6/7/2014 Welcome to RBI - Application Form Print

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Recruitment of Officers in
Grade 'B' (General) -
(Direct Recruitment - DR)-
Advt.No. 5A/2013-14

24035
Registration # : 633480

Full Name :
SAROJ KUMAR
ROUT
Category : UR/GENERAL
If Person with Disability : NO
Type of Disability : -
Whether require services of a Scribe
(Only for those candidates who have physical limitation to write including that of speed) :
NA
Whether domiciled in Kashmir Division of the State of J&K
during the period 1-1-1980 to 31-12-1989 ? :
NO
Do you possess M.Phil. qualification? : NO
Do you possess Doctorate degree/ Ph.D. :? : NO
Do you fall under the category of Retrenched from Govt. Office or Banking Institution/ Ex-Servicemen/
Emergency Commissioned Officer or SSC Officer vide para 5 (b) (ii),(iii) or (iv) of the advertisement?
NO
If yes, select the category : -
Are you Reserve Bank of India Employee (RBI Staff) ?
(As per circular CO. HRMD. No. G-75/ 5599/ 05.01.01/ 2013-2014 dated December 20, 2013):
NO
If Yes, PF Index No : -
Are you working/have worked in RBI as 'Executive Interns (on contract basis)?' : NO
Have you appeared four times in Phase-I exam for this post in RBI in the past ?
(applicable in case of Unreserved/General Candidates only):
NO
Do you have experience as an Officer in Commercial Bank/
Financial Institution in Public Sector or prior experience in Reserve Bank of India : ?
NO
If yes, years of experience (in completed years), excluding probation period : ? -
State / UT which the Centre of online Examination (Objective Type Test-Phase-I) Belongs : : Andhra Pradesh
Centre of Online Examination for Objective Type Test (Phase I) : Hyderabad
Centre of Examination for Descriptive Type Test (Phase II) : Hyderabad
Centre Code : 19
Personal Details :
Name of Applicant : * (Full Name in CAPITAL LETTERS starting with First Name) :
SAROJ KUMAR
ROUT
Date of Birth : 15-03-1988
Age completed as on 01.06.2014 : 26
Gender :
MALE
Father's Name : RATNAKAR ROUT
Mother's Name : SHANTILATA ROUT
Address for Correspondence :
SAROJ KUMAR ROUT SO-RATNAKAR
ROUT
AT-MAHULDHIP PO-PANCHAGAN
6/7/2014 Welcome to RBI - Application Form Print
http://ibpsreg.sifyitest.com/rbioffmay14/registration_print.php?regno=NjMzNDgw&prnsrc=prn 2/2
PS-TIGIRIA
District CUTTACK
State : ORISSA
Pin code : 754030
Contact Details :
Phone No : -
Mobile No : +917799000046
Email ID : saroj.nitrourkela@gmail.com
Educational Qualification Details (as on 01.06.2014):
Exam Passed Subject /Stream Date of Passing % of Marks Name of
University /
Institute
Class / Grade
Graduation /
Bachelor's Degree /
equivalent :
BTECH
BIOMEDICAL
ENGG
30-05-2011 85.40 NIT ROURKELA First Class
Experience with reference to the advertisement (as on 01/06/2014) as given below (start with present employer)
Name of the
Employer
Designation and Rank if
any
From (DD/MM/YYYY) To (DD/MM/YYYY) Duration of
Service
(YY/MM/DD)
Nature of
Duties Performed
POLARIS FINANCIAL
TECHNOLOGY
ASST MANAGER 25/07/2011 01/06/2014 2/10/8 SOFTWARE
DEVELOPME
NT
Total Relevant Experience (in months) : 34

Application Fee / Intimation charges Details :
Payment Mode: ONLINE
Amount : 850.00
Reference ID : MHCC3374881952
Transaction Date : 07-06-2014
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 if at any stage, it is found that any information given in this application is false/ incorrect or that I do not satisfy the eligibility criteria according to the Board,
my candidature/ appointment is liable to be cancelled/ terminated. I have read and understood the stipulation given in the advertisement and hereby undertake to
abide by them
Date: 07-06-2014 Signature of Applicant

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