CORPORATION BANK - RECRUITMENT OF CLERKS

ONLINE APPLICATION FORM FOR THE POST OF CLERKS

34024
Registration # : 183886 Please paste your
recent passport size
photograph and sign
Registration Date and Time: 26-07-2010 16:29:00 across it.Please retain
atleast 5 copies with
you for subsequent
Full Name : PULLAYYA PANTULU MYLAVARAPU use.

Category : General

Person With Disability : No

Type of Disability : - Percentage of Disability : -

Do you intend to use the services of a scribe : -

Whether domiciled in Kashmir Division of the State of J&K during the No

period 1-1-1980 to 31-12-1989 :

Whether you belong to Religious Minority Community : No

Are you an Ex-Serviceman : No

Are you a disabled Ex-Serviceman (DISXS)? : No

Are you a dependent of an Ex-Serviceman (DXS)? : No

Are you seeking relaxation under widow / divorced women / women No

judicially Separated from their husbands and who are not re-married? :

Nationality : INDIAN

State / Union Territory for which you are Andhra Pradesh State / UT code : 2
applying :

Centre of Examination : Hyderabad Centre code : 32

Application Fees including Out of Pocket Expenses :

Receipt Number (TSL Number). : 6583

Branch Name : KAKINADA Branch Code : 162

Deposit Date : 26-07-2010 Amount : 200

Personal Details :
Date of Birth : October 01,1984 Age as on 01.06.2010: 25

Gender : MALE

Husband’s Name / Father’s Name : SRINIVASARAO M Mother’s Name : SATYA LAKSHMI M

Email ID : mylavarapu3@gmail.com

Address for Correspondence : DR NO 2-60 OPPOSITE SRIKANTH SCHOOL, SIMHADRI NAGAR

VALASAPAKALA

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 KAKINADA

District : EAST GODAVARI

State : ANDHRA PRADESH Pin : 533101

Permanent Address : DR NO 2-60 OPPOSITE SRIKANTH SCHOOL, SIMHADRI NAGAR

VALASAPAKALA

KAKINADA

District : EAST GODAVARI

State : ANDHRA PRADESH Pin : 533101

Contact Details:
Phone : 0884-2345483 Mobile : 9347879593

Qualification Details(as on 01.06.2010) :

Exams Passed Subject/Stream Year of Passing % of Marks Class / Grade
HSC / Equivalent : M.P.C 2002 55.00 Second Class
Graduation : B.SC-COMPUTERS 2007 49.00 Pass Class
Would You like to undergo Pre-Exam Training (SC/ST/Minority Community/Ex-Serviceman) : No

Centre for Pre-Examination Training : -

Languages Known Read Write Speak

TELUGU Yes Yes Yes
ENGLISH Yes Yes Yes
DECLARATION:
I hereby certify that the information furnished above is correct to the best of my knowledge and belief. I have not suppressed any material fact or
factual 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 do not satisfy the eligibility criteria according to the advertisement, then my candidature will be rejected/services terminated
even after permanent employment without giving any notice or reasons thereof.
I hereby certify that I am satisfying the eligibility criteria for the post applied for in terms of the advised criteria in respect of age, educational
qualification and experience etc.
I am also willing to serve anywhere in India. I agree that the Bank has the right to transfer me to any part of the country and/or to any job position
at its sole discretion in terms of applicable staff rules from time to time.
I hereby agree that any legal proceeding in respect of any matter(s) or claims or disputes arising out of application or out of said advertisement
can be instituted by me only at Mangalore and Courts/Tribunal/ Forums at Mangalore only, shall have sole and exclusive jurisdiction to try any
cause/dispute. I undertake to abide by all the terms and conditions in the advertisement given by the Bank.

Place : Signature of Applicant

Date : 26-07-2010

PULLAYYA PANTULU MYLAVARAPU

Please retain your Registration No., Password e-mailed to you and copy of print-out carefully for further reference.
NOTE: Please DO NOT SEND application print-out to the Bank

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