Form -'A' GOVERNMENT OF ANDHRA PRADESH ANDHRA PRADESH ELECTRICAL LICENSING BOARD Application for exemption from the Examination for Electrical Wireman (to be filled in English or Telugu) Photo attested by a GAZETTED OFFICER 1. Full Name of the applicant : Surname Name (in block letters) 2. Father's Name : ................................................ 3. Date of birth and Age : ................................................. 4. Present Address : ................................................. 5. Permanent Address : ................................................. 6. (i) Details of Technical qualifications : ................................................. (ii) General Educational qualifications : ................................................. 7. Details of past and present service (date of commencement and termination) with brief description of each to be given to enable assessment of experience in Electrical Works. (For Supervisors only) Period In Main/Con. Name of the Firm ______________ Contractor From To Voltage (a) Not exceeding 650 v. (b) Not exceeding 11000 v. (c) Not exceeding 33000 v. (d) Exceeding 33000 v. (e) Mining (f) Lifts and Excalators 8. Examination to which the applicant wants to be exemped. Supervisor/Wireman 9. Amount od fee remitted : (i) Challan No & Date (give details of amount, name of Treasury, Challen No. and (ii) Treasury date) (iii) Amount 10. Marks of identification of the applicant 1. .......................................... 2. ........................................... 11. Two specimen signatures of the applicant. 12. The following are to be enclosed with this form : (a) (i) Attested copies Xerox copies of Educational and Technical Qualifications. (ii) Attested true copies Xerox copies and its Original of Educational and Technical qualifications in case of Wireman. (b) Cerficates of : (i) Latest Character and Conduct Certificate issued by Gazetted Officer. (ii) Experience in Electrical Installation works in detail specifying the voltage levels. (c) Treasury Orignial Challen. (d) Four copies of latest passport size photes without any attestation. (e) Certificate of training in power medicine & First Aid. (f) Self addressed envelope duly affixing Registered. I hereby declare that the particulars stated above are correct and true to the best of my knowledge and belief. Signature of applicant : Singed in my presence Counter-signature. Designation of the Gazetted Officer: Office Seal : PROSPECTUS TO BE SUPPLIED ALONGWITH THE APPLICATION FORM FOR EXCEPTION FROM WIREMAN COMPETENCY CERTIFICATE EXAMINATION. 1. Candidates who have passed the examination of recognised Institution in Wireman/Electrician Trade or its equivalent examination with a minimum experience of one year in the trade will be exempted from appearing for Wireman Examination. Provided that such certificate when granted to an employee of any Department of Government of the Andhra Pradesh State Electricity Board or any Corporation or any Electrical undertaking shall be valid only for the works carried out by the concerned departments. Those who are employed shall submit their application through through their employer. 2. The following fee shall believed under the Regulation fee for examption from appearing Wireman Examination Rs.135/- (Challan only). The fee shall be paid into a Government Treasury or in any branch of the State Bank of India or State Bank of Hyderabad doing treasury business to credit of Government of the following Head of Account :- 0043 - Taxes and Duties on Electricity. M.H. 102 -Fees under the Indian Electricity Rules. (01) Head Quarters and the original challan shall be sent. 3. Wireman Permit shall be granted to the candidate on producing the certificate obtained from M/s.St. John Ambulance Association, Sultan Bazar, Hyderabad or any other Institute recognised by the Government for having undergone in the prescribed training in "Power Medicine" and "First Aid". (original + zerox). 4. If once the application is rejected for any reasons no further correspondence will be done and the same application will not be considered. 5. Court fee stamp for Rs.5/-. 6. Self addressed cover with postage stamps for Rs.30/-. 7. Latest passport size photos - 4. 8. Signatures of the candidate on white paper. (4Nos.) 9. Application cost of Rs.25/- (I.P.C) 10. Proof of Date of Birth - S.S.C.original + xerox copy. 11. I.T.I. (Original + xerox). 12. Apprentice/experience for one year (original + xerox). SECRETARY, A.P. ELECTRICAL LICENSING BOARD.
