INDIAN BANK - RECRUITMENT OF CLERK

ONLINE APPLICATION FORM FOR THE POST OF CLERK

APPLICATION PRINT-OUT NEED NOT BE SENT TO THE BANK

17033

Registration # : 224324 Please paste your recent

Full Name : Pawan Kumar Singh passport size photograph
and sign across it.
Please retain atleast 5
Category : General copies with you for
subsequent use.
Person With Disability : No
Percentage of -
Type of Disability : -
Disability :
Do you intend to use the services of a scribe : No
Are you a candidate who had ordinarily been
domiciled in Kashmir Division of the state of No
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 Ex-Serviceman? : No
Date of Release/ Retirement from Service : -
Have you passed in Service (Departmental) Examination
which is recognized as equivalent to Civil Examination
-
not below the level
of Matriculation?:
Are you a disabled Ex-Serviceman (DISXS)? : No
Are you a dependent of an Ex-Service man (DXS)? : No
Whether children/family members of those
No
who died in 1984 riots?:
Are you seeking relaxation under window /
divorced women / women judicially Separated from their No
husbands and who are not re-married?:
Nationality : Indian
State / Union Territory for which you are applying : DELHI State / UT code : 26
Centre of Examination : New Delhi Centre code : 55
Application Fee/Postal Charges Details:
Transaction ID/ Scroll No. : 1933415
Branch Name : Mi Road Branch CBS Code : 474
Deposit Date : 24-06-2010 Amount : Rs.300

Personal Details:
Date of Birth : May,09 1990 Age as on 01.01.2010: 19
Gender : MALE
Husband's Name / Father's : Vinod Singh
Mother's Name : Poonam Singh
Email ID : amitmehra6@yahoo.com

Address for Correspondence : 29lions coloney

tonk toad
jaipur
District jaipur
State : RAJASTHAN Pincode : 302011
Permanent Address : 29lions coloney
tonk toad
jaipur
District jaipur
State : RAJASTHAN Pincode : 302011
Contact Details:
Phone No : 0141-98877897 Mobile No : 9887789787

Qualification Details (as on 01.01.2010) :

Exams Passed Subject /Stream Year Of % of Marks Class / Grade
Passing
HSC / Equivalent : pcm 2008 54.77 Second Class
Knowledge of Computer : Yes
Details of computer Knowledge qualification : basic knowledge
Desirous of taking Pre Exam Training : No
If Yes, Centre for Pre Exam Training : -
Languages Known Read Write Speak

English Yes Yes Yes

Hindi Yes Yes Yes
DECLARATION:
I hereby declare that 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 false or incorrect and not satisfying the eligibility
criteria according to the requirements of the relative advertisement my candidature/appointment for the said post is liable to be
cancelled/terminated at any stage and if appointed my services are liable to be terminated
I am willing to serve anywhere in India. I agree that the Bank has the right to post me to any part of the country at its discretion.
I hereby agree that any legal proceeding in respect of any matter(s) or claims or disputes arising out of application or out of
said advertisement can be instituted by me only at Chennai and Courts/Tribunal/ Forums at Chennai only, shall have sole
and exclusive jurisdiction to try any cause/dispute. I undertake to abide by all the terms and conditions mentioned in the
advertisement
given by the Bank.
Place:
Date: 29-06-2010
Signature of Applicant

Pawan Kumar Singh

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