Tripura Public Service Commission: Akhaura Road, Agartala - 799001

TRIPURA PUBLIC SERVICE COMMISSION
Form No.
Akhaura Road, Agartala - 799001

Application Form
A. Post / Services Applied For
B. Preferences of Post/Service (Post Code) :
(where applicable)
1st
C. Advertisement No.:
2nd
3rd
4th
5th
Item No.:
INSTRUCTIONS : 1) Read all the instructions carefully before filling the form. 2) Write with Black Ball Point Pen in boxes using English Capital
Letters Only. 3) Do not make any stray marks on this application form, do not stapple pin, wrinkle, scribble, tear, wet or fold this sheet as it will be
scanned by computer. 4) Fill appropriate circle like this
wherever necessary and not in any other form.
1. Name of the Applicant (Write within the boxes in capital letters ) :
2. Fathers Name :
3. Mothers Name :
4. Husbands Name ( In case of married woman ) :
5. Date of Birth :
6. Sex :
0 Female
Male
Photograph of the
Candidate
( as recorded in Madhyamik or equivalent Certificate )

7. (a) Nationality :
8.(a) Category :
0 Indian
(b) State belongs to:
0 General
0S C 0
ST
0 Tripura 0 Other
0 OBC
(b) Whether SC/ST/OBC/Others Certificate issued by

competent authority of Government of Tripura.
No
11. If currently employed,
0 Yes
Not to be attested
Do not Pin Or Staple
0 No
10. Whether BPL Family Card Holder :
9. Physically Handicapped :
Yes
Affix
Stamp
size recent
Photograph
only
than Tripura
Yes
Please mention whether in
b) Whether NOC enclosed

12. Whether Ex-serviceman :
0 Yes 0 No
0 Yes
0 No
0 No
a(i). Govt. Deptt.
Full Signature of Candidate
a(ii). PSU/Autonomous Body
c) Whether applied through proper channel
13. Present Address :( In capital letters)
PIN :
15.Tel No. With STD Code :
month(s)
14. Permanent Address : ( In capital letters)
PIN :
** 17.
Choice of Center :
(where applicable)
0 Agartala
16. Mobile No. :
0 Yes 0 No
year(s)
if yes, period of war service :
0 Kolkata
For Office Use Only

Receipt Regd. No. ....................................
Allotted Roll No. ......................................
Full Signature of the Candidate
* 18.(a)
Educational Qualification (From Madhayamik onwords):
Sl. No.
Examination
Year of
passing
Board / University
Division Percentage Of Marks
1.
2.
3.
4.
5.
(b) Experience :
(c) Any other additional information like to mention in support of suitability for the post :-
**19.
Necessary particulars to be filled in, if stipulated in the advertisement :-
(a) Physical measurement for the post :- Height:
Chest normal:
cm. Chest expanded:
(b) Any claim on relaxation in Height :
** 20.(a)
cm.
Yes
kg.
cm.
0 No
Name of optional papers/subjects in

abbreviated form (as mentioned in
respective service rules ):
Weight:
if yes, reason :__________________
1.
2.
3.
4.
(b) Whether opted for :

Bengali Composition & Translation (OR) Alternative English :( for TCS / TPS Grade-II and other examination)
21. Have you ever been debarred / disqualified by the U.P.S.C / State P.S.Cs from appearing at its
examination / selection.
If yes, give details._______________________________________
0 Yes 0 No
22.(a) Fee paid Rs.:
( Rupees :............................................................................) only.
(b) Challan number
Dated :
I hereby declare that statements made and information furnished as above are true and correct
to the best of my knowledge and belief.
Place :-........................................
Dated :
Full Signature of the Applicant
Enclose:- Self attested photocopies of the documents in respect

to Sl. Nos. 5, 7(a), 8(a), 9, 10, 11, 12, 18(a) & 18(b).
(IF NOT OTHERWISE INSTRUCTED IN THE NOTIFICATION)
* 1) Attach extra sheet wherever necessary.

** 2) Fill up the items which are applicable only.
NOTE : Affix the Receipt of recruitment

fee deposited to the A/C. No. 14711
of Tripura Gramin Bank, Agartala Branch
payable through any of branch of Tripura
Gramin Bank located at different places,
for the applicants within the state. In case
of applicants out side the State, the
prescribed Recuitment fee is to be paid
to the Ac/No.31176521319 of State Bank
India (core banking branches) in favour
of the Secretary, Tripura Public
Service Commission.
TRIPURA PUBLIC SERVICE COMMISSION

(To be filled in by the candidate)
Admit Card
Name of the Examination/Screening Test:
1.
Name of the Applicant (write in capital letters) :
2.
Fathers Name :
3.
Mothers Name :
4.
Husbands Name ( In case of married woman ) :
Photograph of the Candidate
5. Present Address (
Affix
Stamp
size recent
Photograph
only
Not to be attested
Do not Pin Or Staple
in capital letters ) :
PIN :
Name of Optional Papers offered

(i)
Full Signature of Candidate
( when asked for ) :
(ii)
(iv)
(iii)
Whether Bengali Composition & Translation
(OR) Alternative English ( when asked for ) :
For Office Use Only
Roll No .................................................
Name of the Centre ...............................................................
Date............................................................
Controller of Examinations
N.B.:1) The candidate is to bring and use Black Ball Point Pen for furnishing answers on supplied OMR sheets
for preliminary exam. / screening test to be conducted under Multiple Choice Question system.
2) This Admit card is provisional and do not confer any right against rejection of his/her candidature at
any subsequent stage on detection of wrong / incorrect information towards eligibility.
3) No TA/DA will be paid by the Commission for appearing at the Examination/ Screening Test.
4) Instructions to the candidates appearing for the written examination/ Screening Testa) Do not carry Mobile phones/ electronic gadgets/ programmable calculator etc. in the examination campus.
b) Do not enter in the Examination Hall after 15 minutes from commencement and no books/ papers
except Admit card will be allowed in the Examination Hall.
c) Do not write anything in the Admit Card / Question paper.
d) Do not to adopt any unfair means or attempt to indulge in any disorderly or improper conduct in the
Examination Hall.
e) Do not leave the Examination Hall for toilet before completion of 1st one hour and during the last
(half) an hour of the examination.
f) Do not carry Examination materials to the toilet and slip away from toilet.
g) Do not leave the examination hall till the expiry of the of Examination.
Before leaving, Candidates must deposit the answer scripts to the Invigilator on duty in the hall.
>>Any violation of which may lead to disciplinary action.
Instructions to the candidates

1. The application should be submitted in the prescribed FORM only which is available fron the Tripura Gramin
Bank Branches/Extensions counters on deposit of the prescribed fee as notified in the advertisement.
Prescribed application form can be downloaded and must be printed in colour font (A4 size 90 GSM paper)
from the website http://www.tpsc.gov.in or http://www.tripurainfo.com.
The prescribed form contains 4(four) pages in complete out of which 1st and 2nd pages are meant for the
particulars of the applicant, the 3rd page is to be used as ADMIT CARD carrying important instructions to the
candidates for appearing in the Examination/Screening Test. The 4th page (back page) contains the necessary
instructions to the candidates.
Applicants must be in possession of the prescribed minimum qualification(s) and experience(s) for
respective post(s) on the closing date for submission of application as mentioned in the advertisement.
2.(a) The application should be filled-up in complete form by own hand writing using black ball point pen only.
Prescribed fee is to be deposited to the Tripura Gramin Bank, A/C No. 14711 in favour of the Secretary,
Tripura Public Service Commission, Agartala through any branch /Extension counters of Tripura Gramin
Bank within the State. For the candidates outside of the State, the prescribed Recruitment Fee is to be paid to the
A/C No. 31176521319 of the State Bank of India (core banking branches) in favour of the Secretary, Tripura
Public Service Commission, Agartala. The said deposit Bank Receipt is to be affixed in the specified box on the
2nd page of the Application Form.
(b) Two copies of stamp size recent photograph are to be affixed on the indicated boxes one in the 1st page & the
other in the 3rd page.
(c) Date of birth should be written in Christian Era as recorded in Admit Card of Madhyamik / School Leaving
Examination.
3. The followings are to be enclosed along with the filled-in Application Form if otherwise not instructed
in the advertisement.
(i) Self-addressed envelope (28cm X 12cm) bearing postage worth Rs.5/- (Rupees Five) only affixed thereon for
sending the Admit Card.
(ii) In case of application sent by post, another self-addressed Post-Card indicating the Advertisement No., Item
No. and name of the Post applied for is to be sent along with the application form. It will be used for acknowledgement
of receipt of the application.
(iii) Self-attested copies of the certificates/documents as per requirement of the Application Form.
(iv) While sending by post, the envelope cover to be superscribed as Application for the post of..........
(v) If employed, must apply through proper channel or attach a No Objection Certificate from his/her employer.
However, an advance copy along with copies of all required certificates/documents be sent to the Commission
and another photocopy of the filled-in application to be sent through proper channel. If employed after submission
of application, No Objection Certificate from the concerned employer to be produced at the time of
interview.
(4) The applications may be submitted either in person or by post. Duly filled-in application must reached to
the Secretary, Tripura Public Service Commission, Agartala, West Tripura on or before the last date of
submission of application as indicated in the advertisement for the post(s). The Commission will in no
case be responsible for non-receipt of their applications or any delay in receipt thereof on any account whatsoever.
No application received after the prescribed last date will be entertained under any circumstances and all the
applications received after the closing date will be summarily rejected.
(5) Any application incomplete in any form or defective or containing statements which are incorrect or false or if
there is any suppression of facts, is liable to be summarily rejected. If such discrepancies detected even at the
subsequent stage, it is also liable to be rejected. No correspondence or queries from applicants will be entertained.
(6) No TA/DA will be paid by the Commission for appearing at the Written Examination/Screening Test or Interview.
7.(a) The benefit of reservation of vacancy is applicable only to SC/ST candidates approved by the Govt. of
Tripura as per Rule in force. SC/ST candidates of other staes may apply only for unreserved vacancy as
general candidates.
(b) Upper age relaxation of 5 years is admissible for SC/ST/PH candidates and Govt. Employees.
8. The prescribed esential qualifications are minimum and mere possession of the same does not confer
any right to the candidates to be called for interview except in case of scheduled examination(s).
Where the number of applications received in response to the advertisement is large and it will not be convenient
or possible for the Commission to interview all those candidates, the Commission may restrict the number of
candidates for interview to a reasonable limit on the basis of qualifications and experience higher than the minimum
prescribed in the advertisement or by holding a Screening Test.
9. Canvassing in any form at any stage will disqualify a candidate.
N.B.:- For detailed instructions to the candidates relating to examination, please visit the website.
.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.xxxxxxxxxx.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.*.

Tripura Public Service Commission: Akhaura Road, Agartala - 799001

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TRIPURA PUBLIC SERVICE COMMISSION

Akhaura Road, Agartala - 799001

4. Husbands Name ( In case of married woman ) :

( as recorded in Madhyamik or equivalent Certificate )

(b) State belongs to:

(b) Whether SC/ST/OBC/Others Certificate issued by

11. If currently employed,

10. Whether BPL Family Card Holder :

Please mention whether in

b) Whether NOC enclosed

a(i). Govt. Deptt.

Full Signature of Candidate

a(ii). PSU/Autonomous Body

c) Whether applied through proper channel

13. Present Address :( In capital letters)

14. Permanent Address : ( In capital letters)

16. Mobile No. :

if yes, period of war service :

For Office Use Only

Full Signature of the Candidate

Educational Qualification (From Madhayamik onwords):

Division Percentage Of Marks

Necessary particulars to be filled in, if stipulated in the advertisement :-

(a) Physical measurement for the post :- Height:

cm. Chest expanded:

(b) Any claim on relaxation in Height :

Name of optional papers/subjects in

if yes, reason :__________________

(b) Whether opted for :

( Rupees :............................................................................) only.

(b) Challan number

Full Signature of the Applicant

Enclose:- Self attested photocopies of the documents in respect

* 1) Attach extra sheet wherever necessary.

NOTE : Affix the Receipt of recruitment