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Registration # : 273710
Full Name : SUPRIYA SRIVASTAVA
Category : GENERAL
Whether person with disability : NO
Type of Disability : - Percentage of Disability : --
Do you intend to use the services of a scribe (only for VI & OC
candidates whose writing speed is affected --
by cerebral palsy)?
Whether domiciled in Kashmir Division of the State of J & K during
NO
the period 1-1-1980 to 31-12-1989 ? :
Whether you belong to Religious Minority Community? NO
Religion to which you belong :
Are you an Ex-Serviceman ? NO
Are you a Disabled Ex-Serviceman (DISXS)? : NO
Period of Service ( in months) :
Are you a Dependent of an Ex-Serviceman (DXS)? : NO
Personal Details :
Age completed as on
Date of Birth : October 31,1991 18
01.10.2010. :
Gender : FEMALE
Contact Details:
Email ID : supriya.srivastava95@gmail.com
2/2
Address for Correspondence : C-2 403 Lotus Pond 2A Vaibhav Khand
Indrapuram Ghaziabad Up
District GHAZIABAD
State : UTTAR PRADESH Pin : 201014
District VARANASI
State : UTTAR PRADESH Pin : 221007
Other Details :
Would You like to undergo Pre-Exam Training (SC/ST/Minority Community/Ex-
NO
Serviceman) :
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/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 advised criteria in respect of age, educational qualification
and experience etc.
I am also willing to serve anywhere in India. I agree that the Bank has the right to transfer me to any part of the country and/or to any job
position at its sole discretion in terms of applicable staff rules from time to time.
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 NCT, Delhi only, shall have sole and exclusive jurisdiction to try any cause/dispute. I undertake to abide by all the terms and conditions in the
advertisement given by the Bank.
Place:
Date: 20-11-2010 Signature of Applicant
SUPRIYA SRIVASTAVA
Please retain your Registration No. and Password emailed to you carefully for further reference
NOTE: Please DO NOT SEND application print-out to the Bank