PRAGATHI KRISHNA GRAMIN BANKpragathikrishnabank.com/kannada/images/PDF/s1.pdf · photograph/Photo identity proof issued by a Gazetted Officer/Identity card issued ... Character Certificate

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PRAGATHI KRISHNA GRAMIN BANK

(A Scheduled Bank owned by Government : Sponsored by Canara Bank)

Head Office : Post Box 55, Gandhinagar, Bellary - 583 103 Phone : (08392) 236417, 236404, 236409 Fax: 256886 e-mail: [email protected]

PERSONNEL WING : STAFF SECTION

REF : HO PW SS 826 2013-14 DATE: 23.01.2014

Dear Sir/Madam,

Sub: Your application for the post of Officer Scale-I in the Bank – Call Letter for appearing for the Interview.

With reference to your application for the above post, we are pleased to inform you that you have been qualified for

Interview for the said post subject to the following:

IMPORTANT: YOU ARE ADVISED TO APPEAR FOR INTERVIEW ONLY IF YOU POSSESS

PROFICIENCY IN KANNADA i.e., OFFICIAL LANGUAGE OF KARNATAKA AND YOU MUST HAVE

PASSED KANNADA AS ONE OF THE SUBJECTS AT X STD. OTHERWISE YOU SHALL NOT BE

ALLOWED FOR INTERVIEW.

The interview is scheduled as mentioned below:

Venue : Pragathi Kishna Gramin Bank, Head Office

32, Sanganakal Road, Gandhinagar, BELLARY-583 103

Date : As per list

Time : As per list

1. Please bring the enclosed bio-data form duly completed (1 original + 4 xerox copies), while attending the

Interview. Also note to bring originals and one set of attested true copies of the following certificates /

documents in the same order:

a) Print out of the online application submitted by you with your recent passport size photograph affixed on it.

b) Printout of IBPS scores for the stipulated examination (Score Card of Common Written Examination –

CWE-II for RRBs conducted by IBPS in September/October 2013).

c) X Std examination marks sheet in support of local language proficiency i.e., Kannada.

d) Attested copy of school leaving certificate or any other document as proof of age acceptable to the Bank.

e) Marks card / sheet from X Std examination to the highest examination passed in support of educational

qualification including computer course.

f) Certificate regarding Graduation, Post Graduation, Computer course and other examination passed, if any.

g) Caste / Community certificate issued by the competent authority as mentioned in the advertisement

published in website of the bank in the case of SC / ST / OBC category candidates in the prescribed format

as per the proforma enclosed. Please note that the caste mentioned in the certificate produced by you should

tally letter by letter to that of the caste as mentioned in the Central Government list / notification. OBC

certificate should be of issued on or after 01.04.2013. (if applicable)

h) If you belong to the category of “Persons With Disabilities”, you have to bring a medical certificate in the

revised format issued by the authorized Certifying Authority – i.e. Medical board appointed by the State

Government at District levels comprising of Chief Medical Officer / Sub-Divisional medical Officer in the

District and an Orthopedic / Ophthalmic / ENT Surgeon.

i) Service/discharge certificate issued by the Competent Authority in case of ex-servicemen.

j) Work experience certificate, duly specifying the date of joining, whether confirmed in the services, salary

drawn, nature of work handled, date of relieving and reasons for relieving etc., from present / previous

employer, if any.

k) Photo identity proof such as PAN Card/Passport/Driving Licence/Voters Card/Bank pass book with

photograph/Photo identity proof issued by a Gazetted Officer/Identity card issued by a recognized

College/University/Adhar Card with photograph/Employee ID.

l) Testimonials regarding proficiency in curricular / extracurricular activities, if any.

2. Please note that you shall not be allowed for the interview without the above mentioned certificates /

documents.

3. Please also bring the originals of : a) No Objection Certificate from the present employer (applicable in the case of candidates presently

working).

b) Character Certificate from two respectable persons not related to you, obtained on a recent date.

4. You have to appear for Interview at your own expenses. Only out station SC / ST / Persons With Disabilities

category candidates called for interview will be paid to and fro II Class train fare or actual expenses incurred,

whichever is less from normal place of residence to the place of interview by shortest route, on production of

proof of travel.

Please note that candidates who were found not eligible for the said post applied / do not produce relevant

certificates mentioned above shall neither be permitted to take the Interview, nor shall be paid any traveling

allowance. Any subsequent representation claiming Traveling Allowance shall not be entertained. Please also

note that, the above concession will not be admissible to the SC / ST / Persons With Disabilities category

candidates who are already in service in Central / State Government, Public Undertakings / Local

Government, Institutions and Panchayats.

5. Please note that you will be permitted to attend the Interview as mentioned above, subject to;

i) Your fulfillment of eligibility criteria / conditions regarding qualification, age, experience in the

relevant field etc, as stipulated in the advertisement; and

ii) Correctness of information given by you in application including

a) Caste / Community Certificate in the case of SC / ST / OBC category candidates; and

b) Medical Certificate in the case of Persons With Disabilities category candidates.

6. Please note that this is not an offer of appointment nor does it represent any commitment on the part of

the Bank to select you to any post in the Bank. The decision of the Bank in all matters regarding

Interview, selection of the candidates would be final and binding on the candidates. No correspondence

would be entertained in this regard.

7. Please bring this letter with you when you appear for the Interview.

8. The Bank will not entertain any request / correspondence for change of Date / Time / Venue of the Interview.

Yours faithfully,

CHIEF MANAGER

Note : Formats of Bio-data, Caste Certificate and Medical Certificate (for PWD candidates) enclosed.

PRAGATHI KRISHNA GRAMIN BANK

(A Scheduled Bank owned by Government : Sponsored by Canara Bank)

Head Office : Post Box 55, Gandhinagar, Bellary - 583 103 Phone : (08392) 236417, 236404, 236409 Fax: 256886

e-mail: [email protected]

PERSONNEL WING : STAFF SECTION

List of eligible candidates for interview for the post of Officers Scale-I

Sl No Roll No First Name Date Time

1 1931131180 MAHANTESH SANGANABASAPPA MALUR 03.02.2014 1.30 PM

2 1901131218 VASUDEV DEVENDRA NAYAK 03.02.2014 1.30 PM

3 1811130523 BILAL MOHAMMAD GOKER 03.02.2014 1.30 PM

4 1861131291 GURURAJ PRAKASH KULKARNI 03.02.2014 1.30 PM

5 1811131833 K H VENKATESH 03.02.2014 1.30 PM

6 1821130388 GIRISH R B 03.02.2014 1.30 PM

7 1871133182 SANDEEP G N 03.02.2014 1.30 PM

8 3121130876 SANGAMESH SIDDALINGAPPA MANAHALLI 03.02.2014 1.30 PM

9 1811132379 ABHINANDAN KUMAR K 03.02.2014 1.30 PM

10 1871133649 SOWMYA M 03.02.2014 1.30 PM

11 1911130454 SHIVA SUBRAMANYA PM 03.02.2014 1.30 PM

12 1891130493 KRISHNA M TOSNIWAL 03.02.2014 1.30 PM

13 1891130495 PRABHAKAR BHEEMANAGOUDA NANDYAL 03.02.2014 1.30 PM

14 1901130890 PAVANKUMAR BASAPPA HALINGALI 03.02.2014 1.30 PM

15 1831130772 SANDEEP K L 03.02.2014 1.30 PM

16 1871131961 SANTOSH C S 03.02.2014 1.30 PM

17 1891130786 PRAVEEN S B PATIL 03.02.2014 1.30 PM

18 1911130785 PRAKASH KUMAR KADAKOL 03.02.2014 1.30 PM

19 1831130482 A SRIDHAR 03.02.2014 1.30 PM

20 1881130371 MALLANAGOUDA NINGANAGOUDA TIGADI 03.02.2014 1.30 PM

21 1891130774 BHIMASHAINRAO TIRUMALRAO KULKARNI 04.02.2014 9.30 AM

22 1901130915 MANJUNATH VIVEKANAND BANAD 04.02.2014 9.30 AM

23 1921130265 DEEKSHITH 04.02.2014 9.30 AM

24 1921130439 PRATHIK PRABHU 04.02.2014 9.30 AM

25 1831130075 SMITHA G S 04.02.2014 9.30 AM

26 1831130226 BRIJESH A P 04.02.2014 9.30 AM

27 1841130539 NAVANEETH T N 04.02.2014 9.30 AM

28 1871133353 HARSHA N 04.02.2014 9.30 AM



29 1871134185 CHETAN CHIDAMBAR DESHPANDE 04.02.2014 9.30 AM

30 1901130689 RAKESH BABU V GIRADDI 04.02.2014 9.30 AM

31 1811132331 PAVAN KUMAR T 04.02.2014 9.30 AM

32 1871130789 ARUN KUMAR B N 04.02.2014 9.30 AM

33 1931130737 PRASHANT VENKATESH K 04.02.2014 9.30 AM

34 1261132201 K N BALAKRISHNA 04.02.2014 9.30 AM

35 1661136144 YATISH THIMMAPPA 04.02.2014 9.30 AM

36 1831130770 VINAY H P 04.02.2014 9.30 AM

37 1901130899 LAKSHMEEPRASADA BUDANNAVARA 04.02.2014 9.30 AM

38 1901130919 VEERABHADRASWAMY N 04.02.2014 9.30 AM

39 1901140251 KIRAN KUMAR T G 04.02.2014 9.30 AM

40 3011135609 MANOJ A 04.02.2014 9.30 AM

41 1871130309 SHRUTHI P. RAO 04.02.2014 9.30 AM

42 1891131318 PRABHUGOUDA SHALLAGI 04.02.2014 9.30 AM

43 1901131172 RAJENDRA KALAKAPPA SANTOJI 04.02.2014 9.30 AM

44 1811132374 KIRANKUMAR K SHILLIN 04.02.2014 9.30 AM

45 1841130768 SANTHOSHKUMAR H S 04.02.2014 9.30 AM

46 1871130749 RAJKIRAN BIRADAR 04.02.2014 1.30 PM

47 1871130811 VINAY RAKSHITH H S 04.02.2014 1.30 PM

48 1891130247 RAMESH MALLIKARJUN SHIRUR 04.02.2014 1.30 PM

49 1901131169 RAVI SHARANAPPA VEERAPUR 04.02.2014 1.30 PM

50 1921130357 ANUSHA K PRABHU 04.02.2014 1.30 PM

51 3011134811 SANDEEP E 04.02.2014 1.30 PM

52 3021135562 VINANTH K 04.02.2014 1.30 PM

53 1811132085 BHARATHI S 04.02.2014 1.30 PM

54 1861130204 SANGAMESH KARABASAPPA KINNI 04.02.2014 1.30 PM

55 1871131893 DASANA GOWDARA SANDEEP 04.02.2014 1.30 PM

56 1911130930 RITHESH KUMAR N 04.02.2014 1.30 PM

57 1811131841 H M PAVAN KUMAR 04.02.2014 1.30 PM

58 1841130781 NITHIN B G 04.02.2014 1.30 PM

59 1861130207 SANTOSH HIREMATH 04.02.2014 1.30 PM

60 1871130828 CHANDRAKANTH JAIN 04.02.2014 1.30 PM

61 1871131909 VALLISH H 04.02.2014 1.30 PM

62 1891131284 ANAND TOGARI 04.02.2014 1.30 PM

63 1831131325 JAGADISH CHAND M 04.02.2014 1.30 PM

64 1871130776 RANIT OBERAI 04.02.2014 1.30 PM



65 1871131905 VINOD KUMAR B S 04.02.2014 1.30 PM

66 1891130758 RAJU SIDDAYYA MATH 04.02.2014 1.30 PM

67 1911130157 RAMESH BHAT 04.02.2014 1.30 PM

68 1911130489 PRAMOD LAKHAMAGOUD PATIL 04.02.2014 1.30 PM

69 1811131414 AMRUTHA M S 04.02.2014 1.30 PM

70 1841130041 VIDYA S 04.02.2014 1.30 PM

71 1891130249 BASAVARAJ S SARABADAGI 05.02.2014 9.30 AM

72 1891130843 BHARATI IRANNA HATTALLI 05.02.2014 9.30 AM

73 1901130552 POORNIMA RUDRAYYA HIREMATH 05.02.2014 9.30 AM

74 1911130826 HARSHA A 05.02.2014 9.30 AM

75 1811130511 SUDARSHAN 05.02.2014 9.30 AM

76 1811131781 SANTHOSH KUMAR ANGADI 05.02.2014 9.30 AM

77 1811132360 ARUN KUMAR SOPPINA 05.02.2014 9.30 AM

78 1861130834 SWAPNA 05.02.2014 9.30 AM

79 1871134184 ABHAYA T V 05.02.2014 9.30 AM

80 1871134194 AMITH R 05.02.2014 9.30 AM

81 1891131124 MANSA B KALWAD 05.02.2014 9.30 AM

82 1921130144 SAJITHKUMAR R 05.02.2014 9.30 AM

83 1811130792 RAMALAKSHMI K 05.02.2014 9.30 AM

84 1821130333 LINGARAJU K N 05.02.2014 9.30 AM

85 1871131904 MAHESH GOUDA S M 05.02.2014 9.30 AM

86 1871131975 BASAVARAJ MALLANNA KAPPENAVAR 05.02.2014 9.30 AM

87 1871133251 ARAVIND K M 05.02.2014 9.30 AM

88 1881130411 SHRENIK JAYAPAL CHOUGALA 05.02.2014 9.30 AM

89 1881130710 ILAHIBAKSH DASTAGIRSAB JAMADAR 05.02.2014 9.30 AM

90 1931131590 VEERESH SHANKARAPPA MENASIGI 05.02.2014 9.30 AM

91 1931131603 SAMEER RAMACHANDRA HUNAGUND 05.02.2014 9.30 AM

92 1831131316 MANOJ HEGDE M 05.02.2014 9.30 AM

93 1841130231 SHRIKANTH B KYASAGER 05.02.2014 9.30 AM

94 1861130958 RAHUL 05.02.2014 9.30 AM

95 1891130233 SHANTAKUMAR H SHINGNALLI 05.02.2014 9.30 AM

96 1911130922 JAGADEESHABABU 05.02.2014 1.30 PM

97 1931131245 GIREESH N KARIGER 05.02.2014 1.30 PM

98 1871130816 ELLUR SACHIN KUMAR 05.02.2014 1.30 PM

99 1871135000 SAHANA SHIVAKUMAR 05.02.2014 1.30 PM

100 1871135279 RAJESH K HOSALLI 05.02.2014 1.30 PM



101 1891130508 UMARFAROOQUE JAMARUDDIN JAHAGIRDAR 05.02.2014 1.30 PM

102 1811130730 PRIYA SESHADRI K 05.02.2014 1.30 PM

103 1821130359 CHANDRASHEKAR M T 05.02.2014 1.30 PM

104 1881130707 ABHISHEK R DESAI 05.02.2014 1.30 PM

105 1911130153 RAJU V B T 05.02.2014 1.30 PM

106 1911130165 ASLAM KHAN A 05.02.2014 1.30 PM

107 1911130566 LIKHITA C 05.02.2014 1.30 PM

108 1811130779 BHAVANI 05.02.2014 1.30 PM

109 1811131829 VEERESH K 05.02.2014 1.30 PM

110 1811131831 H M GURU PRASAD 05.02.2014 1.30 PM

111 1861130417 ANAND KUMAR MALLIKARJUN BHOOMA 05.02.2014 1.30 PM

112 1871133142 HARSHA K 05.02.2014 1.30 PM

113 1871134102 CHANDAN BG 05.02.2014 1.30 PM

114 1881130774 MADHURI PATIL 05.02.2014 1.30 PM

115 1891130225 AVINASH TAVANAPPA UPADYA 05.02.2014 1.30 PM

116 1891130350 RENUKA M HIREMATH MALLESHAYYA HIREMATH 05.02.2014 1.30 PM

117 1901131196 SHIVARAJKUMAR MATHAPATI 05.02.2014 1.30 PM

118 1901131233 CHANDRAKANTH RAMA NAIK 05.02.2014 1.30 PM

119 1911130438 JAGADISH P 05.02.2014 1.30 PM

120 1931130670 ANUP GAJANAN GOVEKAR 05.02.2014 1.30 PM

121 1811130286 MADHURI S 06.02.2014 9.30 AM

122 1821130598 SURAJ O S 06.02.2014 9.30 AM

123 1821130614 LOHITH DOMBALA 06.02.2014 9.30 AM

124 1841130548 VINAY K 06.02.2014 9.30 AM

125 1861130198 VISHWANATH S PATIL 06.02.2014 9.30 AM

126 1871130321 SHYLAJA K 06.02.2014 9.30 AM

127 1871131898 SHAMBHU NAGENDRAPPA KAGER 06.02.2014 9.30 AM

128 1901130234 MADANKUMAR ASHOK TEGGI 06.02.2014 9.30 AM

129 1901130924 AJITH IRAPPA MANAGOOLI 06.02.2014 9.30 AM

130 1901131193 VINAYAK BALAPPA BELLIKUPPI 06.02.2014 9.30 AM

131 1921130418 SAAWAN NAGENDRA PARISHWAD 06.02.2014 9.30 AM

132 1861131276 AMARNATH NAGARAJ SHETTY 06.02.2014 9.30 AM

133 1871133665 OLYMPIA 06.02.2014 9.30 AM

134 1891130782 RAHUL RAGAHVENDRA DESHPANDE 06.02.2014 9.30 AM

135 1901130193 SATISH NAGAPPA AJJAPPANAVAR 06.02.2014 9.30 AM

136 1931130305 MARIYA EILINE ANCHULA 06.02.2014 9.30 AM



137 1931130739 VEERAJA GOUDA 06.02.2014 9.30 AM

138 1811130311 SRAVANI N 06.02.2014 9.30 AM

139 1821130617 BASAVARAJ NINGAPPA HULMANI 06.02.2014 9.30 AM

140 1841130770 CHANDAN V 06.02.2014 9.30 AM

141 1871135281 VINAY PRASAD N 06.02.2014 9.30 AM

142 1891131269 SHRIHARI KULKARNI 06.02.2014 9.30 AM

143 1841130492 AVINASH K B 06.02.2014 9.30 AM

144 1871135332 HARISH R 06.02.2014 9.30 AM

145 1901130212 JAGADISH SHANMUKAPPA SIMHASAN 06.02.2014 9.30 AM

146 1931131172 AMARAYYA HIREMATH 06.02.2014 1.30 PM

147 1831130490 SURAJ B V 06.02.2014 1.30 PM

148 1901131199 SANTOSHKUMAR MATHAPATHI 06.02.2014 1.30 PM

149 1911130455 ARUN KUMAR G K 06.02.2014 1.30 PM

150 1811130499 MUNISHWARA A 06.02.2014 1.30 PM

151 1841130535 MANJUNATHA H R 06.02.2014 1.30 PM

152 1851130217 MANOJ MADWESH DESAI 06.02.2014 1.30 PM

153 1871130920 BANDALAPATI L NARAYANA 06.02.2014 1.30 PM

154 1881130050 VEENA GURULING BHANDARI 06.02.2014 1.30 PM

155 1881130881 SHREESHAIL ANGADI MAHADEV ANGADI 06.02.2014 1.30 PM

156 1901130185 MAHESH SIDDARAMAYYA HULEPPANAVARMATH 06.02.2014 1.30 PM

157 1921130142 AKSHARA K 06.02.2014 1.30 PM

158 1931131466 ROSEMARY KALLAKUNTLA 06.02.2014 1.30 PM

159 1851130207 SHREEPADA D 06.02.2014 1.30 PM

160 1861130072 DEEPIKA SOMASHEKHARAYYA MAHAJANMATH 06.02.2014 1.30 PM

161 1911130447 ABDUL RAFEEQ 06.02.2014 1.30 PM

162 1931131145 MAHANTESH SHANKAR BHISTE 06.02.2014 1.30 PM

163 1851130332 NAVEEN KUMAR M S 06.02.2014 1.30 PM

164 1871133207 SUHAS S 06.02.2014 1.30 PM

165 1861130526 MATH LATA MATH MALLIKARJUN MATH 06.02.2014 1.30 PM

166 1891131283 SHIVAKUMAR BASAVARAJ MUKKALMATH 06.02.2014 1.30 PM

167 1891090173 RAJU ARJUN PUJARI 07.02.2014 9..30 AM

168 1901091138 VIJAY RAIKAR 07.02.2014 9..30 AM

169 2791091690 PRITHVI C SHET 07.02.2014 9..30 AM

170 1811091731 MOUNESH 07.02.2014 9..30 AM

171 1821091074 SHAMA BANU M NADAF 07.02.2014 9..30 AM

172 1871093575 DIVYANJALI R 07.02.2014 9..30 AM



173 1931091530 M.SOURABH 07.02.2014 9..30 AM

174 1851090032 SOWMYA N D 07.02.2014 9..30 AM

175 1811090476 AMITH MEGHARAJ 07.02.2014 9..30 AM

176 1871090619 RAJATH U S 07.02.2014 9..30 AM

177 1871091590 HARSHA H V 07.02.2014 9..30 AM

178 1871094086 YATHISHA S R 07.02.2014 9..30 AM

179 1891091201 SHIVANAND 07.02.2014 9..30 AM

180 1821090292 VINAY S KURDEKAR 07.02.2014 9..30 AM

181 1821090934 RAGHAVENDRA SR 07.02.2014 9..30 AM

182 1831091237 FAYAZ A 07.02.2014 9..30 AM

183 1831091244 SHANMUKHA H 07.02.2014 9..30 AM

184 1851090027 MANASA H L 07.02.2014 9..30 AM

185 1911090680 ROHITH K 07.02.2014 9..30 AM

186 1171098933 PRASHANT VEERABHADRA HULAKUNDA 07.02.2014 9..30 AM

187 1831090043 RANJITHA V 07.02.2014 9..30 AM

188 1831090731 HITHENDRA PRASAD G 07.02.2014 9..30 AM

189 1881090133 SANTOSHKUMAR SIDDAPPA SAMPAGANVI 07.02.2014 9..30 AM

190 1901090676 HARSHA F C 07.02.2014 9..30 AM

191 1281092363 RAMPRASAD G 07.02.2014 9..30 AM

192 1281092852 K RAJESWARI 07.02.2014 1.30. PM

193 1861090379 SANTOSH 07.02.2014 1.30. PM

194 1901090675 DANIEL BORGES 07.02.2014 1.30. PM

195 1901091122 SRINIVAS H 07.02.2014 1.30. PM

196 1861090398 CHANNAPPA B K 07.02.2014 1.30. PM

197 1871092310 SARALA C 07.02.2014 1.30. PM

198 1891090161 MALLIKARJUNA 07.02.2014 1.30. PM

199 1911090366 SHARATH BABU P V 07.02.2014 1.30. PM

200 1931090594 VISHWANATH RADDY 07.02.2014 1.30. PM

201 1811090116 ANGADI BASAVESWARI 07.02.2014 1.30. PM

202 1811091146 BANDI VEERESH 07.02.2014 1.30. PM

203 1881090594 BASAVARAJ KADAPPA BIDARI 07.02.2014 1.30. PM

204 1931090838 SHAILA KASHINATH JARTARGHAR 07.02.2014 1.30. PM

205 1811091610 S NANJUNDAIAH 07.02.2014 1.30. PM

206 1861090260 PRIYA 07.02.2014 1.30. PM

207 1871092295 SHWETHA S K 07.02.2014 1.30. PM

208 1931090059 VIJAYKUMAR ISHWAR PATAGUNDI 07.02.2014 1.30. PM



209 1901090411 ARUN HANAMANT CHAKALABBI 07.02.2014 1.30. PM

210 1911090365 SHANTAPPA I HOSAMANI 07.02.2014 1.30. PM

211 1911090672 PRATHIK HUSERMANE HEMANTHKUMAR 07.02.2014 1.30. PM

212 1281092171 G M VAMADEVA 07.02.2014 1.30. PM

213 1811092244 AYYAPPA 07.02.2014 1.30. PM

214 1821090569 VEERACHARI KAMMAR 07.02.2014 1.30. PM

215 1871100965 RADHA N 07.02.2014 1.30. PM

216 1911090421 NAGESH K B 07.02.2014 1.30. PM

217 1831090205 SRINIVASACHAR NV 07.02.2014 1.30. PM

218 1841090093 ARUN KUMAR K 08.02.2014 9.30 AM

219 1871093014 YK SURENDAR BABU 08.02.2014 9.30 AM

220 1871095216 VINAY G SARODE 08.02.2014 9.30 AM

221 1881090130 JAGADISH MALLAPPA KULIGOD 08.02.2014 9.30 AM

222 1891090148 VEERESH T BADIGER 08.02.2014 9.30 AM

223 1901090665 MANJUNATH VINODAPPA BANAKAR 08.02.2014 9.30 AM

224 1911090362 VINAY KUMAR H N 08.02.2014 9.30 AM

225 1811090682 SIREESHA K 08.02.2014 9.30 AM

226 1831090183 THEJES M 08.02.2014 9.30 AM

227 1851090398 P.MOHAMAD KHALEELULLA 08.02.2014 9.30 AM

228 1931091110 SAGAR ADAPPA CHOUDHARI 08.02.2014 9.30 AM

229 1851090026 SHAHANAZ BANU A M 08.02.2014 9.30 AM

230 1861090940 KIRAN KUMAR LAXMAN RAO WANJRE 08.02.2014 9.30 AM

231 1871090624 YOGESH S 08.02.2014 9.30 AM

232 1871094045 SANTOSH YALLAPPA KAGGOD 08.02.2014 9.30 AM

233 1901091142 MAHANTESH KESARAPPANAVAR 08.02.2014 9.30 AM

234 1811091059 RAMANJINI B 08.02.2014 9.30 AM

235 1821090300 MOUNESH B M 08.02.2014 9.30 AM

236 1831090459 MAHESH P 08.02.2014 9.30 AM

237 1831091267 SHIVAPRAKASH N 08.02.2014 9.30 AM

238 1871093019 PRADEEP A M 08.02.2014 9.30 AM

239 1881090122 ROHIT DILIP LAGARE 08.02.2014 9.30 AM

240 1901090415 MANJUNATH SHIVANAIKAR SURYANAIK SHIVANAIKAR 08.02.2014 9.30 AM

241 1901090663 RAGHAVENDRARAJKUMAR DINDI 08.02.2014 9.30 AM

242 1941120001 HARISH 08.02.2014 9.30 AM

243 1811091641 VENKATESH S 08.02.2014 1.30 PM



244 1841090941 MANJUNATH K 08.02.2014 1.30 PM

245 1851090405 SANTHOSH M 08.02.2014 1.30 PM

246 1861090151 BHEEMARAYA CHIKKANNI MALLAPPA CHIKKANNI 08.02.2014 1.30 PM

247 1871092348 YESHODA.S SAMPANGIRAMEGOWDA GOWDA 08.02.2014 1.30 PM

248 1871092976 RAJENDRA S 08.02.2014 1.30 PM

249 1881090320 SURAJ CHANNAPPA CHANDARAGI 08.02.2014 1.30 PM

250 1891090925 SHRIDHAR NAGALINGAPPA PATTAR 08.02.2014 1.30 PM

251 1811090461 JINDAWALI 08.02.2014 1.30 PM

252 1831091260 NARESH G 08.02.2014 1.30 PM

253 1901091134 BASAPPA HULIKERI HAYYALAPPA HULIKERI 08.02.2014 1.30 PM

254 1911090905 ASHOK KUMAR 08.02.2014 1.30 PM

255 1931091111 HONNAPPANAVAR ULLAS REDDY 08.02.2014 1.30 PM

256 1821090283 HEMANTHA MUKAPPARA 08.02.2014 1.30 PM

257 1851090031 VASAVI K K 08.02.2014 1.30 PM

258 1871090691 RAMESHA .B 08.02.2014 1.30 PM

259 1871091741 SOMASHEKHAR LAXMAN ULLIGERI 08.02.2014 1.30 PM

260 1871091777 SAGAR K S 08.02.2014 1.30 PM

261 1871120001 DEEPAK R 08.02.2014 1.30 PM

262 1811091677 RAJESH E 08.02.2014 1.30 PM

263 1811092049 SHAZIA NAAZ 08.02.2014 1.30 PM

264 1871092875 PRADEEP D G 08.02.2014 1.30 PM

265 1921090182 SUSHMA BALAKRISHNA KUTHOOR 08.02.2014 1.30 PM

266 1831090160 MAHESH SK 08.02.2014 1.30 PM

267 1831091225 DWARAKA R 08.02.2014 1.30 PM

268 1881050453 AKHILA K NAIK 10.02.2014 9.30 AM

269 1831050029 ANNAPURNA 10.02.2014 9.30 AM

270 1811051011 THIPPERUDRAPPA G 10.02.2014 9.30 AM

271 1871051543 VIJAY KRISHNA C 10.02.2014 9.30 AM

272 1871052797 SAGAR HK 10.02.2014 9.30 AM

273 2591050233 NAVEEN METHRE 10.02.2014 9.30 AM

274 1871052826 GIREESHKUMAR M R 10.02.2014 9.30 AM

275 1861050491 MAHADEVI S SONATHE 10.02.2014 9.30 AM

276 1871053950 THIPPESWAMY TH 10.02.2014 9.30 AM

277 1831050028 SHANTHAMMA Y T 10.02.2014 9.30 AM

278 1811050098 PRABHAKAR 10.02.2014 9.30 AM

279 1171057874 SUNIL KUMAR N 10.02.2014 9.30 AM



280 1841050921 SWATHIN SOORYA NAIK 10.02.2014 9.30 AM

281 1871052760 MADEV GOND 10.02.2014 9.30 AM

282 1811050947 RAVI 10.02.2014 9.30 AM

283 1811050977 JAYACHANDRA G 10.02.2014 9.30 AM

284 1821070634 NAGARAJA 10.02.2014 9.30 AM

285 1871050516 SHIVARAJ NAYAK 10.02.2014 9.30 AM

286 1921050086 KUMARA RAMA J R 10.02.2014 9.30 AM

287 1661054769 BHASKAR B A 10.02.2014 9.30 AM

288 1811050404 RAMEHSHA G 10.02.2014 9.30 AM

289 1811050958 DURUGAPPA MYAKAL 10.02.2014 9.30 AM

290 1861050490 ROOPA RAMCHANDRA KADADI 10.02.2014 9.30 AM

291 1871055129 MAHESH L 10.02.2014 9.30 AM

292 1831050399 NARESHA N 10.02.2014 9.30 AM

293 1811050985 KIRAN B 10.02.2014 1.30 PM

294 1861050622 VIJAYKUMAR NAGAPPA METHRE 10.02.2014 1.30 PM

295 1871050098 SAVITA P KANYAL 10.02.2014 1.30 PM

296 1931050210 PUSHPARANJINI C R 10.02.2014 1.30 PM

297 1821050035 PAVITHRA C 10.02.2014 1.30 PM

298 1831050139 MOHANKUMAR K V 10.02.2014 1.30 PM

299 1841050194 DEVANANDA B R 10.02.2014 1.30 PM

300 1871050482 VINAY KUMAR NAYAK M M 10.02.2014 1.30 PM

301 1901050134 SOMANNA 10.02.2014 1.30 PM

302 1811050990 CHANDRA SHEKAR M 10.02.2014 1.30 PM

303 1861050789 TANUJA 10.02.2014 1.30 PM

304 1821050760 SUNIL RAJ B M 10.02.2014 1.30 PM

305 1941050130 SHREERANGA GOVINDAPPA 10.02.2014 1.30 PM

306 1661011359 RAJESH 10.02.2014 1.30 PM

307 1811010078 CHAVAN MURALIDHAR 10.02.2014 1.30 PM

308 2661010631 POORNIMA R 10.02.2014 1.30 PM

309 1811010081 VIJAYAKUMARA J 10.02.2014 1.30 PM

310 1871013889 HITHAISH M 10.02.2014 1.30 PM

311 1901010100 SURESH BANDIWADDAR 10.02.2014 1.30 PM

312 1911010082 RAMESH KUMAR 10.02.2014 1.30 PM

313 1911010608 PUNITH C L 10.02.2014 1.30 PM

314 1871011415 YESHWANTH G 10.02.2014 1.30 PM

315 1861010554 VIVEK SHARMA 10.02.2014 1.30 PM



316 1871012539 KEERTHI KUMAR D 10.02.2014 1.30 PM

317 1871012194 MEGHANA M 10.02.2014 1.30 PM

318 1891010651 VAGEESH SHIVANAND HIREMATH 11.02.2014 9.30 AM

319 1931011485 RAJEEV RAVINDRA KALADGI 11.02.2014 9.30 AM

320 1881010526 ANAND KRISHNAJI ADAGAL 11.02.2014 9.30 AM

321 1911010858 MANJUNATH K 11.02.2014 9.30 AM

322 1871011334 RAHUL S TONSANAHALLI 11.02.2014 9.30 AM

323 1871013844 KUMARA T 11.02.2014 9.30 AM

324 1891010276 SNEHA DEVENDRAPPA BAJANTRI 11.02.2014 9.30 AM

325 1871013901 CHOWDAPPA SR 11.02.2014 9.30 AM

326 1891010104 NATARAJ CHIDANAND MEESHI 11.02.2014 9.30 AM

327 1931011492 ANUSH KUMAR T D 11.02.2014 9.30 AM

328 1871010436 RAGHU H S 11.02.2014 9.30 AM

329 1871011369 YOGESH T N 11.02.2014 9.30 AM

330 1871012742 MANJUNATH V S 11.02.2014 9.30 AM

331 1881010815 PRASHANT SHRIKANT BHARAMANNAVAR 11.02.2014 9.30 AM

332 1811010888 MARESHA Y 11.02.2014 9.30 AM

333 1821010714 ARUN KUMAR T 11.02.2014 9.30 AM

334 1911010330 NAGARAJ SHIVANAND SAVANUR 11.02.2014 9.30 AM

335 1931010785 SUDHARANI S 11.02.2014 9.30 AM

336 3021013467 RAJESH KADEMANI 11.02.2014 9.30 AM

337 1811011514 RAGHAVENDRA K B 11.02.2014 9.30 AM

338 1821010172 MADHUSUDHANA H A 11.02.2014 9.30 AM

339 1821010850 GOUTHAMI G 11.02.2014 9.30 AM

340 1831011186 NARESHKUMAR K V 11.02.2014 9.30 AM

341 1861010238 SHRUTI GUNDAPPA NULKAR 11.02.2014 9.30 AM

342 1871011424 CHANDRA SHEKAR.H.C 11.02.2014 9.30 AM

343 1871012708 PRADEEP M B 11.02.2014 1.30 PM

344 1871013533 SHALINI HOLIGI 11.02.2014 1.30 PM

345 1911010007 DEEPIKA C 11.02.2014 1.30 PM

346 1811011322 BALAMMA 11.02.2014 1.30 PM

347 1821010140 PRASHANTH H S 11.02.2014 1.30 PM

348 1861011178 ROHIT TIRMUKHE 11.02.2014 1.30 PM

349 1901010342 MAHENDRA KUMAR RATHOD 11.02.2014 1.30 PM

350 1841010672 DEEPAK K 11.02.2014 1.30 PM

351 1871015101 ROOPESH SHEKAR 11.02.2014 1.30 PM



352 1881010517 PRAKASH RATHOD 11.02.2014 1.30 PM

353 1891011134 VISHWANATH S SALOTAGI SHIVAYOGI SALOTAGI 11.02.2014 1.30 PM

354 1911010299 VINAYAK SURENDRA ADAGAL 11.02.2014 1.30 PM

355 1941010120 VRISHANKA M 11.02.2014 1.30 PM

356 1821011133 YOGISH T 11.02.2014 1.30 PM

357 1831010645 NAGAREDDY 11.02.2014 1.30 PM

358 1811010595 AMBIKA Y 11.02.2014 1.30 PM

359 1821010129 RAVIKUMAR 11.02.2014 1.30 PM

360 1831010273 SHVETHA K V 11.02.2014 1.30 PM

361 1861010103 KRISHNA MURTHY 11.02.2014 1.30 PM

362 1871011470 PRASHANTH N 11.02.2014 1.30 PM

363 1871013520 MADHURI B M 11.02.2014 1.30 PM

364 1871014870 VINAYA K N 11.02.2014 1.30 PM

365 1881010810 NITIN SHRAVANKUMAR KAMBLE 11.02.2014 1.30 PM

366 1901010097 MURAGHENDRASWAMY 11.02.2014 1.30 PM

367 1941010125 RAGHAVENDRA GAJANAN MOGER 11.02.2014 1.30 PM

368 1821011123 S S NAIK 12.02.2014 9.30 AM

369 1871011485 MANU B 12.02.2014 9.30 AM

370 1871012650 VENKATESH BABU 12.02.2014 9.30 AM

371 1871013851 KISHAN V 12.02.2014 9.30 AM

372 1881010426 VEENA ASHOK RAYANNAVAR 12.02.2014 9.30 AM

373 1901010087 RAGHAVENDRA AMARACHINTA 12.02.2014 9.30 AM

374 1931010110 SHASHIKANTH SOMALING KAMBLE 12.02.2014 9.30 AM

INTERVIEW ON :

Head Office, Post Box No.55,

Gandhinagar, BELLARY 583 103

Phone: (08392) 236404, Fax 256886: email: [email protected]

(

BIO-DATA FORM

[To be filled in by the candidate in his/her own handwriting and submitted in 5 copies (1 original + 4 xerox copies). Please read the instructions carefully before filling up this form]

Roll Number :

Post for which called for Interview :

1

Name in full [In Block letters] :

2 Date of Birth and Age : Day Month Year Age :

3 Place of Birth :

4 Native Place : Taluk :

District : State :

5 Father’s / Husband’s Name :

(Strike out which is not applicable)

6 Nationality : Religion :

7 Category : [Please tick whichever is Applicable]

SC ST OBC GEN Persons With

Disabilities Ex Service

Man OC HI VI

8 a]

Permanent Address [in block letters]

b] Communication Address [in block letters]

Pin : Pin :

Phone Res :

Phone Res :

Cell : Cell :

E-mail : E-mail :

….Contd.Pg.2.

Please affix here a recent passport size

photo and sign across it.

….Page.2….

9 Whether you are :

A] A member of Scheduled Caste : YES / NO If YES, furnish sub-caste

B] A member of Scheduled Tribe : YES / NO If YES, furnish sub-caste

C] A member of Other Backward Class : YES / NO If YES, furnish sub-caste

D] In case you belong to SC / ST / OBC category, indicate the serial number of Sub-caste as appearing in the Central Government list

:

E] An Ex-Servicemen / Disabled Ex-Servicemen : YES / NO

If YES, No. of years of service put in Defence Services, date of discharge with reasons

:

F] Orthopaedically Disabled : YES / NO If YES, furnish % of disability

G] Visually Disabled : YES / NO If YES, furnish % of disability

H] Hearing Impaired : YES / NO If YES, furnish % of disability

NOTE: Indicate whichever is applicable. A certificate in original from the Competent Authority should be produced in the case of candidates belonging to Scheduled Castes, Scheduled Tribes and Other Backward Classes [as per the proforma enclosed]. OBC Certificate should be of issued on or after 01.04.2013. In the event of conversion or re-conversion to Hindu or Sikh religion, adequate evidence including a copy of the relevant gazette notification and also other documentary evidence should be furnished. In the case of Ex-servicemen, Discharge Certificate issued by the concerned authority should be produced. In case of Persons With Disabilities, sufficient documentary evidence including the medical certificate issued by the Competent Authority should be necessarily produced.

10

Whether attended Pre-examination training course, conducted by the Bank [applicable to SC/ST/MC category candidates]. If YES, please furnish the name of the centre.

:

11

Marital Status : [Single / Married / Widowed / Divorced / Legally Separated]

12

State the number of persons, who are dependent on you for support [Parents, Wife / Husband, Children, Brothers/Sisters, Others]

:

Name of dependent Age Relationship Occupation Income

Contd..3…

..3…

13

Educational Qualification [Full particulars from X Std onwards to be given. If space is not sufficient furnish in annexure]

Certificate/ Degree / Diploma

obtained

School / College / University / Board

Period From … To……

Principal & Optional subjects studied N

o.o

f

att

em

pts

Cla

ss &

Ra

nk

ob

tain

ed

Pe

rce

nta

ge

of

ma

rks

ob

tain

ed

Prizes / Scholarship

s & other distinctions obtained if

any

X STD

Kannada as one of the subjects in X Std : YES / NO

+2/ PUC

Graduation (Indicate name of the degree):

1)

2)

P G (Indicate name of the PG Degree):

1)

2)

Computer Course.

Others if any (Indicate name of the course):

14 Details of Computer course/knowledge

Please mark the discipline

i] MS DOS / MS Windows :

ii] Basic concepts of Networking & Connectivity

:

iii] MS Office :

iv] Others [Furnish details] :

...4....

15

Work experience [Details of all previous employments, whether temporary or permanent including the present employment, if any, are to be given. If space is not sufficient furnish in annexure]

Name and address of the

employer

Job title / Designation

Period of Employment Salary Job nature

Reasons for

leaving From To

16 a] Mother Tongue :

b]

Languages Known : To Speak :

To Read :

To Write :

17

Particulars of participation in Sports, Athletics, Scouts, NCC, Debates, Dramas or other Extra-Curricular activities in School, College and elsewhere

:

18 Hobbies and other interests :

19 a] Have you ever been arrested, prosecuted, kept under detention or bound down / fined / convicted by a Court of Law or whether any case is pending against you in a Court of Law? If yes, give full details

:

b]

Have you ever been debarred / disqualified by any institution from appearing at its examination / selection or debarred in any manner from any examination or rusticated by any University or any other educational authority / Institution ? If yes, give full details

:

c] Is any case pending against you in any University or any other educational authority / Institution at the time of filling up this form? If yes, give full details

:

d]

Has any case been filed against you at present or in the past by any Bank, Insurance Company etc., for non-payment of any loan taken from them ? If so, please give details

:

..5..

20 a]

In case you are / were an employee of the Government/ Public Sector / Nationalized Bank/ Municipal Corpn.,/ Private Sector Organization, please state whether there is any disciplinary case pending against you or whether any disciplinary case was taken against you during the last 3 years of your service. If so, please give details

:

b]

Were you ever removed, discharged/dismissed/made to resign from such service in the past? If so, please give details.

:

21

Please furnish Name, Occupation and address of TWO respectable persons, NOT related to you, to be given as reference

1]

Name : Occupation : Address :

2]

Name : Occupation : Address :

22 In case you are selected, how soon you can join :

23

Additional information if any, which you wish to furnish

:

The following are to be enclosed in the same order

A. CERTIFIED TRUE COPIES OF :

a) Printout of the online application with a recent passport size photograph affixed on it. b) Score Card of Common Written Examination (CWE-II) for RRBs conducted by IBPS during

September/October-2013. c) X std examination mark sheet in support of local language proficiency i.e., Kannada. d) Attested copy of school leaving certificate or any other document as proof of age acceptable to

the Bank. e) Marks Card/Sheet from X std examination to the highest examination passed, including

technical and professional examinations of each year / semester, if any in support of educational qualification including computer course.

f) Certificate regarding graduation / post-graduation /Computer Course/ other examinations passed.

g) Caste certificate issued by the Competent Authority in the prescribed format as per the proforma enclosed in the case of SC/ST/OBC candidates.

h) Medical certificate from the authorized Certifying Authority – i.e., Medical Board appointed by the State Govt. at District levels comprising of Chief Medical Officer / Sub-Divisional Medical Officer/s in the District and an Orthopedic / Ophthalmologist / ENT Surgeon as the case may be, in the case of candidates belonging to Persons With Disabilities category.

i) Service/Discharge certificate issued by the Competent Authority in the case of Ex-servicemen.

...6... j) Experience Certificate/s from the employer/s regarding present and previous employment

(Essential Experience for Officer Scale-II – Minimum of two years as an Officer in any Bank or Financial institution.)

k) Photo identity proof such as PAN Card/Passport/Driving Licence/Voters Card/Bank pass book with photograph/Photo identity proof issued by a Gazetted Officer/Identity card issued by a recognized College/University/Adhar Card with photograph/Employee ID.

l) Testimonials regarding proficiency in Curricular/Extra-curricular activities, if any.

B. ORIGINAL CERTIFICATES /DOCUMENTS:

1. No Objection Certificate from the employer in the case of candidates working. 2. Character certificate from two respectable persons not related to you, obtained on a recent

date. 3. Caste Certificate issued by the Competent Authority. 4. Printout of online application submitted with recent passport size photograph affixed on it.

I ____________________________________________ hereby declare that the above statements are true, complete and correct and also that no facts have been suppressed. It is understood that employment, if any, offered to me is based upon the truthfulness of the statements made herein and in the event of any information being found false or incorrect at a later date, my appointment is liable to be terminated. I further state that, if selected, I am willing to be posted to any of the branch/office of the Bank.

DATE :

PLACE : SIGNATURE OF THE CANDIDATE

FOR OFFICE USE

Certificates Scrutinized by

Name & Staff No :

Designation :

Office Address :

Date : Signature :

FORM OF CERTIFICATE TO BE PRODUCED BY A CANDIDATE BELONGING TO SCHEDULED CASTE OR SCHEDULED TRIBE IN SUPPORT OF HIS / HER CLAIM.

(Form of Certificate as prescribed in MHA., O.M No. 42/21/49-N.G.S, dated 28.01.1952 as revised in Dept. of Per. & A.R. Letter No. 36012/6/76-Estt.(S.C.T), dated 29.10.1977, to be produced by a candidate belonging to a Schedules Caste or Scheduled Tribe in support of the claim)

1.This is to certify that Sri*/Smt*/Kum*_______________________________________________

son*/ daughter* of______________________________________________________ of village*/

town* ____________________________ in District*/ Division*_______________________of the

State*/ Union Territory*__________________belongs to the __________________________

Caste*/Tribe* which is recognized as a Scheduled Caste*/ Scheduled Tribe*

under :

The Constitution ( Scheduled Castes) Order, 1950 ;

* The Constitution ( Scheduled Tribes) Order, 1950 ;

* The Constitution (Scheduled Castes)(Union Territories)Orders, 1951 ;

* The Constitution (Scheduled Tribes)(Union Territories)Order, 1951 ;

[as amended by the Scheduled Castes and Scheduled Tribes lists (Modification Order),1956, the Bombay Reorganisation Act, 1960, the Punjab Reorganisation Act 1966, the State of Himachal Pradesh Act, 1970, the North-Eastern Areas (Reorganisation)Act, 1971,and the Scheduled Castes and Scheduled Tribes Orders (Amendment) Act,1976]:

* The Constitution (Jammu and Kashmir) Scheduled Castes Order,1956 ;

* The Constitution (Andaman and Nicobar Islands) Scheduled

Tribes Order, 1959 as amended by the Scheduled Castes and Scheduled

Tribes Orders (Amendment) Act, 1976 ;

* The Constitution (Dadra and Nagar Haveli) Scheduled Castes Order, 1962 ; * The Constitution (Dadra and Nagar Haveli) Scheduled Tribes Order, 1962 ; * The Constitution (Pondicherry) Scheduled Castes Order 1964; * The Constitution (Uttar Pradesh) Scheduled Tribes Order,1967; * The Constitution (Goa, Daman and Diu) Scheduled Castes Order, 1968 ; * The Constitution (Goa, Daman and Diu) Scheduled Tribes Order, 1968 ; * The Constitution (Nagaland) Scheduled Tribes Order, 1970 ; * The Constitution (Sikkim) Scheduled Castes Order, 1978 ; * The Constitution (Sikkim) Scheduled Tribes Order, 1978 ; * The Constitution (Jammu and Kashmir) Scheduled Tribes Order, 1989 ; * The Constitution (Scheduled Castes) Orders (Amendment)Act, 1990; * The Constitution (Scheduled Tribes) Orders (Amendment) Ordinance, 1991 ; * The Constitution (Scheduled Tribes) Orders (Second Amendment) Act,1991 ; * The Constitution (Scheduled Tribes) Orders (Amendment) Ordinance, 1996.

………2

:: 2 :: 2** This certificate is issued on the basis of the Scheduled Castes*/ Scheduled Tribes*

Certificate issued to Shri*/ Smt* / Kumari* _________________________________________

Father* /Mother* of Sri*/Smt*/ Kumari*_______________________________________________of

village*/town*______________________in District*/Division*____________________of the

State*/Union Territory*____________________________________________ who belong to

the______________________ Caste*/ Tribe* which is recognized as a Scheduled

Caste*/Scheduled Tribe* in the State*/Union Territory* issued by the

____________________________________ dated _______________________.

3.Shri*/Smt*/Kumari*___________________________________________and/or* his*/her* family

ordinarily reside(s) in village*/town*__________________________ of____________________

Disctict*/ Division* of the State*/ Union Territory* of _____________________

Signature _____________________

Designation ___________________

Place : [With seal of Office] Date : State/Union Terriroty Note : The term "Ordinarily resides" used here will have the same meaning as in Section 20 of the Representation of the Peoples Act, 1950. --------------------------------------------------------------------------------------------------------------------------------------- * Please delete the words which are not applicable. **Applicable in the case of SCs, STs persons who have migrated from one State/Union Territory. List of authorities empowered to issue Caste / Tribe Certificates : 1. District Magistrate / Additional District Magistrate / Collector / Deputy Commissioner / Additional

Deputy Commissioner / Deputy Collector/I Class Stipendiary Magistrate / Sub-Divisional Magistrate / Extra-Asst.Commissioner / Taluka Magistrate / Executive Magistrate.

2. Chief Presidency Magistrate/ Additional Chief Presidency Magistrate / presidency Magistrate. 3. Revenue Officer not below the rank of Tehsildar. 4. Sub-Divisional Officers of the area where the candidate and / or his family normally resides.

-- -- --

FORM OF CERTIFICATE TO BE PRODUCED BY

OTHER BACKWARD CLASSES APPLYING FOR APPOINTMENT TO POSTS UNDER THE GOVERNMENT OF INDIA

(G.I.Dept of Per & Trg. O.M.No.36033/28/94-Estt (Res), dated 2-7-1997)

This is to certify that_____________________________________________Son/Daughter

of______________________________ of _______________________________ village/Town of

______________________District/Division in ___________________________ State belongs to

______________________________community which is recognized as a Backward Class

under:

[i] Resolution No.12011/68/93-BCC[C], dated the 10th September, 1993, published in the Gazette of India, Extraordinary, Part-I, Section-1 No.186, dated the 13th September 1993.

[ii] Resolution No.12011/9/94- BCC [C], dated the 19th October, 1994, published in the Gazette of India, Extraordinary, Part-I, Section-1 No.163 dated the20th October 1994.

[iii] Resolution No. 12011/7/95-BCC [C], dated the 24th May 1995, published in the Gazette of India, Extraordinary, Part-I, Section-I No.88, dated the 25th May 1995.

[iv] Resolution No.12011 / 96 / 94 - BCC, dated 9th March 1996. [v] Resolution No.12011/44/96- BCC[C], dated the 6th December 1996, published in the Gazette of

India, Extraordinary Part-I, Section-1 No.210, dated the 11th December 1996. [vi] Resolution No.12011 / 13 / 97 - BCC, dated 3rd December 1997. [vii] Resolution No.12011/99/94-BCC, dated 11th December 1997. [viii] Resolution No.12011/68 /98-BCC, dated 27th October 1999. [ix] Resolution No.12011/88/98-BCC, dated 6th December 1999 published in the gazette of India.

Extraordinary Part-I, Section-I, No.270, dated 6th December, 1999. [x] Resolution No.12011/36/99-BCC, dated 4th April 2000, published in the Gazette of India.

Extraordinary Part-I, Section-I, No.71, dated 4th April, 2000. [xi] Resolution No.12011/44/99-BCC, dated 21-9-2000, published in the Gazette of India,

Extraordinary Part-I, Section-I, No.210 dated 21-9-2000.

Sri__________________________ and/or his family ordinarily reside[s] in the _______________

District/Division of the________________ State. This is also to certify that he/she does not

belong to the persons /sections [Creamy Layer] mentioned in column 3 of the Schedule to the

Government of India, Department of Personnel & Training OM No.36012/22/93- Estt.[SCT],

dated 8-9-1993.

Dated : District Magistrate or Seal : Deputy Commissioner, etc

………….2

:: 2 :: NB: (a) The term "Ordinarily" used here will have the same meaning as in Section 20 of the Representation of the Peoples Act, 1950. (b) The authorities competent to issue Caste certificates are indicated below: i] District Magistrate / Additional Magistrate / Collector / Deputy Commissioner / Additional Deputy Commissioner / Deputy Collector / First Class Stipendiary Magistrate / Sub-Divisional Magistrate / Taluka Magistrate / Executive Magistrate / Extra Asstt. Commissioner [not below the rank of First Class stipendiary Magistrate]. ii] Chief Presidency Magistrate / Additional Chief Presidency Magistrate / Presidency Magistrate. iii] Revenue Officer not below the rank of Tehsildar; iv] Sub-Divisional Officer of the area where the candidate and/or his family resides.

-- -- --

DECLARATION BY THE CANDIDATE SEEKING RESERVATION AS OBC

“I, _______________________________________________________ Son/daughter of Shri

_____________________________________________________________ resident of

village/town/city ______________________ district___________________ state

___________________ hereby declare that I belong to the ______________________ community

which is recognised as a backward class by the Government of India for the purpose of reservation in

services as per orders contained in Department of Personnel and Training Office Memorandum No.

36012/22/93-Estt (SCT), dated 08.09.1993. It is also declared that I do not belong to persons/sections

(Creamy Layer) mentioned in column 3 of the Schedule to the above referred Office Memorandum,

dated 08.09.1993.”

Place :

Date : (Signature )

DISABILITY CERTIFICATE

Annexure-1 to O.M. dated 29.12.2005

Name and address of the Institute/Hospital:

Certificate No : Date:

1. This is to certified that Sri/Smt/Kum __________________________ Son/Wife/daughter of Sri

__________________________________ age _______ Sex _______identification mark(s)

______________________________________________________________

_____________________________________________________________________is suffering

from permanent disability of following category:

A. Locomotor or cerebral palsy:

i. BL – Both legs affected but not arms.

ii. BA – Both arms affected (a) Impaired reach.

(b) Weakness of grip

iii. BLA – Both legs and both arms affected.

iv. OL – One leg affected (right to left) (a) Impaired reach.

(b) Weakness of grip.

(c) Ataxic

v. OA – One arm affected (a) Impaired reach.

(b) Weakness of grip.

(c) Ataxic.

vi. BH- Stiff back and hips (Cannot sit or stoop).

vii. Mw – Muscular weakness and limited physical endurance.

Recent Phtograph of

the candidate showing

the disability duly

attested by the

Chairperson of the

Medical Board.

..2..

B. Blindness of low vision:

i. B-Blind.

ii. PB – Partially Blind.

C. Hearing impairment:

i. D-Deaf.

ii. PD – Partially Deaf.

(Delete the category whichever is not applicable).

2. This condition is progressive/non-progressive/likely to improve/ not like to improve. Re-

assessment of this case is not recommended/ is recommended after period of _____ years _______

months. (Strike out which is not applicable)

3. Percentage of Disability in his/case is _____ percent.

4. Shri/Smt/Kum ________________________________________________ meets the following

physical requirements for discharge of his/her duties.

i. F- can perform the work manipulating with fingers. Yes/No.

ii. PP- can perform the work by pulling and pushing. Yes/No.

iii. L- can perform the work by lifting Yes/No.

iv. KC- can perform the work by kneeling and crouching Yes/No.

v. B- can perform work by bending. Yes/No

vi. S- can perform work by sitting. Yes/No

vii. ST- can perform work by standing. Yes/No

viii. W- can perform work by walking Yes/No

ix. SE- can perform work by seeing. Yes/No

x. H- can perform work by hearing/speaking Yes/No

xi. RW- can perform work by reading and writing Yes/No

(Dr________________________) (Dr_______________________)

Member Member

Medical Board Medical Board

(Dr________________________)

Member

Medical Board

Countersigned by

Medical Superintendent/CMO/Hc Hospital with seal

* Strike out which is not applicable.

Documents

PRAGATHI KRISHNA GRAMIN BANKpragathikrishnabank.com/kannada/images/PDF/s1.pdf · photograph/Photo identity proof issued by a Gazetted Officer/Identity card issued ... Character Certificate