Yeejleere ms yeQke

eneB HeemeHees& Deekeej kee

neue ner ceW eEKeee ngDee
Heeses efeHekeeeW leLee Gme
Hej efoveebke meefnle HetCe&
nmlee#ej kejW

STATE BANK OF INDIA

kesvere Yeleea SJeb HeoesVeefle efJeYeeie

CENTRAL RECRUITMENT & PROMOTION DEPARTMENT

Paste a recent
passport size
photograph here and
sign across it in full
with date

GcceeroJeej kee DeelcekeLe SJeb meleeHeve Heece&

CANDIDATE'S BIO-DATA-CUM-ATTESTATION FORM

(ke=Heee meeJeOeeveerHetJe&ke He{ves kes HeMeele Heece& DeHeveer nmleefueefHe ceW Yejs)
(Please fill in the form in your own handwriting after reading carefully)

mee#eelkeej kes efueS kesv / Centre for Interview :

Devegeceebke / Roll No. :
Heo kee veece / Name of Post :
mee#eelkeej nsleg Yee<ee kee efJekeuHe efnvoer/Debiespeer

Choice of Language for Interview : Hindi/ English

1.

(ke) Hetje veece megmHe De#ejeW ceW

(a)

Name in full, in block letters :

eer/eerceleer /keg. Shri/Smt./Kum. : ______________________________________________________________

(Ke) JewJeeefnke efmLeefle efJeJeeefnle / DeefJeJeeefnle

(b)
2.

Marital Status : Married / Unmarried

(ke) pevce efleefLe

(a)

Date of Birth

(Ke) 01-12-2014 kees Gce

(b)

Age as on 01-12-2014

efoveebke /Date
Je<e&

(ie) pevce kee mLeeve

(c)

Place of Birth

cenervee / Month
cenervee

Year

Je<e& / Year

Month

efpeuee

jepe

District

State

(Ie) efpeuee leLee jepe peneB kes DeeHe efveJeemeer nQ.

(d)
3.

District and State to which you belong :

(ke) je^erelee :
(a)

Nationality :

(b)

Religion :

(Ke) Oece& :
4.

(ie) keee DeeHe DeuHemebKeke mecegoee mes nQ

neB /veneR

(c) Do you belong to Minority Community

Yes / No

(ke) efHelee /Heefle kee veece SJeb JeJemeee /Heoveece :

(a)

Father's / Husband's name and occupation/profession/designation : __________________________________

_______________________________________________________________________________________

(Ke) ceeB kee veece

(b)
5.

Mother's name : _________________________________________________________________________

(ke) esCeer Jeie& (eLeesefele Deeele ceW mener kee efevn ueieeSW)
(a)

Category (Tick the appropriate box)

De.pee.

De.pe.pee.

meeceeve

Deve efHe[s Jeie&

SC

ST

GEN

DeeefmLe efJeke.

ef efJeke.

eJeCe efJeke.

OH

VH

HI

OBC

(Ke) Devegmetefele peeefle / Devegmetefele pevepeeefle / Deve efHe[s Jeie& kes GcceeroJeej
peeefle/pevepeeefle /mecegoee kee veece oW
(b)

If SC / ST / OBC state the name of

CASTE / TRIBE / COMMUNITY

(ie) eefo DeeHe efJekeueebie nQ lees ke=Heee eLeesefele Deeele ceW mener kee efevn ueieeSB
pewmes DeeefmLe efJekeueebie ee ef efJekeueebie ee eJeCe efJekeueebie
(c)

If you are physically handicapped, please tick appropriate box.

i.e. OH or VH or HI

(Ie) eefo DeeHe Meejerefjke He mes efJekeueebie nQ lees ke=Heee DeHeves efJekeueebielee kee efJeJejCe GuuesKe kejW
(d)
6.

If you are a Physically Handicapped person, please give details of your handicap.

(ke) eefo DeeHe eleeJeefle&le /eJeemeer /efJemLeeefHele Jeeqkele neW lees Gmekee efJeJejCe oW.
(a)

If you are a repatriate / migrant / displaced person, give particulars : ___________________________________________

__________________________________________________________________________________________________

(Ke) eefo DeeHe YetleHetJe& mewefveke nQ lees ke=Heee keee&cegeqkele /mesJeeefveJe=efe keer efleefLe kee GuuesKe kejW.
(b)

If Ex-serviceman, please give date of discharge / retirement.

(ie) keee DeeHe mewve keee&Jeener ces Menero mewefveke kes Deeefele nw leLee Gvekees GHeueyOe Deej#eCe nsleg oeJesoej nwb.
(c)

neB/veneR

Are you a dependant of Serviceman killed in Action and claiming reservation benefits available there under
Yes/ No
eefo Ssmee nw lees DeeHekes oeJes kes eceeCe mJeHe mebueive omleeJespeeW kee efJeJejCe _________________________________________________
if so details of documents submitted in support of your claim _________________________________________________

7. (ke) ceele= Yee<ee

(a)

Mother Tongue :

(b)

3 ) tick mark) :
Knowledge of Languages Other than English (Indicate by a (

(Ke) Debespeer kes Deefleefjkele Deve Yee<eeDeeW kee %eeve (mener kee (3 ) efevn ueieeSs)
Yee<ee

yeesue mekeles nw

Language

He{ mekeles nw

Speak

efueKe mekeles nQ

Read

GeerCe& Hejer#eees, eefo keesF& nes lees

Write

Examination Passed, if any

1.
2.
3.

8. (ke) Mew#eefCeke eesieleeSw

(a)

Educational Qualifications :

GeerCe& Hejer#eeS@
Examinations
Passed
1

mebkeee kee
GuuesKe kejW

kee@uespe
mketue

Indicate
College /
Faculty:Arts/ School
Science/Comm.
2

DeJeefOe / Period
mes

leke

From

Hejer#eCe mebmLee

cegKe efJe<ee

Examining
body

Principal
Subjects

to

efkees iees
eeemees keer
mebKee

esCeer Deewj
eeHle
mLeeve ece

No. of
attempts

Class &
Rank

eeHleebkees kee
eefleMele

Percentage
of marks
9

ke#ee

Class X

ke#ee
Class XII

mveeleke
Graduation

mveelekeesej
Post Graduation

Deve (efJeJejCe oW)

Other (specify)

9. eeHle HegjmkeejeW/HeokeeW/e$eJe=efeeeW kee efJeJejCe

Particulars of prizes/medals/scholarships obtained :

10. (ke) Kesue leLee Heeeeceslej efeeekeueebHees kee efJeJejCe,

efpemeceW DeeHeves Yeeie efueee nw, eeHle ieewjJe leLee efJeefMe eesielee
(a)

Particulars of sports and other extracurricular activities

in which you participated, Credits & Distinctions obtained :

(Ke) DeefYeefeeeB SJeb Deve efeeeB

(b)

Hobbies & other interests :

11. yeQefkebie ceW efJeMes<e Mew#eefCeke eesielee/eefMe#eCe kee efJeJejCe

Particulars of any special qualification / training in Banking

12. (ke) Jele&ceeve leLee Henues kes efveeespeve kee efJeJejCe

(a)

Particulars of present and previous employment :

efveeespeke kee veece

SJeb Helee
Name & Address of
employer

DeJeefOe / Period
mes

From

leke
To

Heo leLee keece kee

efJeJejCe

efveegeqkele kee
mLeeve

Position and
Nature of Duties

Place of
Posting

(Ke) Jele&ceeve efveeespeke keer efmLeefle (mejkeejer/De& mejkeejer/meeJe&peefveke #es$e/efvepeer #es$e)

(b) Status of present employer (Govt. / Semi-Govt. / Pub / Pvt. Sector)

kegue Jesleve

Total Emoluments

Meg ceW

Starting

Deble ceW eeHle

Last Drawn

es[ves kee keejCe

Reasons for
leaving

13. He$e JeJenej kes efueS HetCe& (Jele&ceeve) Helee

14. HetCe& mLeeeer Helee

Present address in full for communication

Permanent address in full :

efHeve kees[

efHeve kees[

PIN CODE

PIN CODE

15. Gve mLeevees kee efJeJejCe peneB DeeHe efHeues Heebe Je<eeX kes oewjeve Ske Je<e& mes DeefOeke mecee leke jns nes

Particulars of places where you have resided for more than 1 year during the last 5 years :

mes

From

leke

To

efveJeeme mLeeve kee Hetje Helee

Residential address in full

yeebes kee@uece ces efoS ieS mLeeve kee efpeuee

cegKeeuee

District Head quarter of the place

mentioned in the left column

16. eefo efkemeer veeeeuee ves DeeHekes efJe efkemeer DeHejeOe kes efueS DeefYeeespeve/
efnjemele/oC[/oes<eefmeef kee efveCe&e efoee nes lees Gmekee efJeJejCe.
Particulars of any prosecution / detention / fine
conviction sentence against you awarded by any court of law for offence.

17. eefo efkemeer veeeeuee ves DeeHekes efJe keesF& ceeceuee (yeQke/Deve efJeeere
mebmLeeDeeW keer $eCe Deoeeieer vener kejves mes mebyebefOele ceeceues meefnle)
efJeeejOeerve nes lees Gmekee efJeJejCe.
Particulars of cases pending against you in any court of law
including case (s) for non-payment of any loan from Banks/
Financial Institution :

18. eefo efkemeer mesJee Deeeesie, Hejer#eCe mebmLee ves DeHeves egveeJe Hejer#ee ceW Deeesie Ieesef<ele efkeee nes
/jeske ueiee oer nes lees Gmekee efJeJejCe.
Particulars of disqualification / debarment by any Service
Commission, examining body at their selection / examination :

19. DeeHekes Jele&ceeve DeLeJee Henues efveeespeke (kees) eje DeeHekes efJe
eejbYe efkeS ieS/efJeeejeOeerve DevegMeemeveelceke keee&Jeener kee efJeJejCe,
eefo DeeHekees efkemeer HeoesVeefle Hejer#ee ceW yewves Hej jeske ueieeF& ieeer nes
lees Gmekee Yeer efJeJejCe oW.
Particulars of any case (s) of disciplinary action instituted /
pending against you by your present or previous
employer (s). Please also state whether you were debarred
from appering in any promotion examination.

20. mebueive eefj$e eceeCeHe$eeW kee efJeJejCe

Particulars of character certificates enclosed

1
2
3

21. oes eefleefle HeefjeeekeeW kes veece, JeJemeee SJeb Heles

Name, occupations and address of two respectable referees :
ece mebKee
veece
Sr. No.
Name

Helee
Address

1.
2.

22. Deve efJeJejCe pees yeQke kes efueS GHeeesieer nes mekeles neW.
Additional particulars, if any, which may be
of use to the Bank :
ceQ eceeefCele kejlee ntB efke GHeeg&kele efJeJejCe cesjer Hetjer peevekeejer leLee efJeMJeeme kes Devegmeej mele, mener Je HetCe& nQ. ceQ Ssmeer efkemeer Yeer yeele mes DeJeiele vener ntB
pees cegPes yeQke keer veewkejer kes efueS GHeegkele nesves ceW yeeOeke efme nes mekeleer nw. ceQ en Yeer Iees<eCee kejlee/kejleer ntB efke cegPes onspe eefle<esMe DeefOeefveece 1961 kes
Debleie&le DeLeJee efJeefOe kes Devegmeej oC[veere efkemeer DeHejeOe kes ceeceues ces keYeer Yeer oefC[le vener efkeee ieee nw.
eefo cesjs eje emlegle efkeee ieee efJeJejCe ieuele ee Demele Heeee peelee nw Deewj/ee Heece& emlegle kejles mecee JeemleefJeke leLeeW kee efHeeee peevee yeeo
keer efleefLe ceW Helee euelee nw lees yeQke kees cesjer efveegeqkele, efveegeqkele kes emleeJe meefnle, pewmee Yeer ceeceuee nes, jodo kejves kee DeefOekeej nesiee. Gkele efJeJejCe Yeejleere
ms yeQke kes efJe%eeHeve mebKee meerDeejHeer[er/SyeermeerSue/2014-15/07 efo.17.11.2014 Deewj cesjs Dee@veueeF&ve DeeJesove-He$e kes meboYe& ceW emlegle efkees iees nQ.
I Certify that the particulars furnished above are true, correct and complete to the best of my Knowledge and
belief. I am not aware of any cirumstance which might impair my fitness for employment under the Bank.
Further, I declare that I have never been convicted for offence under the Dowry Prohibition Act, 1961, or any
criminal offence under any other law.
In case the particulars submitted by me are found to be false or not true and/ or suppression of material facts
by me while submitting the form is revealed at a latter date, the Bank shall have the right to cancel the appointment
including the offer for appointment, as the case may be. The above details are submitted in reference to State Bank
Of India advertisement No. CRPD/ABCL/2014-15/07 dt. 17.11.2014 & my online application thereto.

efoveebke Date :
mLeeve Place :

yeeBes neLe kes Debiets kee efveMeevee

DeYeLeea kee nmlee#ej

Signature of the candidate

Left Thumb Impression

Heefjee kee eceeCe He$e

IDENTITY CERTIFICATE

eceeefCele efkeee peelee nw efke cew eer/eerceleer/kegceejer

Certified that I have Known Shri / Smt./Kum.
eer
kees efHeues
Shri

Deelcepe/Helveer/Deelcepee
son/wife/daughter of
cenervees mes peevelee/peeveleer ntB leLee cesjer peevekeejer

Je<eeX

for the past

years

month/s and that to the best of my

leLee efJeeeme kes Devegmeej Gvekes eje efoee ieee GHeegkele efJeJejCe mener nw~

Knowledge and belief the particulars furnished above by him/her are correct.

mLeeve Place :
efoveebke Date :

nmlee#ej

Signature :

Heoveece

Designation :

Helee

Address :

SEAL
keeee&uee kes GHeeesie nsleg / FOR OFFICE USE ONLY
(1)
(2)

mee#eelkeej ceW meeqcceefuele nesves kee efoveebke

Date of appearing in interview
eesielee/eceeCeHe$eeW kee meleeHeve

eer/eerceleer

Heoveece
Designation :

Eligibility/Certificates verified by Shri/Smt.

(3) keefceeeb leLee eeHle efJemebieefleeeb

Deficiencies and Discrepancies found :

DECLARATION TO BE SUBMITTED BY THE OTHER BACKWARD CLASSES

CANDIDATES SEEKING RESERVATION AS OBC

I______________ _____________________________________________________
Son/daughter of Shri ____________________________________________________
Resident of village/ town/city ___________________ District ______________________
State _____________________________________________ . Hereby declare that I
belong to the ____________________________________________ Community which
is recognised as a backward class by the Government of India for the purpose of reservation
in services as per orders contained in Department of Personnel and Training Office
Memorandum No. 36012/22/93-Estt.(SCT) dated 08.09.1993. It is also declared that as
on 09.12 .2014, I do not belong to persons / sections (Creamy Layer) mentioned in column
3 of the Schedule to the above referred Office Memorandum dated 08.09.1993.

Place :
Dated

(Signature of the candidate)

Deve efHe[s Jeie& kes He ceW Deej#eCe keer ceebie kejvesJeeues Deve efHe[s JeieeX kes
GcceeroJeejeW eje emlegle keer peevesJeeueer Iees<eCee
ceQ ______________ ___________________________________________________
Heg$e/Heg$eer eer __________________________________________________________
efveJeemeer _______________________________________________________________
ieebJe/kemyee/Menj ____________________________ efpeuee _______________________
jepe ________________________________________ Sleodeje Iees<eCee kejlee/kejleer ntB efke
ceQ ____________________________________________ peeefle mes mebyebeOf ele ntB efpemes Yeejle mejkeej
eje keeefce&ke SJeb eefMe#eCe keeee&uee %eeHeve eceebke 36012/22/93-F&Smeerer (Sme meer er) efoveebke 08.09.1993
ceW meceeefJe DeeosMeeW kes Devegmeej mesJeeDeeW ceW Deej#eCe kes eeespeve nsleg Ske efHe[s Jeie& kes He ceW ceevelee oer ieF& nw. en
Yeer Iees<eCee keer peeleer nw efke ceQ efoveebke 09.12.2014 kees GHeeg&kele meboefYe&le keeee&uee %eeHeve efoveebke 08.09.1993
keer Devegmeteer kes mlebYe 3 ceW GefuueefKele JeeqkeleeeW /KeC[eW (efeceer uesej) kes oeejs ceW veneR ntB.

mLeeve
efoveebke

(GcceeroJeej kes nmlee#ej)

5