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ON-LINE APPLICATION FOR SPECIALIST OFFICERS

26034

Registration # :

84329

Full Name:

Vishal Raj

Post : Post Code : Category : If Person with Disability : Type of Disability : Percentage of Disability : Do you intend to use the services of a scribe(only for VI and OC both hands affected by cerebral palsy) ? :

Dy. Manager (IT) JMGS I 07 GENERAL NO NA

Whether Children/Family members of those who died in 1984 riots ?: NO Whether domiciled in Kashmir Division of the State of J & K during the period 1-1-1980 to 31-12-1989?: Whether you belong to Religious Minority Community? : Minority Religion : Are you an Ex-Serviceman ? : Period of Service(in months) : Whether applied for another post ? : Name the additional Post applied for ? : Nationality: Centre of Examination : Centre code : Application Fee / Postal Charges Details : Transaction ID : Branch Name : Branch Code : Deposit Date : Amount : M274778 Vashi 350200 13-07-2011 400 Indian Mumbai 14 NO NO NO -NO

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Personal Details : Date of Birth: Age completed as on 01.01.2011 : Gender : Husband's Name/Father's Name : Mother name: Address for Correspondence : 22-07-1985 25 MALE Bipin Biahri Prasad Ratna Raj Flat Number-5 Sri Ganesh Apartment B-wing Plot Num-68A Sec-4A Koperkharaine Navi-mumbai District State : Pin : Permanent Address : Thane MAHARASHTRA 400709 C/o Ras Bihari Prasad Ram-nagar Kadma Road Hazaribagh District State : Pin : Contact Details: Phone No : Mobile No: Email ID : Qualification Details (as on 24.06.2011): Exams Passed Graduation : Certifications : PG Programme (2 years) in Banking & Finance from NIBM : Do you have Sub-Officer Course from National Fire Service College,Nagpur ? : Working Knowledge of MS Office : YES Stream B.Tech Subject / Stream Electronics Year of Passing 2008 Others-Juniper NO % of Marks 71.00 Class Grade First Class 9320194926 vishalraj126@sify.com Hazaribagh JHARKHAND 825301

Post Qualification work experience details as on 24.06.2011 (Start from present Employee): Name of the Employer / Nature of Employment Reliance communica tion Teamlease Network Engineer 02/2010 06/2011 Network configurat ion and monitorin Network monitoring not applicable Designation and Rank From(mm/yyyy) To(mm/yyyy) if any Nature of Duties Performed Reason for Leaving Years of Service (YY/MM) 1/4

Resident Engineer

10/2008

02/2010

career progress

1/4

Total Relevant Experience ( in months) : Other Details : Languages Known English Read YES

31

Write YES

Speak YES

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Hindi 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 New Delhi and courts/ Tribunal/ forums at New Delhi 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: 14-07-2011 Signature of Applicant

Vishal Raj
Please retain your Registration No. and Password emailed to you carefully for further reference