TELANGANA RESIDENTIAL EDUCATIONAL INSTITUTIONS RECRUITMENT BOARD

HYDERABAD.
TREI-RB NOTIFICATION NO: _____/2023
BASIC INFORMATION DATA
(CHECK LIST)
(To be filled by the candidate)

NAME OF THE POST :

OTR ID : PHOTO OF THE
HALL TICKET NO : CANDIDATE

DATE OF VERIFICATION :

Signature of the candidate

Name of the Candidate

01 (as per SSC)

02 Father’s Name

03 Mother’s Name

04 Gender Male Female

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

(Age as on Years Months days

06 01/07/2023)

Date of
Qualification Max. Marks % of
acquiring Name of University
Marks secured Marks
qualification

SSC

Professional
(Qualification as on 05/04/2023)

Qualifications
As per Notification

07

Official use :
 OC SC ST BC
A B C D E
Community
(integrated
Community Certificate 1. Caste Certificate issued by Telangana Govt. Yes\No
08
Issued by Tahsildar for
SC/ST/BC from 2. Certificate No __________________________ Dt:_______________
Telangana State 3. Official use :
Govt.)

Whether non-creamy layer YES NO

BC Candidates should certificate produced
Submit Non Creamy
Layer certificate as
per G.O.Ms.No:8 of
2014 1. Date of issue of Non-creamy Layer certificate:_______________
09
2. Certificate No ________________________ Dt:_______________
&
3. Official use :
MemoNo.3009/BCW/
OP/2011, Dt:18-12-
2015.

VH HH OH MH

1. Percentage of Disability ______%

10 PH –Category
2. Certificate No __________________________Dt:_____________
3. Official use :

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

I
Indicate the evidence
(Original Study II
Certificate to be
produced) OR III
12 Residence certificate
for 7 yrs. Prior to VII IV
Class in case of private
Study. V

VI

VII
 District Zone Multi Zone
District, Zone & Multi
13
Zone belongs to

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

Details of Sports
15
Certificates

Declaration
I hereby declare that

i) All the columns filled in by me containing my bio-data and other particulars, are true to the
best of my Knowledge.
ii) The certificates such as, 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
TREI-RB and other PSCs and also criminal prosecution, if I am found involved in any unfair
means / malpractice.
v) I further declare that the information furnished by me is correct and my candidature shall be
16
cancelled at any stage if it is found incorrect.
Address.
…………………………………………………………..….

……………………………………………………………….

……………………………………………………………….

Mobile No……………………………………..

Place:
Date: Signature of the candidate.
 FOR OFFICIAL USE

The Candidate is shortlisted for further process of selection.

Verification Officer Chief Verification Officer Camp In-charge

TO BE USED FOR REJECTION

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

Supdt. Camp In-charge EO(Convenor)

CHAIRMAN