HYDERABD DISTRICT TEACHER'S PARTICULARS

Employee Treasury ID ( 7 Digits )

DETAILS OF THE EMPLOYEE
Name * Surname
Father Name * Gender *
Date of Birth *   Pick a date Caste *
Religion * Mobile No. *
Aadhaar Number * Mail ID
Local Status(As per 4th to 10th study certificate OR as per S.B.) If you are belonging to Non-Local, Mention District
Marital status *
Married Un Married Widow Legally Separated
Whether belongs to PHC
Yes No
Whether Spouse is Govt. Employee or not
Yes No
SPOUSE DETAILS (If spouse is State/central/local/municipal/Public sector undertaking Employee *
Spouse Treasury ID Spouse Name
Department Designation
Working Place Mandal
Dist whether previously Spouse category availed
Yes No
If availed Mention Month & Year
PHC DETAILS *
Category of PHC % of PHC *
whether PHC allowance claimed * Sadarm Certificate Number & Date    Pick a date
SALARY ACCOUNT DETAILS
Present Scale of Pay Present Basic Pay
Name of the Bank Branch Name
Account Number IFSC Code
RESIDENTIAL ADDRESS
H.No. Street
Land Mark / Near By * Mandal *
District * Pincode *
SCHOOL INFORMATION
Name of the Zone * Name of the Mandal *
Name of the School *
School UDISE Code (11 Digits-NEW) -
Date of Joining in the Present School Pick a date Management of the School *
Name of the School Complex (Your School  under comes which School Complex)* Whether the School is Success or not *
Category of the School * Type of the School *
Numnber of Mediums Running in the School * School Water CAN number
Whether the School is Running under Shift System or General System Type of School Building
School Electricity Meter Number Name of the Electricity ERO Zone
SCHOOL POSTAL ADDRESS
H.No. Street
Land Mark / Near By * Mandal *
District * Pincode *
School Land line / Mobile Number School Mail ID
SERVICE  DETAILS
Date of first Appointment    * Pick a date
First Appointment Cadre
Name of the First Appointment Dist. *
Medium of the Post You are Appointed *
Management of the First Appointment*

Date of joining in Present Category    *

Pick a date
Whether Present Category is Promotee /Direct Recruitment
Present Designation *
Date of joining in SA Cadre   Pick a date
Have You ever Rejected the Promotion within one Year
Yes No
Month
Year
Whether Appointed as a Spl. V.V. (2002)
Yes No
Date of First Appointment Pick a date
Date of Passing D.Ed. / B.Ed. Pick a date
Date of absorbtion Pick a date
Whether Appointed as a Spl. Teacher. (398)
Yes No
Date of Spl. Teacher Appointment Pick a date
Date of absorption / Regular Scale Awarded Pick a date
Are you Identified Under 610
Yes No
Exempted Under Spouse      
Retained as per Court Order
Whether Transferred Under Inter District Transfer (IDT)
Yes No
Under which Category you Transferred
From Which District You Transferred
Date of Joining in HYD. Dist. Pick a date
Year of APPSC / DSC * Rank Marks
Appointed as a * Native District   Whether Selected Under OPEN(LOCAL & NON-LOCAL) or LOCAL Category *
Break of Service / Dies non  if any Years Months Days Reasons for Break of Service/ Dies Non
Academic Qualifications  *

Name Of Degree

Subjects

Medium

Name of the Board/University

Year of Passing

SSC
INTER 
DEGREE
ADDL.DEGREE1
ADDL.DEGREE2
P.G.
ADDL.P.G.
M.PHIL
PhD.
Other
Professional Qualifications * (From TTC / D.Ed.)**Mention the Methods Only for B.Ed. Candidates**
Name of  Degree Method -I Method -II

Medium

Name of the Board/University

Year of Passing

Additional Methods If Any...

Additional Methods

Name of Method

Medium

Name of the Board/University

Year of Passing

Method-III

MMethod-IV
Departmental Tests Result *
Name of  Test Result Month of Passing Year of Passing
Whether Passed GOT
Whether Passed EOT
Whether Passed Spl language (Telugu)
Whether Passed Spl language (Hindi)
Deputy Inspector of Schools Test
Professional Advancement Test
ELIGIBLE TO GET PROMOTION ( Check dropdowns and Select According to your Qualifications Only, If not applicable select Not Applicable) *
           
SSC Class Handling Details
Whether handling SSC for last 3 years continuously
Yes No
Whether Handling SSC in Present Academic Year i.e., for 2016 - 2017
Yes No
Subject Medium1 Medium2 No of years Experience
OTHERS

Pending Disciplinary Cases if any

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DECLARATION BY TEACHER

I here by declare that the above particulars submitted by me are true and correct and if any false information found in the above I will be personally held responsible as per CCA Rules

                                                                     

Signature of the Teacher

Certificate by DYEO/DYIOS/HM

I certified that the above particulars submitted by the candidate are verified with the Original Certificates and the service register of the individual and found correct

                                                Signature of Dy.E.O. / Dy.I.O. / Headmaster: