNATURE OF CANDIDATE)

Note: *The data sheet should be signed in front of the Company Officials at the Regional Language Test Venue

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