LIFE INSURANCE CORPORATION OF INDIA

CENTRAL OFFICE, "YOGAKSHEMA", JEEVAN BIMA MARG, MUMBAI 400 021

Recruitment for the Post of ASSISTANT ADMINISTRATIVE OFFICER
(Generalists / Chartered Accountants / Company Secretary/ Legal)

Unique Application Registration Number : 101177665

Post Applied Post Code Category DOB Nationality Gender Age as on 01/11/2010
(GENERAL/
(DD/MM/YYYY) YEAR MONTH DAYS
OBC/SC/ST)
ASSISTANT 101 SC 24/12/1987 INDIAN MALE 22 10 8
ADMINISTRATIVE
OFFICER(GENERALISTS)

1 . Candidate Name AMRUTA JANAWALEKAR

2 . Father's/Husband's Name MADHUKAR G JANAWALEKAR

3 . Mother's Name MADHAVI MADHUKAR JANAWALEKAR

4. Choice of Examination City : 5. Sub-Category

Name of City City Code PH Please write : Yes/No, if ECO/SSRCO LIC Employee
required Scribe

VH OH
No No
MUMBAI 25 No No

6. Are you a member of Institute of Chartered Accountants of India ?

Are you a member of ICAI Membership No. Membership Date

No

7. Are you a member of Institute of Company Secretaries of India ?

Are you a member of ICSI Membership No. Membership Date

No

8. Candidate Address

Name : AMRUTA JANAWALEKAR

Father's/Husband's : MADHUKAR G JANAWALEKAR

Address : /111,OM SMRUTI SAVITRI

BEHIND R.P.F. QTRS,DEOLEKAR WADI SPACE FOR

PHOTOGRAPH
KALYAN E

District : KALYAN

State : MAHARASHTRA Pin Code : 421306

Contact STD Code Tel. No.

Details :
Mobile No. 8080116060 Email ID. a.m.janawalekar@gmail.com
Signature of Candidate
9. Details of Fee :

LIC Branch Code A/C Code No. Transaction Date Transaction No. Miscellaneous Collection Amount (Rs.)

10. Educational Qualification

Year of Passing % age of marks

Name of Examination Name of Examination Passed Name of University / Institute
12th COMMERCE MUMBAI BOARD 2006 54.0

Graduation T.Y.B COM MUMBAI UNIVERSITY 2009 60.0

Post Graduation

Professional

Other Examination

11. Post Qualification Experience :

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DECLARATION

I hereby declare that all statements made in this application are true and correct to the best of my knowledge and belief. I understand that
in the event of any information being found false or incorrect or not satisfying the prescribed eligibility criteria for the post applied for,
my candidature is liable to be cancelled / rejected at any stage of selection.

Place :

Date :
Signature of the Applicant