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ON-LINE APPLICATION FOR COMMON WRITTEN EXAM FOR SPECIALIST
OFFICERS
3403
Registration # : 3000396706
Full Name : Ajit Yadav
Post : I.T.Officer (Scale-I)
Post Code : 01
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 & OC both hands affected by cerebral palsy) ?
:NA
Whether you Chi ldren / fami ly members of those who d ied in
1984 riots? : NO
Whether you domiciled in Kashmir Division of the State of
J&K during the period 1-1-1980 to 31-12-1989? :NO
Are you an Employee of any participating Bank ? : NO
Name of the Participating Bank : --
Employee Number : --
Are you an Ex-Serviceman ? NO
Nationality / Citizenship : Indian
State/ UT which the Centre of Examination Belongs :
Rajasthan
State / UT Code : 39
Centre of Examination : Jaipur
Centre Code : 139
Application Fee / Intimation Charges details:
Payment Mode: ONLINE
Online Ref ID : MPNB2674224883
Amount : 450
Personal Details :
Date of Birth : 01-09-1987
Age completed as on 01.12.2011 : 24
Gender : MALE
Husband's Name/Father's Name : Shiwpujan Singh Yadav
Mother's Name : Dhaneshwari Yadav
Address for Correspondence : House No.-67
Dadabari Extension
Chota Chauraha
District Kota
State : RAJASTHAN
Pin : 324009
Permanent Address : Vill+po-burhanpur
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District Ghazipur
State : UTTAR PRADESH
Pin : 275203
Contact Details :
Email ID : [email protected]
Phone No : -
Mobile No : 8233342677
Qualification Details (as on 01.12.2011):
Exam Passed Degree Subject /Stream Date of Passing % of Marks
Class / Grade
Graduation: B.E.Electronics &
Telecommunications14-05-2010 62.40 First Class
As on date for Post Qualification Work Experience should be
01.12.2011
Name of the Employer &
Nature of Employment
Designation and
Rank if any
From(mm/yyyy) To(mm/yyyy) Nature of
Duties Performed
Remark(Reason for Leaving) Years of
Service (YY/MM)
Total Experience (in months) : -
Languages Known Read Write Speak
Hindi YES YES YES
English YES YES YES
DECLARATION:
I hereby declare that all 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 my not
satisfying any of the eligibility criteria stipulated, my
candidature is liable to be cancelled.
Place:
Date: 18-01-2012 Signature of Applican
Please retain your Registration No. and Password emailed to you
carefully for further reference
NOTE: Please DO NOT SEND application printout to IBPS
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