Option Form
Option Form
00916726
Information Required for Allocation of State Services Personnel
{Vide section 77 in Part VIII of the Andhra Pradesh Reorganization Act, 2014}
Name of the Department
1.
Chinnammagari Mallikarjuna
2(a).
Employee ID
1209071
2(b).
3.
Date of Birth
02/11/1961
4.
Gender
Male
5.
Social Status
BC-B
6.
Marital Status
Married
7.
02/11/1993
8.
8(a).
Jail Warder
8(b).
8(c).
8(d).
Month & Year in which you have first appeared for the
aforementioned examination (10th class)
03 / 1978
9.
Yes
10.
Yes
Residuary State of AP
By virtue of Residence
Details of Places where you Resided for a period of 7 years immediately preceding the date of notification for the post
Period of Residence
S.No
Place of Residence
From
To
Month / Year Month / Year
District
03 / 1977
03 / 1978
LINGAREDDYPALLI
Anantapur
03 / 1976
02 / 1977
LINGAREDDYPALLI
Anantapur
03 / 1975
02 / 1976
LINGAREDDYPALLI
Anantapur
03 / 1974
02 / 1975
LINGAREDDYPALLI
Anantapur
03 / 1973
02 / 1974
LINGAREDDYPALLI
Anantapur
03 / 1972
02 / 1973
LINGAREDDYPALLI
Anantapur
03 / 1971
02 / 1972
LINGAREDDYPALLI
Anantapur
11.
Head Warder
Others
13.
By Promotion
14.
Regularly Appointed
15.
Yes
16.
Head Warder
17.
18.
No
19. Preference
I prefer to be alloted to the State of Andhra Pradesh
19(a). The reason why I prefer to be alloted to the State of
Andhra Pradesh
No
No
No
Affirmation
I solemnly declare that information given above is correct to the best of my knowledge and belief and nothing has been concealed.
Signature :
Name : Chinnammagari Mallikarjuna
Reorg ID : 16726
Mobile : 9492393089
Place :
Date :
Note #1:
Note #2:
Incase you claim preferential allotment in terms of paragraph 18(k) / 18(l) or 18(m), please furnish full particulars in support of
your claim in separate sheet and attach it to this form along with supporting documents to establish your claim duly certified and
recommended by the Head of Department.
Note #3:
It is here by made clear that while the preference in favour of a State expressed by a Government servant will be taken into
account while allocating the employee to a State, it shall not be mandatory for the Government to allot the employee to the State of his / her
choice;and that is open to the Government to allot the employee in accordance with the Guidelines framed under the Andhra Pradesh
Reorganisation Act. 2014. It shall also be open to the Government to depute an employee allocated to a State to the other Successor State
in terms of proviso to Section 77(2) of the A.P Reorganisation act, 2014.
00916726