SBI ASSOCIATE BANK- RECRUITMENT OF CLERKS

ONLINE APPLICATION FORM FOR THE POST OF CLERK IN SBI ASSOCIATE BANK
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Registration # : 222873

Full Name : kumar gautam dixit

Bank State Bank of Travancore

1] Category : General

2] Person with Disability : No

Percentage of
Type of Disability :
Disability :

3]Domiciled in Kashmir : No

4] Belong to Religious Minority Community : No

5] ExServicemen : No

6]Matriculate Ex-servicemen, who have obtained the Indian Army Special Certificate of Education /
Corresponding Certificate in the Navy or the Air Force , who have put in not less than 15 years of service in
Armed Forces of the Union : No

7]Still serving in Armed Force of Union:No

8]Date of Discharge :

9] Secured employment under Central Government in group C & D : No

10] Disabled Ex-servicemen : No

11] Are you seeking age relaxation under widows, divorced women and women judicially separated from
their husbands & who are not remarried: No

12]State applied for: Kerala

13] Centre of Exam : Kochi Center Code: 58

14] Branch Code : 0947 Branch Name sbi,vellore

15]Deposit Journal No : 010081749

16] Application Fee

Deposit Date : 15 December, 2008 250
:

Age in completed
17] Date of Birth : 28 February, 1983 years as on 25
31.12.2008 :

18] Gender : Male

19] Father's Name : Binod kumar singh Mother's Name : Nirmala singh
20 Email ID : indomitable.indian@gmail.com

21] Address for c/o k.murughaiya,plot no.-6

Correspondence :
saraswati nager,old katpadi

vellore

Tamil Nadu Pin :632007

22] State :

23] Contact Details:

0416-2240108 Mobile No : 9894976298
PhoneNo :

24] Qualifications Details as on 31.12.2008

Exams Passed

Subject Studied

Year Of Passing

% of Marks

HSC

Science
1999
60.58

Graduation

Other
2009
70.00

25] Language Proficiency

Language

Read

Write

Speak

English

Yes
Yes
Yes

hindi

Yes
Yes
Yes
Whether desirous of taking Pre-Exam Training(only for SC/ST/XS/MINORITY COMMUNITIES ):

Centre of Training:

Whether desirous of using services of Scribe(Only for VI and OC both hands affected by cerebral palsy):No

Signature of the
candidate
Name :

Place :

Date :

• The candidate must retain the print out of the application form for further reference.

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