Institute of Banking Personnel Selection 360141

Common Recruitment Process (CRP) for Recruitment of Probationary Officers/ Management Trainees in Participating
Organisations - (CRP PO/MT-IX)

Registration Number : 1770385415

Full Name : SUMITRA BEHERA

Category : OBC

Are you a person with benchmark disability of 40% and above ? : NO

Type of Disability : -

Do you need compensatory time at the time of examination ? : -

Are you suffering from cerebral palsy and your writing speed is affected : -

If Yes, Do you need compensatory time at the time of examination? : -

Whether your dominant (Writing) hand is affected : -

If Yes, Do you need compensatory time at the time of examination? : -

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

Are you a child/ family member of those who died in 1984 riots? : NO

Are you a person domiciled in the State of Jammu & Kashmir during the period 1-1- : NO
1980 to 31-12-1989:?

Are you an Ex-Serviceman : ? : NO

Actual service rendered in defence services which may be counted for qualifying as an : -
Ex-serviceman (In Months)

Date of relief from defence services : -

Have you joined a Government job on the civil side after availing of the benefits given : -
as an ex-serviceman?

Religion to which you belong : Hindu

Do you belong to Religious Minority Community ? : NO

Whether serving in Govt./ quasi Govt./ Public Sector Undertakings (including : NO

Nationalised Banks & Financial Institutions) ?

Have you appeared for the CWE-PO/MT earlier ? : NO

How many attempts ? : -

Select the CWE-PO/MT attempted earlier : -

Nationality / Citizenship : Indian

State/UT/NCR to which centre of examination belongs : Odisha

State code : 36

Centre of Preliminary Examination : Balasore

Centre of Main Examination : Bhubaneshwar

Application Fee / Intimation charges

Payment In : ONLINE

Fees : 508.48

Tax : 91.52 (IGST)

Amount : 600.00

Payment Status : PAID

Reference ID : QSM27890042114

Transaction Date : 20-08-2019

Personal Details
 Date of Birth : 17-03-1996

Age completed as on 01.08.2019 : 23

Gender : FEMALE

Marital Status : Unmarried

Father's Name : AJAY KUMAR BEHERA

Mother's Name : BASANTI BEHERA

Spouse's Name : -

Address for Correspondence : AT RAMCHAK

Address 2 : PO BELI
Address 3 : PS SINGLA

District : BALASORE

State : ORISSA

Pincode : 756023

Permanent address : AT RAMCHAK

Address 2 : PO BELI

Address 3 : PS SINGLA

District : BALASORE

State : ORISSA

Pincode : 756023

State for GST invoicing : Permanent Address (ORISSA)

Contact Details

Mobile No : +91 8117908852

Alternative Number : -
(Mobile No/Landline No)

Email ID : sumitrabehera449@gmail.com

Educational Qualification (as on 28.08.2019)

Exam Passed Degree Subject / Stream Date of % of Marks Class / Grade

Passing

Graduation / Equivalent B.A. Arts 24-05-2016 53.50 Second Class

Do you have Operating and working knowledge in : YES

computer systems

Details of Computer Knowledge: : Diploma in

: Computer Operations

1 Bank of India
2 Punjab National Bank
3 Bank of Baroda
4 Central Bank of India
5 UCO Bank
6 Union Bank of India
7 United Bank of India
8 Syndicate Bank
Banks in order of Preference 9 Oriental Bank of Commerce
10 Punjab & Sind Bank
11 Indian Bank
12 Canara Bank
13 Bank of Maharashtra
14 Andhra Bank
15 Allahabad Bank
16 Corporation Bank
17 Indian Overseas Bank

Other Details :

Whether desirous of taking Pre-Exam Training : -

(Applicable only for SC/ST/ Minority Community):

If Yes ,Centre for Training : -

Whether any prosecution/ detention/ fine/conviction/ : NO
sentence against you has been awarded by any
court of law for any offence?

If yes, particulars of the same : -

Other Details :

Languages Known Read Write Speak

ODIA YES YES YES

HINDI YES YES YES

ENGLISH YES YES YES

Uploaded Document Details :

1. Left Thumb Impression

2. Hand Written Declaration

Declaration:

I hereby declare that all the statements made in this application are True, Complete and Correct to the best of my knowledge and belief. I understand that in the
event of any information being found untrue or incorrect at any stage or I am not satisfying any of the eligibility criteria stipulated, and also in case of creating
influence/undue pressure regarding recruitment shall tantamount to cancellation of my candidature.

Date: 20-08-2019 Signature of Applicant

Left Thumb Impression

Hand Written Declaration