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Recruitment of Officer JMG Sc-I,Officer MMG Sc-II and Office Assistants (Multipurpose)

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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 # : Full Name : Post : Post Code : Category : If Physically Challenged : 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) :

1019074 SUSHIL KUMAR Officer (JMG) Scale-I 02 GENERAL NO NA

Are you candidate who had ordinarily been domiciled in Kashmir Division of the State NO 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/Commissioned Officers(Including ECOs/SSCOs) : Actual Period of service rendered in defence services as an Ex-serviceman (in months) : Are you seeking relaxation under widow / divorced women / women judicially Separated from their husbands and who are not re-married : Nationality : Centre of Examination : Centre code : Application Fee / Postal Charges Details : Payment In: Transaction ID : Branch Name : Branch Code No : Date of Deposit : Amount : Punjab National Bank M437040 SUSHANT LOK I GURGAON 461400 15-02-2012 500 NO INDIAN SHIMLA 13 NO -NO

Personal Details : Date of Birth : Age completed as on 01-11-2011 : Gender : Father's Name / Husband's Name : 13-04-1988 23 MALE TULA RAM

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Mother's name : Address for Correspondence : TARA DEVI VILLAGE GUNTHLA PO BHARERI TEH KUMARSAIN District : State : Pin : Permanent Address : SHIMLA HIMACHAL PRADESH 172024 VILLAGE GUNTHLA PO BHARERI TEH KUMARSAIN District : State : Pin : Contact Details: Email ID : Phone Number : Mobile Number : Qualification Details (as on 01.11.2011): Exam Passed Graduation/Equivalent : Professional Qualification : Working Knowledge of Computers : Details of Computer Knowledge: Post Qualification work experience details (Start from present Employer): Name of the Employer Designation From(mm/yyyy) To(mm/yyyy) Nature of Reason for Leaving Length of Duties Performed Service (YY/MM) WELCOME DESK 6 NOT APPLICABLE 0/6 Name of the Course/Degree Science Others-MBA IN MARKETING Year of Passing 2009 2011 YES OUTLOOK CRM IRP % of Marks 51.25 70.00 Class / Grade Second Class First Class sushilverma88@gmail.com 9650373101 SHIMLA HIMACHAL PRADESH 172024

HDFC BANK

ASSISTANT MANAGER

05/2011

11/2011

Total Experience (in months) : Other Details : Whether desirous of taking Pre-Exam Training -(Only for SC/ST/Minority/EXS) : If Yes Centre for Training : -Languages Known Hindi ENGLISH Read YES YES Write YES YES

Speak YES YES

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/ 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.

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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 Mandi and courts/ Tribunal/ forums at Mandi 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: 15-02-2012 Signature of Applicant

SUSHIL 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