NEW CODE DETAILS OF BUSINESS CORRESPONDENT APPLICATION FORM FOR APPOINTMENT AS CSP OPERATOR 1. Applicant Name (IN BLOCK LETTERS) y. 2. Father's / Husband's Name 3. Date of Birth 4, Gender (Please Tick) Marital Status (Please Tick) 6. Educational Qualifiation Working knowledge with computer system: Previous employment detais, any Name of the organization Length of service 7.a.Whether member in any Self-Help Group If Yes, please furnish details 8, Address for communication 9. Permanent Address 10. Mobile No. 11-Telephone No, 12, E-mail ID REPLACEMENT CODE S.RUBAVATHI ‘S.SOLOMON RAJA 03/03/1990 age: 33. | Male | Fevale v Malied / Unmarried MSc yes No | Ws,SHALOM GROUPS | 07 Years | Yes/No D.No. Tower 33, Flat No.701,7th Floor, Area Chetna Phase, North Town Estaie Ltd Street Name" No.4,5,6,7, Stephenson Road Village / Town : Land Mark : Binny Mills Tehsil Perambur, District Chennal State TamilNads PIN Code: 600012 D. No. 'No.34/41,Maligapuram First Street Area Kaladipet, Street Name: Thiruvatryur, lage! Town: Crarncy Tehsil os District Chennai State Tamil Nadu PIN Code: 6 ) =< 2) me Telephone No, ‘SHALOMGROUPS@HOTMAIL,COM13, Currently Banking with INDIAN BANK 14, Bank Account Number Ac No, Unsatisfactory features observed in CIBIL report > Adverse feedback received from local people on the applicant > Any other reasons (Please specify) Place: BRANCH / CHIEF MANAGER Date FOR USE OF MANAGER (Fi), RBO Visited the proposed location on ‘and conducted additional due diligence on applicant Mr/Ms, ‘and found satisfactory. Forwarded to LHO for necessary action (oR) ‘The application is returned / rejected due to the following reasons: a b Recommended Forwarded to LHO Place: Date MANAGER (FI) CHIEF MANAGER (COMPLIANCE) FOR USE OF DY. GENERAL MANAGER (Fi), LHO Based on the recommendations of Link Branch Manager & Manager (Fl), approved application of MriMs. ‘as CSP Operator at (location). Place: DY. GENERAL MANAGER (FI) DatePart A Quantitative Assessment SCORING SHEET FOR APPOINTMENT AS CSP OPERATOR ‘Name of the Applicant: Mrs, S.RUBAVATHI Sr.| Parameter | Criteria Marks | Max. | Marks No. Marks Scored 1 | Ownership of Owned , 3 premises ii)Rented / leased 1 3 2 | Type of premises | )Commercial a ii)Residential 2 3 3 i)Located at central 3 place/prominent place | 3 ii)Located elsewhere at the 2 centre ‘4 _| Distance from link )Distance between the place of branch ‘business of CSP & Link branch | 3 is within 5 Kms. 3 ii)Beyond 5 Kms 1 [3 _| Residential status Desai inthe areafor>3 yrs 2 | ii)Residing in the area for >2 yrs. | 1 2 iRosiding inthe area for>1 yrs | 0 6 | Education )Graduate and above 3 ] ii)12” Class Pass 2 3 o 7 | Feedback received i) Positive & Acceptable 5 5 from local people __ii) Not acceptable** o | | [Amenities available i)Available ] | (adequate sitting ii)Not available idles space & drinking water) ‘9 | Employer's = Satisfactory conduct certificate 1 certificate submitted | submitted 1 |__| (itemployed in past) | i)Not submitted o TOTAL 25 * Minimum Eligible Quantitative Score: 15 “Application to be rejected if negative feedback received from local people ** If not applicable, score is to be normalized SCORING SHEET FOR APPOINTMENT AS CSP OPERATOR Contd. 6 Authorized SignatoryName of the Applicant: PART B: QUALITATIVE A Knowledge Marks | Score High | Has full knowledge in financial products and insight into local trends. 5 Possesses computer knowledge Medium | Has working knowledge 3 Low | New to the activity and no knowledge 2 |B Financial soundness High Having sufficient means to invest in infrastructure T ] required (present /future) for smooth conduct of the |S outlet Wedium | Getting support from family & fiends in procuring the required infrastructure and wiling to mobilize the required resources. 3 Tow | Not having sufficient means fo run the activily. oO Sales Orientation High | Has experience in the line of activity 5 Medium | Aware of sales methods like approaching shops and | houses (door to door) & getting contacts from prominent | 3 local bodies and residents | Tow | No prior experience / New to the activity o D | Acceptability High | Deep rooted and strong focal rapport 5 Medium | Moderate influence in the society 3 Low | Limited influence in the society 2 E | Experience in handling Cash / Accounts High | Has good experience in handing cash & Keeping of = | ‘accounts Medium | Has some experience in handling cash / Keeping [eeu accounts | TLow Has limited experience in handling cash/keeping of 2 accounts, | Total 3 * Minimum Eligible Quantitative Score: 12 Authorized Signatory Name Designation: BC Name: Mobile No. BC Name: Sealsided) oicar farmers GOR TE OA 2 SE Ea <2, Gastejossr wenn, Glasaianear ~ 600 006. DEPARTMENT OF GOVERNMENT EXAMINATIONS, CHENNAI - G00 006. Cosfleneort isnafle sevele enon sip HIGHER SECONDARWGOURSE CERTIFICATE j Quimgysesdell | GENERAL EDUCATION sipprO 218d Beye Pda exc OepmeaduO pgs \U" Gpiert RUBAVATHI J MAR. 2007 ga EinaAlanais eral Qoxs orginic Bing s Crees Apésrapid fiAsdrsonsrj 1 Quiwysirewn’ digg anetimaéaici iQ Certified that the above mentioned candidale appeared for the Higher Secondary Public Examination | and obtained the folowing marks Guipp wpliveuam 200 8S MARKS OBTAINED FOR 200 186 ONE EIGHT SIX 149 ONE FOUR NINE ENGLISH ji 141 ONE FOUR ONE PHYSICS RY 159 ONE FIVE CHEM: BIO-CHEMISTRY. 192 ONE NINE 165 ONE SIX MATHEMATICS: Ghongs WiGleier eee 09792 ZERO NINE NINE TWO UP Glaueis/ REGISTER NO.] 10.54.11. G $US OL cisr&pyircit / THR CODE NO. & DATE G421571 14, 05. 2007 Url Gis GUL] ever / GROUP CODE 104 Gini poner ATE OF BIRTH 93/03/90 s00z02 drat Gaui NAME OF THE SCHOOL V € HSS THIRUVOTTIYUR |FpiiMdanen Gor sporay ? gaDAITG UN_AMBI, DAG 1 WAUGUEw OiipGalivOib. Gai VGH wore) AiGNOPA BHAA Qugaadeid QuTAgI, BADUIE uppnd Oniyreyps Apiapxcr Danes vn sieaded| BRiih Duin as@uid Gaiahed 150k ge Gow gona; 30 UPEOuswaemt:, Dakiipenpp GxicAed H0as4 Gyn F) o1e10 1010x910 Cusp Baise. . i Minimum for a Pass: 70 Marks out of 200 In each subject. This Includes passing under ¢ compartmontal system also. For the subjects consisting of Theory and Practical Examinations Minimum Marks for a Rass Is 30 out of 180 19 Theory and 40 oUt of 80 In Prachg Qawionari Tata usaf Cperayach Gepion. muAlDeO ‘SECRETARY Gps civ‘TAMIL NADU POLICE POLICE VERIFICATION REPORT ‘To whomsoever it may concern PVR No. 1112100126087 Date of Issue 28-05-2021 This is to certify that § RUBAVATHI W/o $ SOLOMON RAJA is currently residing at NO. 34/41, MALLIGAPURAM IST STREET, KALADIPET, THIRUVOTTRIYUR,, CHENNAI CITY District, 600019, She is not found to be involved in any eri al ca as per the records avai ible with Police department Remarks of the Approving Authority : Approved Issued by ‘Tamil Nadu Police Department Disclaimer |. This isan authentic system generated report from the official website of TN Police ‘(www eserviees.inpolice.gov.in) and does not require signature 2. The authenticity ofthe document can be verified by scanning the Bar code or through "Verily’ option on the website 3. The verfication has been conducted based on the records available with TN Police 1e-a¥st O Relat:eae ona See au earusase, j 4856 3654 3925