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IDBI BANK - SPECIAL RECRUITMENT DRIVE

ONLINE APPLICATION FORM FOR THE POST OF ASSITANT MANAGER / MANAGER / ASSITANT GENERAL MANAGER

Please check Print Preview in A4 size Portrait format with 0.25" margin from all sides (Click to Print)

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Registration # : 148456 Please paste your recent

passport size photograph
and sign across it. Please
retain atleast 5 copies of
First Name : Shri SHYAM
same photograph with you
for subsequent use.

Middle Name : JEET

Last Name : SHAHI

Post : Assistant Manager - Grade 'A'

Post Code : 01
Category : SC
Name of Caste/ Tribe/Class: KORI
Name of the State where Certificate Issued: UTTAR PRADESH
Certificate Issued By SDM
Date Of Issue Of Certificate 20/06/2009
Certiifcate No. : 47409401291

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 candidates whose writing -
speed is affected by cerebral palsy)? :
Are you candidate who had ordinarily been
domiciled in Kashmir Division of the State of J & K NO
during the period 1-1-1980 to 31-12-1989?
The Children/Family Members of those who died in 1984 Riots: NO
Whether Permanment Staff Of IDBI Bank Ltd. : NO

Ex-Employee of banking Institute NO

Whether you belong to Religious Minority Community? NO

Religion to which you belong : -

Are you an Ex-Serviceman ? NO

Total Period of Service as Exserviceman (in months) -

Nationality : INDIAN

Place of Birth : LUCKNOW

District : LUCKNOW
State : UTTAR PRADESH

Centre for Written Test and Personal Interview : Kanpur Centre code : 20

Application Fee / Postal Charges Details :

Payment In : IDBI
Transaction ID / Challan No.: 10STFREC047116

Branch Name : INDIRA NAGAR

Branch Code : 277

Deposit Date 15/10/2010

Amount : 75
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Personal Details :
Age as on 01.09.2010 (i.e
Date of Birth (As per School Leaving
24/08/1986 upto & inclusive of 24years,0months,7days
Certificate SSLC/SSC) :
31/08/2010):
Gender : MALE

Marital Status : Single

Father's Name/ Husband's Name : RAMJEET SHAHI

Contact Details:
Email ID : shyam.jeet66@gmail.com

Address for Correspondence :

Flat no. / Building name and No FLAT NO 006 GYAN-GANGA APARTMENTS

Road/ Street name : FAIZABAD ROAD

Locality : NEAR NEW-HYDERABAD

Town and City : LUCKNOW

State : UTTAR PRADESH Pin : 226007

Permanent Address :

Flat no. / Building name and No 4/2/17

Road/ Street name : STATION ROAD

Locality : JALWANPURA

Town and City : AYODHYA FAIZABAD

State : UTTAR PRADESH Pin : 224123

Phone No : 0522-4005750 Mobile No : 9838534087

Qualification Details (as on 01.09.2010 i.e upto & inclusive of 31/08/2010) :

Exams Passed Name Of the Subject /Stream Specialisation Month/Year of % of Marks

Institution/University passing
INTEGRAL COMPUTER COMPUTER
Graduation : 08/2008 76.00
UNIVERSITY APPLICATION APPLICATION

Knowledge of Computer: YES

Post Qualification work experience details as on 01.09.2010 i.e upto & inclusive of 31/08/2010 (Start from present Employment):

No Experience

Total Relevant Experience as an Officer with a Commercial Bank

-
(in months) ?
Have your services ever been 'terminated' either from IDBI Bank
(in case of ex-staff candidates) or from any of your previous NO
employer(s)?

If yes, give the reason for the same -

Have you ever been subjected to any disciplinary proceedings or

NO
penalties by your previous employer(s)?

If Yes, Give details of the same -

Have you ever been arrested for any reason or convicted or

NO
committed to prison or adjudicated insolvent?

If Yes, Give details of the same -

Are you presently being prosecuted for any criminal act? NO

If Yes, Give details of the same -

Other Details
Whether desirous of taking Pre-Exam Training (SC/ST) : YES

If yes Centre for Training : Kanpur

Languages Known Read Write Speak

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ENGLISH YES YES YES
HINDI YES YES YES

DECLARATION:
I hereby certify that the information furnished above is true and accurate to the best of my knowledge and belief. I have not suppressed any
material fact or factual information in the above statements. I am aware, that, in case, I have given wrong information or suppressed any material fact or factual
information, or I do not satisfy the eligibility criteria according to the advertisement, then my candidature will be rejected/services terminated forthwith even after
permanent employment without giving any notice or reasons thereof.

I also understand that if I do not fulfill the eligibility criteria as stipulated in the advertisement, Bank would not call me for Written Test/Interview,
without any further communication. I agree that the Bank has a right to attach/shift me to any of the branches / offices/ business units/ departments of the
Bank/ Bank's associate institutions anywhere in India/abroad.

I undertake to abide by all the terms and conditions in the advertisement given by the Bank. I hereby agree that any legal proceedings in respect
of any matter(s) or claims or disputes arising out of this application and/or out of said advertisement can be instituted by me only at Mumbai and
Courts/Tribunals/Forums at Mumbai 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: 17/10/10 Signature of Applicant

Name: SHYAM
NOTE:
Candidate must submit at the time of interview, the offer letter (s), appointment letter(s), relieving letter(s) as well as the experience
certificate(s) of all the previous employer(s) and the offer letter, appointment letter alongwith the recent pay slip of the present
employer, as declared above. Non submission of even one of these documents will render the candidates ineligible for the Personal
Interview. No undertaking or additional time for sumission will be entertained for the same.
Please retain your Registration No. and Password emailed to you carefully for further reference.
NOTE: Please DO NOT SEND application print-out to the Bank