17041

Registration #: 3025511 Please paste your

recent passport
size photograph
Full Name : VIJAY BHARGAV VARRI
and sign across it.
Please retain
Category OBC
atleast 5 copies
with you for
If Physically Challenged: NO subsequent use.
Whether domiciled in Kashmir Division of the State of J&K during the period 1-1-1980 to 31-12-1989 : NO
Ex-Serviceman : NO
Are you a Dependent of an Ex-Serviceman (DXS)? : NO
Are you seeking relaxation under window / divorced women / women judicially Separated from their
NO
husbands and who are not re-married?:
Domicile of Andhra Pradesh: YES
Nationality: INDIA
Center of Examination : VIZIANAGARAM Center Code : 17
Application Fee/ Postal Charges Details:-
Payment In : ANDHRA PRADESH GRAMIN VIKAS BANK
Transaction ID : 0205785
Branch Name : APGVB JAMI
Branch Code: 2219
Deposit Date : 06/01/2011
Amount : 280
Personal Details:
Date Of Birth : 07/07/1989
Age completed as on 01.09.2010 : 21
Gender : MALE
Husbands / Fathers Name: SATYANARAYANA
Mothers Name: MANGA DEVI
Address for Correspondence: VIJAY BHARGAV VARRI
S/O SATYANARAYANA
SANTHAPETA VEEDHI JAMI
District VIZIANAGARAM 535250
State: ANDHRA PRADESH Pincode: 535250
Permanent Address: VIJAY BHARGAV VARRI
S/O SATYANARAYANA
SANTHAPETA VEEDHI JAMI
District VIZIANAGARAM 535250
State: ANDHRA PRADESH Pincode: 535250
Contact Details:
E-mail ID: vijaybhargav47@gmail.com
STD Code. 0896 Phone No. 278552
Mobile No: 9959032487

Qualification Details(as on 01.09.2010):

Exams Passed Subjects/Streams Year Of Passing % Of Marks
SSC/Equivalent : MATHES 2004 74.00
HSC/Equivalent : MPC MATHES 2006 68.00
Graduation/Equivalent : B-TECH CH 2010 54.00
Working Knowledge of Computers: YES
Other Details:
Would You like to undergo Pre-Exam Training (SC/ST/EXS/DISXS/DXS): NO
Languages Known Read Write Speak
TELUGU YES YES YES
ENGLISH YES YES YES
DECLARATION:

I hereby certify that the above information furnished is correct to the best of my knowledge and belief. I have not
suppressed any material fact or factual information in the above statement. 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/ service terminated even after permanent employment without
giving any notice or reasons thereof.

I hereby certify that I am satisfying the eligibility criteria for the post applied for in terms of advised criteria in respect
of age, caste, educational qualification etc.

I hereby agree that any legal proceeding in respect of any matter or claims or disputes arising out of application or
out of said advertisement can be instituted by me only at Raipur and courts/ Tribunal/ forums at Raipur only, shall have
sole and exclusive jurisdiction to any cause/ dispute. I undertake to abide by all the terms and conditions in the
advertisement given by the Bank.
Place:
Date: 07/01/2011 Signature of Applicant:

VIJAY BHARGAV VARRI

Please retain your Registration No. and Password emailed to you carefully for further reference.
NOTE: APPLICATION PRINT-OUT NEED NOT BE SENT TO THE BANK