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Reg. Number (For Office use only)

Roll Number

Date of Interview d d - m m - y y y y

Venue of Interview

PERSONAL DATA (To be filled up completely by the candidate in his/her own handwriting)
Name of the Candidate
1 (in Block Letters, as appearing in the
matriculation or equivalent certificate)
Sex ( the appropriate box) Male Female
Date of Birth in DD/MM/YYYY (as per
matriculation / equivalent certificate)
d d - m m - y y y y Please affix your recent
passport size color
4 Age (as on 01.07.2017) years months
photograph (without
Phone with STD Code: dark glasses) and sign
E-mail ID registered with us:
Alternate Email ID:
Communication address (in Block letters) with PIN code: Permanent Address (in Block letters) with PIN code

6 7

8 Nationality

9 Place of Domicile with district & state

If yes, name of the Caste/ Tribe
Do you belong to Scheduled Caste/ Tribe
10 (Attach self attested copy of the
(furnish Yes or No)
Academic Qualifications: - Attach self attested copies of mark lists / certificates etc. Percentages of marks are not
allowed to be rounded off to arrive at the minimum percentage of marks stipulated. ( For example : A candidate who
secured only 59.99% of marks will not be permitted to appear for the interview in case the minimum stipulated
percentage is 60)
Date, Month & Year
Name of the School / Name of the Course of passing (as per
Main Subjects / % of
Particulars College & University / (eg: BA, B Sc, LLB, copy of the mark
Streams marks
Board MA, MBA, etc) sheet / certificate

Standard X

Standard XII


Post Graduation


Roll Number: 1 Signature of the candidate

12 Particulars of Post Qualification work experience (If applicable)
Period of service Length of Last drawn
Name of employer & nature Reason for
Designation From To service in monthly
of duties performed leaving service
(dd/mm/yy) (dd/mm/yy) months salary

Details of Computer courses, if any,

13 undergone (attach self attested
copies of the certificates)

Details of other relevant exposures

14 (like student apprenticeship, project
work, seminars, public speaking etc)

Details of period during which

15 candidate was neither employed nor
Languages known (underline mother Read Write Speak


Have you had any major illness,

17 operation or accident? If yes, give

Do you have any physical disability?

If yes, details?

19 Your blood group

What are your extracurricular

20 activities? (attach self attested copies
of the certificates, if any)

Have you received any prize/

21 distinction or scholarship? If yes, give
Have you or any of your close
22 relatives, ever been convicted of an
offence? If yes, state details

23 Father’s / Guardian’s name

24 Occupation of your Father / Guardian

Annual Income of your Father /


Employment Number of
Name of spouse Annual Income
details children
26 If married , furnish details

Roll Number: 2 Signature of the candidate

How many brothers and sisters do
27 Brothers Sisters
you have?

Are your brothers or sisters

28 employed? If yes, state their age and
present employment?

Whether any of your family members

29 are suffering from any major illness?
If yes, give details

Do you have any relative in the

service of Federal Bank?
If yes,
1. Name of the Employee
2. Designation
3. Branch / Office now working
4. Period of service
5. Relationship

Are you related to any Directors of

Federal Bank? If yes,
1. Name of the Director
2. Relationship
Have you applied earlier for any post
32 in Federal Bank?

If yes, give details.

Why do you consider yourself suitable for Banking Job? Please emphasize on your notable achievements in the past
and also a brief description of your career since leaving college.


Name and full address of three reputed persons (referees) who are not your relatives and who know you well
Sl No Name Full communication address Contact no and e-mail ID


34 (ii)


Roll Number: 3 Signature of the candidate

If you are absorbed in Federal Bank;
a) Indicate any specific functions in the
Bank where you would like to work.
b) Are you ready to work in any Branches /
Yes / No
Offices of the Bank
35 c) Indicate your place of preference, if any
(District / State)
d) Whether you have any objection /
difficulty in taking up the assignment
outside your Home State.
If yes, state the reasons.

Eligibility Criteria for recruitment process for the post of Clerk (Advertisement Route)

 Candidates who completed Graduation (as on 04.09.2017) in any discipline with minimum 60% marks, from any
recognized university or other institutions established by an Act of parliament or declared to be deemed as a University
under Section 3 of U G C Act, 1956.

th th
Candidates should have acquired the stipulated educational qualification (10 , 12 & Graduation) through regular mode
of study.
 Candidates should not exceed 24 years of age as on 01.07.2017 (Candidates should be born on or after 02.07.1993).
 The place of domicile of candidates should be located in the states of Assam, Karnataka, Maharashtra, New Delhi / NCR
or Telangana.
 Candidates selected for appointment will be on probation for a period of 6 months.

 Graduation course or equivalent examination must entail a minimum of 3 years of education after completing higher
secondary schooling (10+2) or equivalent
 Graduation in Agriculture / Engineering means those who have passed 10+2+4 year course
 Graduation in Law means those who have passed 10+2+5 year course in law or degree in any subject +3 year course in
 The percentage of marks obtained by the candidate would be based on the practice followed by the University /
Institution from where the candidate has obtained the degree. In case of the candidates being awarded grades / CGPA
instead of marks, equivalence would be based on the equivalence certified by the University / Institution from where
they have obtained the degree.
 Year wise / semester wise mark sheet for each year / semester in respect of the qualifying examination from the
concerned University should be available. Since the reverse side of the mark sheet contains the instructions,
photocopies of both sides of the mark sheets is necessary.



I, ………………………………………………………………………………………………………………………………., hereby declare that I have gone

through the eligibility criteria and other norms stipulated by the Bank, for recruitment process for the post of Clerk, and
agree to abide by the said stipulations. I also certify that the particulars furnished above are true to the best of my
knowledge and belief.
I understand that if at any stage, I am not found eligible or the declaration / details represented in the application submitted
herein is found to be false / misrepresented / incorrect, my candidature / empanelment / appointment is liable to be
cancelled at any stage, without notice and compensation.

Place: Signature of the candidate:

Date: Name of the candidate:

The Federal Bank Limited, Regd. Office, Aluva

Roll Number: 4 Signature of the candidate

F O R O F F I C E U S E O N L Y (Documents to be verified at the time of interview)
(Documents proving academic qualifications, date of birth, valid proof of identity etc are to be verified in original to
ascertain the eligibility criteria as reproduced in this application and self attested copies of the same have to be
countersigned by the authorized signatory).

Details Particulars Certificate / Document verified

1 Reg. Number

2 Roll Number

a Date of Birth (dd/mm/yyyy) d d - m m - y y y y

Age as on 01.07.2017
b (should be born on or after ........... years ………. months

a Name of the qualifying exam

% of marks & date in the

4 passing certificate / mark
sheet of qualifying
(Graduation should be
completed as on 04.09.2017)
 60% marks for Graduation, SSC or equivalent exam & Plus 2 or equivalent exam is mandatory
 10th,12th & Graduation should be completed through regular mode

State & Place of domicile Domicile certificate

(Should be located in Assam,Karnataka,
5 Maharashtra, New Delhi / NCR or
If any other document specify :

Valid proof of identity (PAN card /

Passport / Aadhar Card / Voters ID
6 Card / Driving License or any
other valid proof of identification
with a photograph)

Valid proof of address (Aadhar

Card / Voters ID Card / Driving
License / Ration Card / or any
other valid proof of address)

Details of work experience if any


Reasons for obtaining declaration

(if any)

Remarks / Discrepancies
10 observed, if any ( to be filled in by
the Official in RED INK)

Date: Name, Signature and Stamp of authorized signatory

The Federal Bank Limited, Regd. Office, Aluva

Roll Number: 5 Signature of the candidate