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1/3 Recruitment of Officer JMG Sc-I,Officer MMG Sc-II and Office Assistants (Multipurpose) 22034 Please paste your recent passport size photograph and sign across it. Please retain atleast 5 copies of same photograph with you for subsequent use. Registration # : Full Name : Post : Post Code : Category : If Physically Challenged : Type of Disability : Percentage of Disability : Do you intend to use the services of a scribe (only for VI & OC candidates whose writing speed is affected by cerebra
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  Recruitment of Officer JMG Sc-I,Officer MMG Sc-II and Office Assistants (Multipurpose)  22034 Please paste your recentpassport size photographand sign across it. Pleaseretain atleast 5 copies of same photograph with youfor subsequent use.   Registration # :1019074Full Name :SUSHIL KUMAR Post :Officer (JMG) Scale-IPost Code :02Category :GENERALIf Physically Challenged :NOType of Disability :-Percentage of Disability :-Do you intend to use the services of a scribe (only for VI & OC candidateswhose writing speed is affected by cerebral palsy) :NAAre you candidate who had ordinarily been domiciled in Kashmir Division of the Stateof J&K during the period 1-1-1980 to 31-12-1989 :NOWhether you belong to Religious Minority Community ? :NOReligion to which you belong :--Are you an Ex-Serviceman/Commissioned Officers(Including ECOs/SSCOs) :NOActual Period of service rendered in defence services as an Ex-serviceman (inmonths) :Are you seeking relaxation under widow / divorced women / women judiciallySeparated from their husbands and who are not re-married :NONationality :INDIANCentre of Examination :SHIMLACentre code :13 Application Fee / Postal Charges Details :  Payment In:Punjab National BankTransaction ID :M437040Branch Name :SUSHANT LOK I GURGAONBranch Code No :461400Date of Deposit :15-02-2012Amount :500   Personal Details :  Date of Birth :13-04-1988Age completed as on 01-11-2011 :23Gender :MALEFather's Name / Husband's Name :TULA RAM 1/3  Mother's name :TARA DEVIAddress for Correspondence :VILLAGE GUNTHLAPO BHARERITEH KUMARSAINDistrict :SHIMLAState :HIMACHAL PRADESHPin :172024Permanent Address :VILLAGE GUNTHLAPO BHARERITEH KUMARSAINDistrict :SHIMLAState :HIMACHAL PRADESHPin :172024 Contact Details:  Email ID :sushilverma88@gmail.comPhone Number :-Mobile Number :9650373101 Qualification Details (as on 01.11.2011) : Exam PassedName of the Course/DegreeYear of Passing% of MarksClass / Grade Graduation/Equivalent :Science200951.25Second ClassProfessional Qualification :Others-MBA IN MARKETING201170.00First ClassWorking Knowledge of Computers :YESDetails of Computer Knowledge:OUTLOOK CRM IRP Post Qualification work experience details (Start from present Employer):Name of the EmployerDesignationFrom(mm/yyyy)To(mm/yyyy)Nature of Duties PerformedReason for LeavingLength of Service(YY/MM) HDFC BANKASSISTANT MANAGER05/201111/2011WELCOME DESKNOT APPLICABLE0/6Total Experience (in months) :6 Other Details : Whether desirous of taking Pre-Exam Training(Only for SC/ST/Minority/EXS) :--If Yes Centre for Training :-- LanguagesKnownReadWriteSpeak HindiYESYESYESENGLISHYESYESYES  DECLARATION:   I hereby certify that the above information furnished is correct to the best of my knowledge and belief. I have not suppressed any material fact orfactual information in the above statement. I am aware that in case I have given wrong information or suppressed any material fact or factual information or I donot satisfy the eligibility criteria according to the advertisement, then my candidature will be rejected/ service terminated even after permanent employmentwithout giving any notice or reasons thereof.   I hereby certify that I am satisfying the eligibility criteria for the post applied for in terms of advised criteria in respect of age, caste, educationalqualification etc. 2/3    I hereby agree that any legal proceeding in respect of any matter or claims or disputes arising out of application or out of said advertisement can beinstituted by me only at Mandi and courts/ Tribunal/ forums at Mandi only, shall have sole and exclusive jurisdiction to any cause/ dispute. I undertake to abideby all the terms and conditions in the advertisement given by the Bank.   Place:Date: 15-02-2012Signature of Applicant   SUSHIL KUMAR Please retain your Registration No. and Password emailed to you carefully for furtherreferenceNOTE: Please DO NOT SEND application print-out to the Bank  3/3
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