6/2/2014 Welcome to State Bank of India - Application Form Print

http://ibps.sifyitest.com/sbiclkmay14/registration_print.php?prnsrc=prn&q=171404007674a05f33d6f8677a2b58af 1/2

RECRUITMENT OF ASSISTANT INCLERICAL CADRE INSBI AND
SPECIAL RECRUITMENT FOR KASHMIR VALLEY (UNDER J & K STATE)


43038
Registration # : 1300587694

Full Name :
SANTOSH
SAHEBRAO A
VHAD
Category : OBC
If Person with Disability : NO
Type of Disability : -
Percentage of Disability : -
Do you intend to use the services of a scribe (only for VI and OH candidates whose writing speed is affected by cerebral palsy)? : -
Are you seeking relaxation under widow / divorced women / women judicially Separated from their husbands and who are not re-married? : NO
Whether domiciled in Kashmir Division of the State of J&K during the period 1-1-1980 to 31-12-1989 ? : NO
Whether you belong to Religious Minority Community ? : NO
Religion to which you belong : Hindu
Are you an Ex-Serviceman : NO
Are you a Disabled Ex-Serviceman (DISXS) : NA
Actual service rendered in defence services which may be counted for qualifying as an Ex-serviceman (In Months) : -
Have you joined a Government job on the civil side after availing of the benefits given as an ex-serviceman: -
Are you a Dependent of Serviceman killed in Action (DXS) : NO
Are you a matriculate Ex-Servicemen candidate, who has obtained the Indian Army Special Certificate of Education or corresponding
Certificate in the Navy or the Air Force after having completed not less than 15 years of service in Armed Forces of the Union as on
01.09.2014:
-
Nationality : Indian
State/UT (for which you have applied): Maharashtra
Centre of Examination : Mumbai/Thane/Navi Mumbai
Application Fee/ Postal Charges Details :
Payment Mode: ONLINE
Amount : 450.00
Reference ID : MSBI3369282135
Transaction Date : 02-06-2014
Personal Details :
First Name : SANTOSH
Middle Name : SAHEBRAO
Last Name : AVHAD
Date of Birth : 17-03-1989
Age completed as on 01.05.2014 : 25
Gender : MALE
Husband's / Father's First Name : SAHEBRAO
Husband's / Father's Middle Name : MHASUJI
Husband's / Father's Last Name : AVHAD
Mother's First Name : SUMAN
Mother's Middle Name : SAHEBRAO
Mother's Last Name : AVHAD
Address for Correspondence : ROOM NO 16 OLD POLICE LINE
R B CHANDORKAR MARG
AGRIPADA
District MUMBAI
State : MAHARASHTRA
Pin code : 400011
Permanent Address : ROOM NO 16 OLD POLICE LINE
R B CHANDORKAR MARG
AGRIPADA
District MUMBAI
6/2/2014 Welcome to State Bank of India - Application Form Print
http://ibps.sifyitest.com/sbiclkmay14/registration_print.php?prnsrc=prn&q=171404007674a05f33d6f8677a2b58af 2/2
State : MAHARASHTRA
Pin code : 400011
Contact Details :
Phone No : -
Mobile No : 9594939681
Email ID : santoshavhad2007@gmail.com
Educational Qualification Details (as on 31.08.2014):
Exam Passed Subject /Stream Date of Passing
(Date mentioned in marksheet or
certificate whichever is earlier)
% of Marks
Graduation/ Equivalent :
Passed
Others - BE 21-08-2010 66.20
Post Graduation : MMS 23-07-2012 82.43
Other Details :
Whether desirous of taking Pre-Exam Training (SC/ST/XS/Religious Minority Community) : NA
Languages Known Read Write Speak
English YES YES YES
Kashmiri NO NO NO
Urdu NO NO NO
Marathi YES YES YES
Hindi YES YES YES
Place:
Date: 02-06-2014 Signature of Applicant

Please retain your Registration No. and Password emailed to you carefully for further reference