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9/25/2019 LIFE INSURANCE CORPORATION OF INDIA - RECRUITMENT OF ASSISTANT

LIFE INSURANCE CORPORATION OF INDIA 350149


LIFE INSURANCE CORPORATION OF INDIA - RECRUITMENT OF ASSISTANT

Registration Number : 1780358944


Full Name : VIJAY PRAKASH MEENA

Category : ST

Are you a person with benchmark disability of 40% and above ? : NO

Type of Disability : -

Do you need compensatory time at the time of examination : -


Are you suffering from cerebral palsy and your writing speed is affected : -

If Yes, Do you need compensatory time at the time of examination? : -

Whether your dominant (Writing) hand is affected : -

If Yes, Do you need compensatory time at the time of examination? : -


Do you intend to use the services of a scribe? : -

Religion to which you belong : Hindu

Do you belong to Religious Minority Community ? : NO

Are you a Child/Family Members of those who died in 1984 Riots? : NO

Are you a Person ordinarily domiciled in the State of Jammu & Kashmir during the : NO
period from 01.01.80 to 31.12.89.?
Are you an Ex-Serviceman : NO

Are you a Disabled Ex-Serviceman (DISXS) : NO


Actual period of service rendered in defence services as an Ex-servicemen (in : -
Months)

Are you a Confirmed LIC employee? : NO


Are you a Temporary LIC employee? : NO

If yes, Employee No. : -


Language opted for section 1 of Prelim exam ? : English
Zone : North Zone

Choice of Division : JAIPUR


Choice of State of Examination : RAJASTHAN

Choice of Centre Phase-I: Preliminary Examination : JAIPUR


Choice of Centre Phase-II : Main Examination : JAIPUR
Nationality / Citizenship : Indian

Application Fee / Intimation charges


Payment In : ONLINE

Fees : 85.00
Tax : 15.30 (IGST)
Amount : 100.30

https://ibpsonline.ibps.in/licastaug19/registration_print.php?q=NjEzNWRkOTQ3MzY0MzdkMzNmMDY4ZGM0ZmQ0OWY0Y2R8MTc4MDM1ODk… 1/3
9/25/2019 LIFE INSURANCE CORPORATION OF INDIA - RECRUITMENT OF ASSISTANT
Payment Status : PAID

Reference ID : QSM28018029537
Transaction Date : 25-09-2019

Personal Details

Date of Birth : 16-03-1996


Age completed as on 01.09.2019 : 23

Gender : MALE
Marital Status : Unmarried

Father's Name : KUMBHA RAM MEEN


Mother's Name : PREMA DEVI
Spouse's Name : -

Address for Correspondence : 34 BHAGWATI NAGAR 2ND


Address 2 : KARTARPURA PHATAK
District : JAIPUR

State : RAJASTHAN
Pincode : 302015
Permanent address : 34 BHAGWATI NAGAR 2ND
Address 2 : KARTARPURA PHATAK

District : JAIPUR
State : RAJASTHAN
Pincode : 302015
State for GST invoicing : Communication Address
(RAJASTHAN)

Contact Details

Mobile No : +91 8275251728


Alternative Number : -
(Mobile No/Landline No)

Email ID : vijaymn38@gmail.com

Educational and Professional Qualification Details(as on 01.09.2019)

Exam Passed Degree/ Subject / Stream Date of % of Marks Class / Grade


Passing

Matriculation / Equivalent : MATHEMATICS AND 31-05-2011 70.30 First Class


SCIENCE

12th / Diploma : MATHEMATICS AND 24-04-2013 72.30 First Class


SCIENCE
Graduation Others - ENGINEERING 12-10-2017 71.30 First Class

Whether any Court Order obtained : NO


If "YES", Details of Court Order : -
CASE NUMBER : -
COURT DETAILS : -
DATE OF ORDER : -

Other Details :

Languages Known Read Write Speak

https://ibpsonline.ibps.in/licastaug19/registration_print.php?q=NjEzNWRkOTQ3MzY0MzdkMzNmMDY4ZGM0ZmQ0OWY0Y2R8MTc4MDM1ODk… 2/3
9/25/2019 LIFE INSURANCE CORPORATION OF INDIA - RECRUITMENT OF ASSISTANT

ENGLISH YES YES YES

HINDI YES YES YES

TELUGU NO NO YES

Uploaded Document Details :

1. Left thumb impression


2. Hand written declaration

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 in the event of any information being found untrue or incorrect at any stage or I am not satisfying any of the eligibility criteria
stipulated, and also in case of creating influence/undue pressure regarding recruitment shall tantamount to cancellation of my candidature.

Date: 24-09-2019 Signature of Applicant

Left thumb impression

Hand written declaration

https://ibpsonline.ibps.in/licastaug19/registration_print.php?q=NjEzNWRkOTQ3MzY0MzdkMzNmMDY4ZGM0ZmQ0OWY0Y2R8MTc4MDM1ODk… 3/3

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