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ON-LINE APPLICATION FOR SINGLE WINDOW OPERATOR(SWO)

25024

Registration #: Full Name: Category : If Person with Disability : Type 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? Whether you belong to Religious Minority Community? : Religion to which you belong : Are you an Ex-Serviceman? : Are you a disabled Ex-Serviceman (DISXS)? : Period of Service in months : Are you a dependent of an Ex-Serviceman (DXS)? : Are you seeking relaxation under widow/divorced women/ women judicially Separated from their husbands and who are not re-married : Nationality : State / Union Territory for which you are applying : State code : Centre of Examination : Centre code : Application Fee / Postal Charges Details : Receipt Number (TSL No.) : Branch Name : Branch Code No : Date of Deposit : Amount :

3216526 Palakuru Padmaja SC NO -NO NO NO -NO NO -NO NO indian Andhra Pradesh 02 Hyderabad 31 Percentage of Disability : --

001976 gandhi road 0557 25-04-2011 50

Personal Details :
Date of Birth : Age as on 31.03.2011: Gender : Father's Name / Husband's Name : Mother's Name : Address for Correspondence : 10-04-1990 20 FEMALE P Papaiah P Meenakshi Dr No:5-64 Telephone Colony

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Lingeswar Nagar (near)bairagipatteda Tirupati District State : Pin : Permanent Address : Chitoor ANDHRA PRADESH 517501 Dr No:5-64 Telephone Colony Lingeswar Nagar (near)bairagipatteda Tirupati District State : Pin : Chitoor ANDHRA PRADESH 517501

Contact Details:
Phone No : Mobile No: Email ID : Qualification Details (as on 31.03.2011): 9030670834 padmaja1990@gmail.com

Exams Passed
Graduation : working knowledge of computers : Details of Computer Knowledge : Other Details :

Subject/Stream
BTech

Year of Passing
2011 YES

% of Marks
65.79

Class / Grade
First Class

Ms office and c lang

Whether desirous of taking Pre-Exam Training (SC/ST/ExServicemen/Minority Community/DISXS/DXS) : If Yes Centre for Training :

NO --

Languages Known Read

Telugu Hindi English Tamil YES YES YES NO

Write
YES YES YES NO

Speak
YES YES YES YES

DECLARATION:
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/ service 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 advised criteria in respect of age, caste, educational qualification etc. 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 Mangalore and courts/ Tribunal/ forums at Mangalore only, shall have sole and exclusive jurisdiction to any cause/ dispute. I undertake to abide by all the terms and conditions in the advertisement given by the Bank.

Place: Date: 25-04-2011 Signature of Applicant

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

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NOTE: Please DO NOT SEND application print-out to the Bank