REG: - RECRUITMENT OF ONE GENERAL MANAGER (IT), TWO CHIEF MANAGERS (IT) AND TWO CHIEF MANAGERS (RISK

MANAGEMENT) IN THE BANK *****

To, General Manager (HRD) Punjab & Sind Bank Bank House, 6th Floor 21- Rajendra Place New Delhi -110008

Paste Passport size Photograph & sign across the Photograph

With reference to your advertisement, appeared in the _______________(news paper) on _______________ (date) & on the Banks website for the captioned post, I submit my application in prescribed format for the post of _______________________________________________(name of the post applied for)

PERSONAL DETAILS
1 2 3 4 5 6 Name (In full) Gender Fathers/Husbands Name Date of birth Age in years as 31/12/2012 Address correspondence

on for

8 8A

8B

9 10 11

Permanent address (if same as (6), write SAME) Category (GEN/SC/ST/OBC/PWD) In case OBC, whether Creamy layer/ NonCreamy Layer Person with disability (PWD): Y/N If Y : Type of disability Percentage of disability Nationality Religion Marital status If married, Name of spouse Age Childrens name & age

1. 2.

FEE DETAILS
Draft Number Date Bank branch

EDUCATIONAL/PROFESSIONAL QUALIFICATION (GRADUATION & ABOVE) -AS ON 31.12.2012

Qualification Board/ University Full/ Part time Year of Passing % Marks (up to two decimals) Subject (compulsory)

NOTE: Please give complete details (particularly of subjects) and use separate sheet in case space is inadequate. Duly attested (by a Gazetted Officer) photocopies of all educational & professional qualification certificate to be furnished

EXPERIENCE (AS ON 31.12.2012)

Sr. No. Name of the Organization Designation From-To (mention dates) Responsibilities / Project undertaken *
Extra Ordinary achievements

*NOTE: Please give complete details (particularly of Responsibilities/Projects undertaken, extra ordinary achievements) and use separate sheet for the said purpose

CURRENT EMPLOYMENT DETAILS

Name Address Contact No. E.mail address Public/Private/Other (Mention details)

Organization

Working since Candidates office details

Address E.mail address Phone Scale/Designation* Salary/ Compensation drawn Present work assignment*
*Give complete details, if required use separate sheet

REFERENCES
1. Name Address Contact No Name Address Contact No

2.

DECLARATION
I hereby declare that the particulars furnished above are true and correct to the best of my knowledge and belief and I understand that in the event of any information being found false or incorrect at any stage or not satisfying the eligibility criteria according to the requirements of the relative advertisement, my candidature/ appointment for the said post is liable to be cancelled/ terminated at any stage and if appointed, my services is liable to be terminated. I am willing to serve anywhere in India. I agree that Bank has right to transfer me to any part of the country at its discretion. I hereby agree that any legal proceedings in respect of any matter of claims or disputes arising out of this application and/or out of said advertisement can be instituted by me only at Delhi and Courts/ Tribunals/ Forums at Delhi undertake to abide by all the terms and conditions mentioned in the advertisement displayed on Banks Website.

(Signature of applicant) Place: New Delhi Date: __/__/2013 Enclosures: 1. 2. 3.