You are on page 1of 1

UnitedIndiaInsuranceCompanyLimited

ApplicationformforthepostofAdministrativeofficer(scale1)2012

ApplicationFormUIICL2012

ApplicationNumber
PostApplyingfor QualifyingExamination
PersonalDetails

UII2048175
GroupB(I.T) BE/B.Tech.(ComputerSciences/ECE/EEE)

FullName Father'sName Mother'sName DateofBirth DomicileState/UT

ABHISHEKGERA PREMSAGARGERA ANITAGERA 12Jan1990 Rajasthan

Gender Category MinorityCategory BelongtoECO/SSROCategory. MaritalStatus AssamResidentbetween1/1/1980 to15/8/1985 No

Male UnReserved NO NA Single No

StayinJ&Kbetween1/1/80 No to31/12/89 PersonwithDisability No ConfirmedEmployeeofGICandotherPublicSectorCompanies


ContactDetails

AddressLine1 AddressLine2 AddressLine3 City PINCode


UnitedIndiaEmployee

34COPPOSITETOBALWANT SINGH NURSURYPSGERAPAYAL TAKIES

State EmailId.

Rajasthan er.abhishek.1990@gmail.com 8764043150 01542487230 76Chandigarh

ROAD,NEARNANDAKOTI10NO MobileNo. GALI SRIGANGANAGAR 335001 TelephoneNo TestCenter

UIICLEmployeeNo
EDUCATIONDETAILS

Qualification BTECH
PaymentDetails

Subject/Specialization COMPUTERSCIENCE

YearofPassing 2011

Institute/University LovelyProfessionalUniversity

Percent 63.99

ModeofPayment JournalNumber SBIBranchName

Challan 00009419927 SRIGANGANAGAR

SBIBranchCode PaymentDate ApplicationFee

01778 19Apr2012 525

DECLARATION:I,herebydeclarethatallthestatementsmadeinthisapplicationaretrueandcorrecttothebestofmyknowledgeandbelief. Iunderstandthatintheeventofanyinformationbeingfoundfalseorincorrect,mycandidaturefortheappliedpostisliabletobecancelled/rejectedat anystageofRecruitment/duringthecourseofemploymentwithoutanynoticetome. Date:19Apr2012

You might also like