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ONLINE APPLICATION FORM FOR THE POST OF PROBATIONARY OFFICERS

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 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 # : 167500

Full Name : NARESH KUMAR

Category : OBC

Whether person with disability : NO

Type of Disability : - Percentage of Disability : --

Do you intend to use the services

of a scribe (only for VI and OC those candidates whose --
writing speed has been affected by cerebral palsy):
Are you candidate who had
ordinarily been domiciled in Kashmir Division
NO
of the State of J&K during the period
1-1-1980 to 31-12-1989 ? :

Whether you belong to Religious Minority Community? NO

Religion to which you belong :

Are you an Ex-Serviceman ? NO

Are you still serving in Defence

NO
and applying as an Ex � Service man ? :

f Yes, Date of Release / Retirement from Service : --

Nationality : Indian

Choice of Centre for Examination : : Delhi

Centre code : 16

Application Fee / Postal Charges Details :

Receipt No : AA104572

Branch Name : CIVIL ROAD ROHATAK

Branch Code : 0843

Deposit Date : 2010-11-09 Amount : 400

Personal Details :

Age completed as on
Date of Birth : January 12,1988 22
30.09.2010 :

Gender : MALE
 ather's Name/ Husband's Name : ZILE SINGH

Mother's Name : DHANNO DEVI

Contact Details:

Email ID : hinisar.786@gmail.com

Address for Correspondence : HOSTEL NO - 4

ROOM NO-124 NILGRI HOSTEL

District ROHTAK

State : HARYANA Pin : 124001

Permanent Address : VILL-SUNDERPUR PO-KHARAK RAMJI

TEH&DISTT-JIND

District JIND

State : HARYANA Pin : 126102

Phone No : - Mobile No : 9671562991
Educational Qualification Details (as on 01.10.2010)::
Exams Passed Subject/Stream Year Of Passing % of Marks Class / Grade
Graduation : Others 2008 58.33 Second Class
Knowledge of Computer : YES
Details of Computer Knowledge Qualification : BASIC COMPUTER
Post Qualification work experience details as on 01.10.2010. (Start from present Employment):
Name of the Designation and From(mm/yyyy To(mm/yyyy Nature of Duties Reason of Years of
Employer rank, if any ) ) Performed leaving Service (YY-
MM)
Other Details :
Would You like to undergo Pre-Exam
Training (SC/ST/Ex-Servicemen/Religious --
Minority Community) :
f Yes Centre for Training : --

Languages
Read Write Speak
Known
HINDI YES YES YES
ENGLISH YES YES YES
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 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 or claims or disputes arising out of application or out of said
advertisement can be instituted by me only at NCT, Delhi 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:
Date: 2010-11-09 17:37:28 Signature of Applicant

NARESH KUMAR
Please retain your Registration No. and Password emailed to you carefully for further reference
Note : Please do not send the application print out to the Bank.

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