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Annex-01
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APPLICATION FOR ADDITIONAL ACQUIRING OFFICER
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1. Title:-
Dr.Mr.
Mrs.
Miss
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2. Name with Initials:-
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3. I.D. Number:-
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4. Date of Birth:-
(DD/MMM/YYYY)
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5. Date of First Appointment in Public Service:-
(DD/MMM/YYYY)
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6. Date promoted to the Class 1 - SLAS:-
(DD/MMM/YYYY)
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7. Retired Date:-
(DD/MMM/YYYY)
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8. Retired Class / Grade :-
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9. Contact Numbers - Fixed :-
10. Mobile :-
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11. E-Mail Address:-
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12. Highest Academic Qualification:- (PhD, Master, Degree, Diploma, etc..)
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QualificationInstituteDate of Award
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13. Particulars of Service in Public Service:- (Please start with the retired station)
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FromToPosition HeldInstituteDetail of Work Place
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Page 1 of 2
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14. Land related experience
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IntitutePositionFromTo
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15. Project related works experience
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Name of the ProjectPositionFromTo
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16. Preferred districts for service
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17. if you currently engaged any other works, please specified
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18. I certify that the above particulars are true and correct.
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Date:-
………………………………….
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DD/MMM/YYYY
Signature of Applicant
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Page 2 of 2
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