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ON-LINE APPLICATION FOR COMMON WRITTEN EXAMINATION(CWE) FOR RECRUITMENT OF POS/MTS IN 19 PSBS- CWE PO/MT-II

This online application is provisional subject to payment of application fees/ intimation charges

20031
Registration # : 5000202407

Full Name :

GAURAV MITTAL

Category : If Person with Disability : 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) ? : Whether Children/Family Members of those who died in 1984 Riots? :

GENERAL NO NA NO

Whether domiciled in Kashmir Division of the State of J & K during the period 1-1-1980 to 31-12-1989? : NO Are you an Employee who has completed 5 years of service in RRBs : Are you a Clerical employee of a Participating Public Sector Bank ? : If yes, please specify the Name of the Public Sector Bank : Are you an Ex-Serviceman ? : Whether you belong to Minority Community ? : Religion to which you belong : Have you appeared for CWE PO/MT exam held on 18/09/2011 and 13/11/2011 ? : Nationality / Citizenship : State/ UT which the Centre of Examination Belongs : State Code : Centre of Examination : Centre Code : Application Fee / Intimation Charges details: Payment Mode: Amount : Personal Details : Date of Birth : Age completed as on 01.01.2012 : Gender : Husband's Name/Father's Name : Mother's Name : Address for Correspondence : 05-11-1986 25 MALE VED PRAKASH MITTAL SUDHA MITTAL Sector-2a 200 Vinay Nagar Behind Green Garden School District State : Pin : Permanent Address : Gwalior MADHYA PRADESH 474012 Sector-2a 200 Vinay Nagar Behind Green Garden School District Gwalior CBS 450.00 NO NO NO NO NO Indian Madhya Pradesh 19 Gwalior 66

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State : Pin : Contact Details : Email ID : Phone No : Mobile No : Qualification Details (as on 01.01.2012): Exam Passed Graduation/Equivalent : Professional Qualification : Other Details : Whether desirous of taking Pre-Exam Training (SC/ST/ Minority Community) : If Yes, Centre for Training : --Subject /Stream BCOM MBA Date of Passing 15-07-2008 31-12-2011 % of Marks 62.00 61.00 gmittal465@gmail.com 9993491605 MADHYA PRADESH 474012

DECLARATION:
I hereby declare that all statements made in this application are true. complete and correct to the best of my knowledge and belief. I understand that in the event of any information being found untrue or incorrect at any stage or my not satisfying any of the eligibility criteria stipulated, my candidature is liable to be cancelled.

Place:

Date: 16-03-2012

Signature of Applicant

Please retain your Provisional Registration No. and Password emailed to you carefully for further reference NOTE: Please DO NOT SEND application printout to IBPS