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IDBI BANK - RECRUITMENT OF EXECUTIVE (ON CONTRACT)

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Registration # : Full Name : Category : Name of Caste/ Tribe/Class : Name of State issuing Caste Certificate : Certificate Issued By : Date Of Issue Of Certificate : Certificate No. : If Person With Disability : Type of Disability : Percentage of Disability :

1063948
Shri HAREKRUSHNA SAHOO OBC GUDIA ORISSA TAHASILDAR SALIPUR 11/06/2012 272 NO -

Do you intend to use the services of a scribe (only for VH & OH candidates whose writing speed is affected by cerebral palsy) : NA Whether domiciled in Kashmir Division of the State of J & K during the period 1-1-1980 to 31-12-1989? The Children/Family Members of those who died in 1984 Riots : Are you an Ex-Employee of banking institutions : Are you an Ex-Serviceman? Are you a Short Service Commissioned Officers? Are you an Emergency Commissioned Officers? Whether you belong to Religious Minority Community? Religion to which you belong : Nationality : Place of Birth : District : State : Centre for Written Test : Centre Code : Application Fee / Postal Charges Details : Payment In : Transaction ID/Journal No. : Branch Name : Branch Code No. : Deposit Date( 10.07.2012 - 23.07.2012) : Amount : IDBI 10STFRECO97620 COLLEGE SQUARE 0217 20/07/2012 400 NO NO NO NO NO NO NO INDIAN NANDOL CUTTACK ORISSA Bhubaneswar 14

Personal Details :
Date of Birth (As per School Leaving Certificate SSLC/SSC) : Age completed as on 01-06-2012 (i.e upto & inclusive of 31-05-2012) : Gender : Marital Status : Father's Name/ Husband's Name : Email ID : 05/04/1987 25 MALE Single UPENDRA SAHOO harekrushna277@gmail.com

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Address for Correspondence : Flat no. / Building name and No : Road/ Street name : Locality : Town and City : State : Pin : Permanent Address : Flat no. / Building name and No : Road/ Street name : Locality : Town and City : State : Pin : AT-NANDOL P.O-BHATAPADA VIA-BAHUGRAM CUTTACK ORISSA 754200 C/O-RADHANATH MISHRA JOBRA NUASAHI COLLEGE SQUARE CUTTACK ORISSA 753003

Contact Details :
Phone No : Mobile No : 9090278658

Qualification Details (as on 01-06-2012 i.e upto & inclusive of 31-05-2012) :

Exam Passed
High School (Class 10th) Intermediate (Class 12th) Graduation

Name Of the Institution/University


B.S.E C.H.S.E UTKAL UNIVERSITY

Subject/Stream

Specialisation

Month/Year Of Passing
11-2002 07-2004 07-2007

% of Marks

FLO,SLE,TLS,SCP,SCL, ARTS ARTS

N.A N.A ECONOMICS

50.00 40.00 40.00 YES PGDCA

Knowledge of Computer : Details of Computer Knowledge : Post Qualification work experience details (Start from present Employer) : No Experience Total Experience (in months) : Have your services ever been terminated either from IDBI Bank (in case of ex-staff candidates) or from any of your previous employer (s)? Have you ever been subjected to any disciplinary proceedings or penalties by your previous employer(s)? Have you ever been arrested for any reason or convicted or committed to prison or adjudicated insolvent? Are you presently being prosecuted for any criminal act? Is there any case pending against you? Other Details : Whether desirous of taking Pre-Exam Training : If yes, Centre for training :

NO NO NO NO NO

NA -

Languages Known
ENGLISH HINDI ODIA

Read
YES YES YES

Write
YES YES YES

Speak
YES YES YES

DECLARATION:
I hereby certify that the information furnished above is correct 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 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 the advertised criteria in respect of age, educational qualification etc. 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: 23/07/2012 Signature of Applicant

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Name: HAREKRUSHNA SAHOO

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