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Annexure - III

APPLICATION FORM

(For the posts below Manager Cadre)

Post applied for

Advertisement No . and Date

1.	Name of the Candidate ( in BLOCK LETTERS)
2.	Gender ( Tick in relevant Box)	Male	Female
3.	Date of Birth	Date	Month	Year
4.	Age as on 1st Jan/ 1st July of the year ( as the case may be) (in complete years)
5.	Fathers Name
6.	Mothers Name
7.	Marital Status ( Tick in relevant Box)	Married				Unmarried
8.	Spouse Name Husband/ Wife
9.	If applicant is Female	Widow		Destitute Widow		Others
10.	Place of Birth
11.	Native District and State
12.	If other than TN, Specify the Name of the State
13.	Mother Tongue
14.	Other Language known
15.	Nationality ( Tick in relevant Box)	Indian		Others
16.	Religion (Please specify)
17.	Address for Communication
	Door No.	Street Name:
	City / Village:	District :
	State:	Pin Code:

18.

Permanent Address

Door No. Street Name:

City / Village:

District :

State:

Pin Code:

19.

Communal Category ( Please Tick in relevant Box)

OC

BC

MBC

SC

SC(A)

ST

DNC

20.

Name of the Sub Caste

a.

Community Certificate No.

b..

Date of Issue

Date

Month

Year

c.

Issuing Authority

d.

Name of the Taluk

e.

Name of the District

21.

Are you a Differently Abled Person?

Yes

No

If Yes, please specify

22.

Whether Coming Under Priority? If yes, tick the relevant box

DW

Inter Caste Marri age

Ex-Service man Dependents of Ex-service man, dependents of serving Army personnels

Freedom Fighter and Thiyagis for Tamil language

Burma/Ceylon Repatriate

Owner of the land acquired by Govt.

Physically Handi- capped exclusively Ortho

Orphans

Not applicable

a.

Certificate No.

b.

Date of Issue

Date

Month

Year

c.

Issuing Authority

d.

Name of the District

e.

Name of the Taluk

23

Educational Qualification

Medium of Instruction

Name of the Institution

Year of Passing

Total Marks

Marks Secured

%

Grade/Class

a.

S.S.L.C

b.

H.S.C. (+2)

c.

ITI/Teacher Training (2 Years)

d.

Diploma

e.

Degree (3 years)

f.

Diploma in Co.op.

g.

Post Graduate Degree

h.

M.Phil.

i.	Ph.D
j.	PG Diploma
k.	Typing Tamil
l.	Shorthand in Tamil
m.	Shorthand in English
n.	Others
24.	Details of previous employment if nay		Name and address of the Institution	Designation	Scale of Pay		From	To
			25.	Details of conviction / punishment / Disqualification/criminal case, disciplinary proceedings etc., if any
26.	Mobile No. / Phone No

1. Declaration:

   I hereby, declare that all the particulars furnished in this application are true, correct and complete to the best of my knowledge and belief. In the event of any information being found false or incorrect or ineligibility being detected before or after the examination, action can be taken against me by Kanyakumari District Cooperative Milk Producers Union Ltd. Nagercoil.

   Date:

   Place:

2. Signature of the Candidate

   Encl: 1. Self attested Xerox copies of Certificate

   1. Self Addressed Envelope 3 Nos. (Size 27 X 11 cm)

   2. Self addressed post card.

Annexure III (a)

Format for Envelope for submission of filled in applications (Please write following on the envelope)

APPLICATION FOR THE POST OF ..................................

Advertisement No. 6/2017

To

The General Manager,

Kanyakumari District Co-operative

Milk Producers Union Limited,

K.P.Road, Nagercoil,

Kanyakumari District 629 003.

From

...........................

...................................

...............................................

THE KANYAKUMARI DISTRICT COOPERATIVE MILK PRODUCERS UNION LTD.,

NAGERCOIL

ADDITIONAL INFORMATION AND INSTRUCTIONS TO THE CANDIDATES-1

1. Name of the District Cooperative : Kanyakumari District Co-operative Milk Producers Union Limited, Milk Producers Union Limited,

   K.P.Road, Nagercoil, Kanyakumari District 629 003.

2. Jurisdiction of the District Cooperative : Kanyakumari District Milk Producers Union

3. Name of the Post and vacancies to be Filled up and educational qualification Prescribed :

Sl. No .	Name of the Post	Scale of Pay	Vacancy	Educational Qualification prescribed
1.	Deputy Manager (Dairying)	Rs.9300-34800 + Grade Pay Rs.4400	SC(A) - Women- (Destitute Widow) Priority - 1	Must possess Degree and IDD/ NDD or Post Graduate Degree in Dairy Science/ Dairying or B.Tech in Food Technology/ Dairy Technology/ Food Processing from any approved institutions.
2.	Junior Executive (Office)	Rs.5200- 20200+Grade Pay Rs.2400/-	SC(A&P)-Women- (Destitute Widow) Priority-1	Must be a Graduate in any discipline. Must have passed in Cooperative Training as detailed in Rc.No.51928/2013/SF2 dated 18.07.2013 of the Registrar of Cooperative Societies, Chennai. Exemption for holders of degree in B.A (Co.op) / B.Com (Co.op) from passing cooperative training.
3.	Junior Executive (Typing)	Rs.5200- 20200+Grade Pay Rs.2400/-	General Turn Non-Priority - 1	Must be a graduate in any discipline with Typewriting Higher Grade in English and Tamil.
4.	Private Secretary Grade III	Rs. 5200-20200 + Grade Pay Rs. 2800/-	General Turn Non-Priority - 1	Must possess a degree in any discipline. Must have passed Typewriting English Higher Grade & Tamil Lower Grade & Shorthand English Higher Grade and Tamil Lower Grade

5	Technician (Operation)	Rs. 5200-20200 + 2400	General Turn (Priority)	1. Pass in SSLC with ITI certificate in the trade of Mechanic Refrigeration & Air-conditioner/Fitter/Mechanic Motor Vehicle/Electrician/Instrument Mechanic with NTC (or) Diploma in Mechanical/ Electrical and Electronics/Instrumentation and Control Engineering.
6	Light Vehicle Drivers	Rs. 5200-20200 + Grade Pay Rs.2400	GT (Priority) 1 , SC(A) - Women- (Destitute Widow) Priority - 1	Must have passed VIII Std 2. Must be in possession of a valid Driving License to drive Light Vehicles. Must have minimum 3 years experience as Light Vehicle Driver.

1. Age for Recruitment (as on 1st Jan 2017 of the year)

   (Please refer Enclosure -1 cadre wise)

   1. Minimum age is 18 years

   2. Maximum age

      Sl. No	Name of the Post	SC/SCA/ST	MBC/DNC/BC	OC
      1.	Deputy Manager (Dairying)	No Age Limit	No Age Limit	30 Years
      2.	Junior Executive (Office)	No Age Limit	No Age Limit	30 Years
      3.	Junior Executive (Typing)	No Age Limit	No Age Limit	30 Years
      4	Private Secretary Grade III	No Age Limit	No Age Limit	30 Years
      5.	Technician (Operation)	35 Years	32 Years	30 Years
      6.	Light Vehicle Drivers	35 Years	32 Years	30 Years

      Relaxation up to 10 years for differently abled candidates for all categories

2. No. of application to be sent

   If a candidate is eligible for more than one post, He / She should send separate application for each post. The filled in application, complete in all respects along with Xerox copies of required documents and other enclosures should be sent to the address mentioned in the advertisement either by Registered Post or Speed Post. If sent by any other mode, it is the responsibility of the candidate to ensure the receipt of the application in the office before the last date mentioned in the advertisement. Management will not be responsible for postal delay, if any. The envelope containing the application should mention the post to which the application relates and should be written in the format indicated below.

   Format for Envelope for submission of filled in applications (Please write following on the envelope)

   APPLICATION FOR THE POST OF ....

   Advertisement No: 6 /2017

   To

   The General Manager,

   Kanyakumari District Co-operative Milk

3. Producers Union Limited, K.P.Road,

4. Nagercoil, Kanyakumari District - 629 003

   From

   ...........................

   ...................................

   ...............................................

   (A) Selection Procedure

Selection will be made based on the marks obtained by the candidate in the academic qualification and oral test.

1. For academic qualification 90 marks

2. For Oral test 10 marks

Allocation of Marks

Sl.No.	Detail	Prescribed Qualification
		Graduation	If more than one degree	Post Graduation	Less than Graduation
1.	Marks obtained in the SSLC / X std	15	15	15	30
2.	Marks obtained in +2 / Diploma	15	15	15	-
3.	Marks obtained in graduation	50	-	20	-
4.	Marks obtained in the prescribed qualification	-	30+30	40	50
5.	Marks of Higher Qualifications in the same field (related to the post)	10	-	-	10
6.	Oral Test	10	10	10	10
	Total	100	100	100	100

ADDITIONAL INFORMATION AND INSTRUCTIONS TO THE CANDIDATES-2

1. Applications

   If a candidate is eligible for more than one post he / she should send Separate application for each post. The filled in application, complete in all respects along with Xerox copies of required documents should be sent to the address mentioned in the advertisement either by Registered post or speed Post. If sent by any other mode, it is the responsibility of the candidate to ensure the receipt of the application in the office before the last date mentioned in the advertisement. Management will not be responsible for postal delay, if any. Application should be sent along with filled in Hall ticket and other enclosure listed in the Application. In the Hall ticket the Examination Roll No. need not be filled up by the applicant at the time of submission and the same will be assigned by the Management while sending Hall ticket for appearing for the written test.

2. Qualification in Tamil

   Every candidate on the date of the Notification for the post should possess and adequate knowledge in Tamil.

   Explanation : For this purpose a person will be deemed to possess and adequate knowledge in Tamil:

   1. In the case of a post for which the educational qualification prescribed is the Minimum General Educational Qualification and above, He / She must have passed the S.S.L.C. Public Examination with Tamil Medium.

      (OR)

   2. The candidate should pass the Tamil Language proficiency test, conducted by the Tamilnadu Public Service Commission within 3 years from the date of entry into service.

3. Community Certificate

   In the case of an applicant who claims to be a member of SC/SC(A) or ST or MBC/DC or BC (Other than BCM) or BCM, a certificate from the following authority noted against each should be produced in the form as specified in G.O.Ms.No.781, Revenue Department, Dated 2nd May 1988.

   Name of the Community	Competent authority to issue the Certificate
   1. ST	R.D.O / Asst. Collector / Sub Collector / Personal Assistant (General ) to the Collector of Chennai / District Adi-Dravidar Welfare officer.
   2. SC / SC(A)	Taluk Tahsildar
   3. MBC/DC, BC (Other than Muslim) and BCM	Revenue Officer not lower in rank than a Tahsildar or Head Quarters Deputy Tahsildar or Special Deputy Tashildar appointed to issue Community Certificate. Additional Head Quarters Deputy Tahsildar and Zonal Deputy Tahsildar.
   4. Thottia Naicker (including Rajakambalam, Gollavar, sillavar, Thockalavar. Thozhuva Naicker and Erragollar) included in the list of MBC/DC)	Head Quarters Deputy Tahsildar.

   Community Certificate should have been issued by the competent authorities referred to above, in whose jurisdiction the candidate claims to have permanent residence. The Certificate obtained by the candidates in the form other than the one

   prescribed in G.O.Ms.No. 781, Revenue Department, Dated 2nd May 1988 and solely

   based on the entries in S.S.L.C. or Transfer Certificate or other School / College records will not be accepted.

   Candidates are warned that if the community recorded in the certificate produced by them from the competent authority is not included in the list of Scheduled Castes, Scheduled Tribes, Most Backward Classes / De-notified Communities or Backward classes, they will not be considered as belonging to Scheduled Caste, Scheduled Tribes or Backward Classes/De-notified Communities or Backward Classes as the case maybe. They will, in that case, be considered only under Others and if they are not qualified to be considered under Others, their applications will be rejected.

4. Priority Certificate

   In the case of an applicant who claims priority under Priority Category, a Certificate from the following authority noted against each should be produced in the form as specified.

   Order of priority	Competent authority to issue the Certificate
   1. Destitute Widow	R.D.O / Asst. Collector / Sub Collector / Personal Assistant (General) to the Collector of Chennai/ District Adi-Dravidar Welfare officer.
   2. Inter caste marriage (one of spouse should belongs to Hindu Adi Dravida)	Tahsildar.
   3. Ex-Servicemen, Dependants of Ex-serviceman, Dependants of Serving Military service personnels	Assistant Director, Ex-servicemen Office, For serving ex-servicemen Commandant, Army Headquarters.
   4. Freedom Fighter Tamil language (only sons and daughters)	Tahsildar.
   5. Burma / Ceylon Repatriates	Tahsildar
   6. Owners of land acquired by Government	Tahsildar
   7. Physically handicapped exclusively Ortho.	Competent Medical authority
   8. Orphans	Tashildar, Institutions concerned

   Candidates claiming priority Under Priority Category should submit the Certificates issued by the competent authority only. The certificates issued by other than competent authority will not be considered. They will in that case be considered under non-priority category only.

5. Communication with the Management

   1. Any communication intended for the Management must be made in writing and addressed only to the General Manager, Kanyakumari District Co- operative Milk Producers Union Ltd., Nagercoil-3.

   2. If a reply is sought, it must be accompanied by an envelope affixed with sufficient Postage Stamps with the address to which the reply is to be sent.

   3. Communications asking for reasons for non-selection and request for exemption from age limit or other qualifications will not receive any attention.

   4. The Management will receive communications only from candidates. Communications in the name of pleader or agent will not receive any attention.

6. Disqualification / Debarment Disqualification:

   1. If a candidate attempts to canvas to bring influence on the authorities concerned or any member of the Committees personally / by letter / through relatives, friends, patrons, officials or other persons.

      Debarment

      1. If the applicant attempts any tampering, alteration with the documents or certificates, he is liable to be debarred from appearing for any of the selections conducted by the Management and consequently from entry into service.

      2. (i) Candidates furnishing false particulars in the matter of qualification or the nature of pass in various subjects, experience gained, their religion or community etc.

         1. Suppression of materials information regarding

            1. Employment in Government or Local Bodies, Public Corporations etc.,

            2. Information regarding arrest, convictions / debarment / Disqualification by any recruiting agency, criminal or any disciplinary proceeding initiated or finalized, participation in agitation or any political Organization, candidature in election for Parliament

               / State Legislature / Local Bodies etc., if any, should also be furnished to the Management at the time of application i.e the details thereof, originals of the Judgment of Acquittals order / or

               G.O dropping further action in Departmental proceedings or any document that may prove the suitability of such candidates for an appointment must be produced at the stage / time of Certificate Verification.

            3. Making false or vexatious allegations against the Management in petitions addressed to it or nay other authority, will be viewed seriously and that the candidate responsible for such act will be debarred from appearing for selections by the Management permanently or for such a period as the Management may decide.

            4. Their admission at all the stages of examination for which they are admitted by the Management viz. oral Test will be purely

   provisional, subject to their satisfying the prescribed eligibility conditions. If on verification any time before or after the oral test, it is found that they do not fulfill any of the eligibility conditions, their candidature for the examination will be cancelled by the Management.

7. Minimum marks prescribed for selection

   Those candidates who have an overall score of less than 40% shall not be considered for selection.

   Other conditions

   1. Selection of candidates by Management carries with it no guarantee of actual appointment.

   2. The Number of vacancies advertised is only approximate and is liable to modification.

   3. Any claim by a candidate that he / she has obtained a higher or additional qualification made after the submission of an application will not be entertained.

   4. The claims of the candidates with regard to the date of birth, educational / technical qualifications and community are accepted only on the information furnished by them in their applications.Their candidature therefore will be provisional and subject to the Management satisfying itself, about their age, educational / technical qualifications, community etc. Mere admission to the interview or inclusion of name in the list will not confer on the candidates any right for appointment. The candidature is therefore, provisional at all stages and the Management reserves the right to reject any candidature at any stage, even after the selection has been made.

   5. The candidature of candidates, if found ineligible, shall stand cancelled even after declaration of their result.

   6. A candidate found by the Management qualified to compete for the appointment must be prepared to appear when summoned before the Management at the place notified at their own expenses.

8. Payment of TA & DA

   Candidate is not entitled for Travelling A llowance and Dearness Allowance.

9. Probation

   Candidates selected and appointed to a post should undergo probation prescribed for the post.

   At any time before the end of the prescribed period of probation, the probation of a candidate appointed may be terminated and he may be discharged from the service.

10. List of Documents to be produced at the time of Certificate Verification / Oral Test (*if applicable):

1. Evidence of Date of Birth (SSLC / HSC / TC )

2. Community Certificate from the competent authority (ie. Life card)*.

3. Evidence of Educational Qualifications (SSLC / HSC / Diploma / Degree / PG degree or Provisional certificate etc.)

4. Evidence for Typewriting / Shorthand qualifications*.

5. Evidence of Tamil qualification (viz. SSLC /HSC /Degree / Certificate for having passed Tamil conducted by the Tamil Nadu public Service Commission).

6. Veterinary Registration Certificate / Driving Licence*.

7. Differently Abled Certificate from the competent Medical Officer to the effect that he / she is a fit person to discharge his / her duties and with the entries therein regarding the percentage of Differently abled*.

8. A certificate of Destitute Widow from the RDO or the Assistant Collector or the Sub-Collector concerned in the format prescribed*.

9. A certificate as evidence for claim in respect of Ex-sericeman*.

10. Tamil Medium: Persons Studied in Tamil Medium (PSTM) have to produce the evidence, such as Transfer Certificate, Provisional Certificate/ Convocation Certificate / Degree Certificate if needed mark sheets eceived from the Board of University or from the Institution, with a recording that he/she studied prescribed education in Tamil Medium as per G.O.Ms.No.145 P & AR (S) Department dated 30.09.2010. If no evidence for Person studied in Tamil Medium is available as said, then a certificate from the Head of the Institution as given below must be furnished.

PSTM Certificate

(To be issued only by the Head of Institution)

This is to certify that Thiru/Tmt. .................................................... (name)

...................................... has studies (course Name) .........................................

.. (B.A./B.Sc., etc.,) during the year .................................................

to .............................................. in Tamil Medium. This certificate is issued after verifying the course content / statement of Marks / Transfer Certificate. The candidate has / has not obtained scholarship for having studied in Tamil Medium.

Date:

Place:

Registrar/Principal

Seal of the Institution

• Organization : Kanyakumari District Cooperative Milk Producers Union Ltd
• Organization City, State : kanyakumari, tamil nadu
• Organization Website :