ON-LINE APPLICATION FOR BANK OF BARODA CLERKS RECRUITMENT PROJECT

Please check Print Preview in A4 size Portrait format with 0.25" margin from all sides (Click to
Print)
40032

Please paste your recent passport size photograph and sign across it. Please retain atleast 5
copies of same photograph with you for subsequent use.

Registration # : 3839674
Full Name : Mr SAHU VINOD KUMAR
Category : OBC
If Person with Disability : NO
Type of Disability : -- Percentage of Disability : --
Do you intend to use the services of a scribe( only for VH and
OH candidates whose writing speed is affected by cerebral palsy) : --
Are you candidate who had ordinarily been domiciled in Kashmir
Division of the State of J&K during the period 1-1-1980 to 31-12-1989? NO
Are you Children/family members of those who died in 1984 riots NO
Whether you belong to Religious Minority Community NO
Minority Religion : --
Are you an Ex-Serviceman (Including ECO/SSCO)? NO
Are you a disabled Ex-Serviceman (DISXS) NO
Are you a dependent of an Ex-Serviceman (DXS) NO
Have you passed in Service (Departmental) Examination which is equivalent to Civil Examination
not below the rank of HSC? NO
Are you seeking relaxation under widow/divorced women/women judicially/ Separated from their
husbands and who are not re-married? NO
District Preference for Posting :
District Preference 1 : JABALPUR
District Preference 2 : BHOPAL
District Preference 3 : INDORE
Are you an employee of Bank of Baroda : NO
If yes,E. C. No :
Nationality : INDIAN
State / Union Territory for which you are applying : Madhya Pradesh
State / UT code : 26
Centre of Examination : BHOPAL
Centre code : 23
Application Fee / Postal Charges Details :
Transaction ID : M389034
Branch Name : NAPIER TOWN
Branch Code No : 0717
Deposit Date : 09-02-2011
Amount : 200

Personal Details :
Date of Birth : December 23,1986 Age as on on 01.01.2011. : 24
Gender : MALE
Father's Name/ Husband's Name : SHRI C.L. SAHU
Mother's Name : SMT SUMITRA SAHU
Email ID : nehamishra.neha76@gmail.com
Address for Correspondence : MPEB COLONY BIRSINGHPURPALI QTR NO
F/587 DISTT-UMRIA
District UMRIA
State : MADHYA PRADESH
Pin : 484552
Permanent Address : MPEB COLONY BIRSINGHPURPALI QTR NO
F/587 DISTT-UMRIA
District UMRIA
State : MADHYA PRADESH
Pin : 484552
Contact Details:
Phone No : -
Mobile No: 9713009094
Qualification Details (as on 01.01.2011):
Exams Passed Subject/Stream University / Board Year Of Passing % of Marks
HSC / Equivalent : MATHS MP BOARD 08-04-2004 68.00
Diploma in Banking : NO
Possess certificate in computer literacy : YES
Post qualification work experience details as on 01.01.2011 (Start from Present Employer) :
No Experience
Other Details :
Whether desirous of taking Pre-Exam Training (SC/ST/PWD/Minority Community) : --
If Yes Centre for Training : --
Languages Known Read

Write
Speak
English YES YES YES
Hindi YES YES YES

If Yes Centre for Training : --

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
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(s) or claims or
disputes arising out of this application or out of said advertisement can be instituted by me only at
Mumbai and Courts/Tribunal/ 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: 10-02-2011 Signature of Applicant

SAHU VINOD KUMAR

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