HIGH COURT OF JUDICATURE AT HYDERABAD FOR THE STATE OF TELANGANA AND THE STATE OF ANDHRA PRADESH

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HIGH COURT OF JUDICATURE AT HYDERABAD FOR THE STATE OF TELANGANA AND THE STATE OF ANDHRA PRADESH APPLICATION for post of Civil Judge (Junior Division) under State Judicial Service, (General Recruitment) Paste here your recent passport size photograph. Photo to be attested by Gazetted Officer (Signature, Name, designation and office seal of Gazetted Officer) APPLYING UNDER (DIRECT RECRUITMENT OR RECRUITMENT BY TRANSFER) APPLICATION NUMBER: (For office use) HALL TICKET NO. (For office use) NOTE: DO NOT LEAVE ANY COLUMN BLANK CANDIDATES EITHER TO FILL THE COLUMN OR WRITE NA IF NOT RELEVANT TO THEM. 1. Name of Candidate in full SURNAME with surname, as mentioned in SSC or its equivalent examination. NAME (IN BLOCK LETTERS) 2. (a) Parent s Name as mentioned in SSC or its equivalent examination. (b) Spouse Name (if applicable) 3. Address for Communication with District and PIN- CODE 4. Native Place and District PIN CODE 5. Telephone /Mobile No. 6. E.mail ID 7. Permanent Address with District and Pin Code Contd...2

-2-8. Sex 9. Class/Category (OC,BC-A,B,C, D and E, SC/ST 10. Wher applicant belongs to Ex-Servicemen / Physically Handicapped Category(orthopaedica I ly Handicapped of Lower portion of body) 11. Dateof Birth (as per SSC or its equivalent examination) (i) In figures (ii) In Words 12. Ageason 01.2.2016 Years Months Days. Educational Qualifications Name of Year of Class/Division Percentage Name of Degree passing of Marks University! Institution Tt1 CLASS 10 INTERMEDIATE DEGREE LLB LLM 14. Or academic/technical Qualifications, if any. 15. FOR DIRECT RECRUITMENT A) Date of Enrolment as an Advocate (If enrolled) B) Standing at Bar with Date (If_practicing) C) Place of Practice (If_Practicing) Contd...3

-3-16. FOR RECRUITMENT BY TRANSFER: A) Name and Post now held B) Wher applicant is approved Probationer in Present Post? (If not, particulars of post in which applicant is approved probationer in eligible category) C) Date of declaration of Probation in eligible category D) Date of Confirmation in eligible category 17. Wher applicant is working in State/Central Government, if so, particulars 18. Marital status, wher married or Unmarried. 19. If married, name, occupation and address of spouse. 20. Wher applicant has been debarred/disqualified or found ineligible for candidature in any previous selections by any Public Authority? If so, furnish details. 21. Wher applicant has been Dismissed/terminated/compulsorily retired from service of Central/State Government/Quasi Government Institution/Government Owned Company/Corporation/ Local Self Government Institution? If yes, furnish details. 22. Was any penalty or than what is mentioned above has been imposed on applicant during his service? If yes, furnish details. 23. a) Wher any First Information Report relating to a crime has been registered against applicant and if so, furnish details of same. b) Wher applicant was arrested in connection with any crime involving moral turpitude and concerned with same. Contd...4

-4-24.1 Wher applicant has been prosecuted or convicted in any Criminal Offence? If yes, furnish particulars including number of Case and Name of Court. 25 Wher applicant was subjected to any proceedings for professional misconduct by Bar Council? If so, out come of same. 26. Are any Disciplinary Proceedings? Vigilance Enquiry initiated or contemplated against applicant? If so, furnish details. 27. Wher applicant has filed any Insolvency petition or wher any insolvency Petition has been filed against applicant or wher applicant had been adjudicated as insolvent by any court and if so furnish details: 28. Identification Marks: (i) (ii) 29. Details of Application/Examination Fee 1. Demand Draft Number 2. Name of Bank and Branch 3.DateofD.D. 4 Amount DECLARATION I hereby declare that information furnished above and all statements made in this application are true and correct and complete to best of my knowledge and belief. I furr declare that I possess sound health and active habits. Contd...5

-5- I am free from any bodily defect or infirmity which would render me unfit to work as a Civil Judge in Judicial Service in States of Telangana and Andhra Pradesh, and that my character and antecedents are such that y will not disqualify me from State Judicial Service. I have carefully read contents of notification, conditions and instructions stipulated rein, and I hereby undertake to abide by m. I furr declare that I fulfill all conditions of eligibility regarding age limit, educational Qualifications etc., prescribed for appointment to post of Civil Judge (Junior Division) and that copies of documents enclosed to application are true copies of originals kept in my custody. I undertake that in event of any information furnished by me being found false or incorrect or ineligibility being detected before or after examination/interview/appointment, I shall be liable to be proceeded with, in accordance with law. STATION: DATE SIGNATURE OF THE CANDIDATE NOTE: Unsigned applications and hail tickets, applications not properly filled by candidates and applications without necessary enclosures are liable to be rejected summarily. I. Attested Copies of: I) SSC or equivalent examination, showing Date of Birth LIST OF ENCLOSURES ii) Caste Certificate obtained from competant authority in case of BC/SC and ST(for claiming reservation) iii) Medical Certificate duly obtained from Medical Board in respect of Physically Handicapped Applicants, specify percentage of disability. (for claiming PH reservation) iv) Law Degree (Convocation Certificate)/ Provisional Certificate

v) Enrolment Certificate (if enrolled) vi) Practice Certificate from Presiding Officer of of Bar Association in which is practicing (if practicing) Court/President/Secretary he/she in of Direct Recruitment respect For Recruitment By Transfer Candidates: vii) Proof of declaration of Probation/Confirmation with specific in eligible category. date in respect viii) Copy of proceedings of Employer permitting employee to Law Degree Course into service. prosecute ix) Service and Conduct Certificate obtained from Employer. after cfr Recruitment entering >. by Transfer For Ex-Servicemen: ix) Discharge Certificate duly obtained from Concerned Official in of Ex-Servicemen respect candidate II. TWO Self envelops (12 cm x 26 cm) for sending Hall Ticket-cum-Identity Sheets to applicants by RPAD (Postal affixed on ONE envelop) addressed stamped thick stamps worth of Rs.30/- to be III.Four(4) duly filled in Hall Ticket-cum-Identity (Each Hall Ticket-cum-Identity Sheet, one original and duplicate for Screening and one original and duplicate for Written Examination has to be printed on and on legal size only.) paper Test Sheets. separate papers NOTE: The applicants working in Government have to send ir applications THROUGH PROPER CHANNEL. State/Central

IDENTITY I ORIGINAL1 HIGH COURT OF JUDICATURE AT HYDERABAD FOR THE STATE OF TELANGANA AND THE STATE OF ANDHRA PRADESH HALL TICKET - SHEET FOR SCREENING TEST FOR THE POST OF CIVIL JUDGE (JUNIOR DIVISION) CUM - Hall Ticket No. DATE TIME NAME OF THE EXAMINATION CENTRE 1 NAME AND FULL POSTAL ADDRESS OF THE CANDIDATE (To be filled by candidate) Identification Marks: (To be filled by candidate) Paste here your recent (i) (taken within last six months) passport size photograph (Do not staple or pin) Photo to be attested by Gazetted Officer Signature of candidate (To be signed before Gazetted Officer) (Photograph and Signature of candidate are to be attested by Gazetted Officer) ( Signature, name, designation and office seal of Gazetted Officer) VERY Note: IMPORTANT: Please note that scrutiny of applications has been postponed until declaration of result of screening test and hence, ultimately, your candidature will be subject to fulfillment of criteria mentioned in advertisement. REGISTRAR (RECRUITMENT)

CUM IDENTITY DUPLICATE HIGH COURT OF JUDICATURE AT BYDERABAI) FOR THE STATE OF TELANGANA AND THE STATE OF ANDHRA PRADESH SHEET FOR SCREENING TEST FOR THE POST OF CIVIL JUDGE (JUNIOR DIVISION) HALL TICKET - - Hall Ticket No. DATE TIME NAME OF THE EXAMINATION CENTRE NAME AND FULL POSTAL ADDRESS OF THE CANDIDATE (To be filled by candidate) Identification Marks: (To be filled by candidate) Paste here your recent (taken within last (fl six months) passport size photograph (Do not staple or pin) Photo to be attested by Gazetted Officer Signature of candidate (To be signed before Gazetted Officer) (Photograph and Signature of candidate are to be attested by Gazetted Officer) (Signature,name,designation and office seal of Gazetted Officer) VERY IMPORTANT: Please note that scrutiny of applications has been postponed until declaration of result of screening test and hence, ultimately, your candidature will be Note: subject to fulfillment of criteria mentioned in advertisement. REGISTRAR (RECRUITMENT)

IDENTITY ORIGINAL HIGH COURT OF JUDICATURE AT HYDERABAD FOR THE STATE OF TELANGANA AND THE STATE OF ANDHRA PRAI)ESH HALL TICKET- CUM SHEET FOR WRITTEN EXAMINATION FOR - THE POST OF CIVIL JUDGE(JUNIOR DIVISIQ Hall Ticket No. DATE TIME NAME OF THE EXAMINATION CENTRE 1 NAME AND FULL POSTAL ADDRESS OF THE CANDIDATE (To be filled by candidate) Identification Marks: (To be filled by candidate) Paste here your recent (taken within Last (I) six months) passport size photograph (Do not staple or pin) Photo to be attested by Gazetted Officer Signature of candidate (To be signed before Gazetted Officer) (Photograph and Signature of candidate are to be attested by Gazetted Officer) ( Signature, name, designation and office seal of Gazetted Officer) REGISTRAR (RECRUITMENT)

CUM IDENTITY -- HIGH COURT OF JUDICATURE AT HYDERABAD FOR THE STATE OF TELANGANA AND THE STATE OF ANDHRA PRADESH HALL TICKET SHEET FOR WRITTEN EXAMINATION FOR THE POST OF CIVIL JUDGE(JUNIOR DIVISION) - Hall Ticket No. DATE TIME NAME OF THE EXAMINATION CENTRE NAME AND FULL POSTAL ADDRESS OF THE CANDIDATE (To be filled by candidate) Identification Marks: (To be filled by candidate) Paste here your recent (taken within last (j six months) passport size photograph.. (Do not staple or pin) Photo to be attested by Gazetted Officer Signature of candidate (To be signed before Gazetted Officer) (Photograph and Signature of candidate are to be attested by Gazetted Officer) (Signature, name, designation and office seal of Gazetted Officer) REGISTRAR (RECRUITMENT)