Application Form

APPLICATION FOR APPOINTMENT AGAINST SPORTS QUOTA 2022 IN PRE-REVISED PAY BAND / SCALE RS.9300 - 34800/- WITH GRADE PAY RS.4600/-, PRE-REVISED PAY BAND / SCALE RS.5200 - 20200/- WITH GRADE PAY RS.2400 & PRE-REVISED PAY BAND / SCALE RS.5200 - 20200/- WITH GRADE PAY RS.1800

To

The Additional Commissioner of Income-tax
(Hqrs) (Admin & TPS)
"AAYAKAR BHAWAN"
No. 121, Mahatma Gandhi Road
Nungambakkam
Chennai - 600 034.

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* File size should be less than 30 kb

Post Applied For (In Order of Preference) :*

Inspector of Income-tax :

Tax Assistant :

Multi-Tasking Staff :
1. Name of the Candidate :*
Email Id:*
Mobile No:*
Father's Name :*
Occupation of Father:
2. AADHAAR Number:*

Available Applied For
3. Date of Birth (In Christian Era) :*

In Figure

(As per School Leaving Certificate) :*

In Words
i) Age as on 01-04-2022 :*
4. Sex :*
5. (A) Permanent Address
(with Pincode, nearest Rly Station):*
5. (B) Present Postal Address
(with nearest Rly Station):*

Tick If, Same As Permanent Address
6. (A) Nationality:*
6. (B) Religion:*
6. (C) Category :*

ST SC OBC GN

7. Educational Qualification :*

*Each file size should be less than 200 kb

Examinations Passed	Name of the School / Board / Univesity or organization and full address of the school	Year of passing	Class Division	Marks Obtained	% of Marks

8. a) Discipline (Sports) :*
8. (b) As per the notification, mention
the highest sports achivements during the period of 2019 to 2022 :*
8. (c) Current sports achievement in 2022, 2021, 2020 and 2019:*

2022.

2021.

2020.

2019.
9. Two Identification Marks :*

1.

2.
10. Incase of serving persons :

i) Name of the organization where employed

ii) Designation

iii) Date of Appointment

iv) Address of the employer

v) Whether NOC obtained Applied For Yes

11. Details of enclosures :**(Each file size should be less than 200 kb)

1.a) Copy of Form 1 from Competent Authority
b) Merit Certificate
c) Participation Certificate
d) Form I Download (Click here to download)

2.a) Copy of Form 2 from Competent Authority
b) Merit Certificate
c) Participation Certificate
d) Form II Download (Click here to download)

3.a) Copy of Form 3 from Competent Authority
b) Merit Certificate
c) Participation Certificate
d) Form III Download (Click here to download)

4.a) Copy of Form 4 from Competent Authority
b) Merit Certificate
c) Participation Certificate
d) Form IV Download (Click here to download)

5.a) Copy of Form 5 from Competent Authority
b) Merit Certificate
c) Participation Certificate
d) Form V Download (Click here to download)

12. Copy of Degree Certificate / Provisional Certificate *
(Each file size should be less than 200 kb)
13. Copy of Matriculation Certificate *(Each file size should be less than 200 kb)
14. Copy of Community Certificate *(Each file size should be less than 200 kb)

Declaration

I, ____________________________________ son / daughter of Shri / Smt ______________________________ hereby solemnly declare the statements furnished above are true and complete to the best of my knowledge. If any information provided above is found to be incorrect / false at any stage, my candidature / service stands liable to be cancelled / terminated any time.

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Place:*
Date:*