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ON-LINE APPLICATION FOR SPECIALIST OFFICERS

3003

Registration # : 47496

Full Name: Saif Ahmad

Post : Dy. Manager (IT) JMGS I

Post Code : 07

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 VI and

OC both hands affected by cerebral palsy) ? :NA

Whether Children/Family members of those who died in 1984 riots ?: NO

Whether domiciled in Kashmir Division of the State of J & K

during the period 1-1-1980 to 31-12-1989?:

NO

Whether you belong to Religious Minority Community? : YES

Minority Religion : Muslim

Are you an Ex-Serviceman ? : NO

Period of Service(in months) :

Whether applied for another post ? : NO

Name the additional Post applied for ? :

Nationality: Indian

Centre of Examination : Delhi

Centre code : 12

Application Fee / Postal Charges Details :

Transaction ID : M449160

Branch Name : PNB Industrial Area

Branch Code : 066600

Deposit Date : 08-07-2011

Amount : 400

Personal Details :

Date of Birth: 05-07-1987

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Age completed as on 01.01.2011 : 23

Gender : MALE

Husband's Name/Father's Name : Murtaza Hussain

Mother name: Wahida Parveen

Address for Correspondence : FAIZ CHASMA GHAR

NEAR MASJID MARKET

GORAKHNATH ROAD

District GORAKHPUR

State : UTTAR PRADESH

Pin : 273015

Permanent Address : NAURANGA BAD ZAHIDA BAD

GORAKHNATH

District GORAKHPUR

State : UTTAR PRADESH

Pin : 273015

Contact Details:

Phone No : -

Mobile No: 9555865772

Email ID : ahmad.saif7985@yahoo.com

Qualification Details (as on 24.06.2011):

Exams Passed Stream Subject / Stream Year of Passing % of Marks Class Grade

Graduation : B.Tech Electronics 2010 64.17 FC

Certifications : --

PG Programme (2 years) in Banking & Finance from NIBM : NO

Do you have Sub-Officer Course from National Fire Service

College,Nagpur ? :

Working Knowledge of MS Office : YES

Post Qualification work experience details as on 24.06.2011 (Start from present Employee):

Name of the

Employer /

Nature of

Employment

Designation and Rank

if any

From(mm/yyyy) To(mm/yyyy) Nature of

Duties

Performed

Reason for

Leaving

Years

of

Service

(YY/MM)

Total Relevant Experience ( in months) : -

Other Details :

Languages

Known

Read Write Speak

Hindi YES YES YES

English YES YES YES

Arabic YES YES NO

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/ serv ice terminated even after permanent employment without giving any notice or reasons thereof.

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I hereby certify that I am satisfying the eligibility c riteria 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 ar ising out of application or out of

said advertisement can be instituted by me only at New Delhi and courts/ Tr ibunal/ forums at New Delhi 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: 11-07-2011 Signature of Applicant

Saif Ahmad

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

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