Yeejleer³e mìsì yeQkeÀ

³eneB HeemeHeesì& DeekeÀej keÀe
neue ner ceW eEKe®ee ngDee
HeÀesìes ef®eHekeÀe³eW leLee Gme
Hej efoveebkeÀ meefnle HetCe&
nmlee#ej keÀjW

STATE BANK OF INDIA
kesÀvêer³e Yeleea SJeb HeoesVeefle efJeYeeie
CENTRAL RECRUITMENT & PROMOTION DEPARTMENT

Paste a recent
passport size
photograph here and
sign across it in full
with date

GcceeroJeej keÀe DeelcekeÀL³e SJeb mel³eeHeve HeÀece&
CANDIDATE'S BIO-DATA-CUM-ATTESTATION FORM

(ke=ÀHe³ee HeÀece& DeHeveer nmleefueefHe ceW Yejs)
(Please fill in the form in your own handwriting)

Yeejleer³e mìsì yeQkeÀ kesÀ men³eesieer yeQkeÀes ceW efueefHekeÀ ÞesCeer ceW Yeleea
Recruitment to Clerical Cadre in Associate Banks of State Bank of India

mee#eelkeÀej kesÀ efueS kesÀvê / Centre for Interview :
Deveg¬eÀceebkeÀ / Roll No. :

GÊeerCe& /Qualified Under :__________________ ÒeJeie&/Category
(pewmes efkeÀ yegueeJee He$e ceW GefuueefKele nw/As shown in the Call Letter)

Heo keÀe veece / Name of Post :
mee#eelkeÀej nsleg Yee<ee keÀe efJekeÀuHe ë efnvoer/Debie´speer (jepeYee<ee DeefOeefve³ece ces HeefjYeeef<ele `keÀ` #es$e kesÀ GcceeroJeejeW keÀeW mee#eelkeÀej nsleg efnvoer efJekeÀuHe GHeueyOe nw)
Choice of Language for Interview : Hindi/ English (Hindi option available for candidate appearing for Interview in Region ‘A’ states only,
as defined in the Official Languages Act)
1.

(keÀ) Hetje veece megmHeä De#ejeW ceW ë
(a)

Name in full, in block letters :
Þeer/Þeerceleer /kegÀ. Shri/Smt./Kum. : ______________________________________________________________

(Ke) JewJeeefnkeÀ efmLeefle ë efJeJeeefnle / DeefJeJeeefnle
(b)
2.

Marital Status : Married / Unmarried

(keÀ) pevce efleefLe
(a)

Date of Birth

(Ke) 01-08-2012 keÀes Gce´
(b)

efoveebkeÀ /Date
Je<e&

Age as on 01-08-2012

cenervee / Month
cenervee

Year

/ Year

Month

(ie) pevce keÀe mLeeve

efpeuee

jep³e

(c)

District

State

Place of Birth

Je<e&

(Ie) efpeuee leLee jep³e peneB kesÀ DeeHe efveJeemeer nQ.
(d)
3.

(a)

4.

District and State to which you belong :

(keÀ) jeä^er³elee :
Nationality :

(Ke) Oece& :

(ie) ke̳ee DeeHe DeuHemebK³ekeÀ mecegoe³e mes nQ

neB /veneR

(b)

(c) Do you belong to Minority Community

Yes / No

Religion :

(keÀ) efHelee /Heefle keÀe veece SJeb J³eJemee³e /Heoveece :
(a)

Father's / Husband's name and occupation/profession/designation : _______________________________________
______________________________________________________________________________________________

(Ke) ceeB keÀe veece ë
(b)
5.

Mother's name : ________________________________________________________________________________

(keÀ) ÞesCeer Jeie& (³eLeesef®ele Dee³ele ceW mener keÀe ef®evn ueieeSW)
(a)

De.pee.

De.pe.pee.

meeceev³e

Dev³e efHeí[s Jeie&

SC

ST

GEN

OBC

Category (Tick the appropriate box)

(Ke) Devegmetef®ele peeefle / Devegmetef®ele pevepeeefle / Dev³e efHeí[s Jeie& kesÀ GcceeroJeej
peeefle/pevepeeefle /mecegoe³e keÀe veece oW
(b)

If SC / ST / OBC state the name of
CASTE / TRIBE / COMMUNITY

(ie) ³eefo DeeHe MeeefjjerkeÀ ©He mes efJekeÀueebie nQ lees ke=ÀHe³ee ³eLeesef®ele Dee³ele ceW
DeeefmLe efJekeÀ.
mener keÀe ef®evn ueieeSB. pewmes DeeefmLe efJekeÀueebie ³ee ¢efä efJekeÀueebie ³ee ÞeJeCe efJekeÀueebie
(c)

If you are physically handicapped, please tick appropriate box.
i.e. OH or VH or HI

OH

(Ie) ³eefo DeeHe MeejerefjkeÀ ©He mes efJekeÀueebie nQ lees ke=ÀHe³ee DeHeves efJekeÀueebielee keÀe efJeJejCe GuuesKe keÀjW
(d)

If you are a Physically Handicapped person, please give details of your handicap.

1

¢efä efJekeÀ.

ÞeJeCe efJekeÀ.

VH

HI

ke̳ee DeeHe efJeOeJee/leueekeÀMegoe m$eer/ keÀevetveer ©He mes Heefle mes Deueie nw leLee HegveefJe&Jeen vener efkeÀ³ee nQ neB/veneR Are you a widow/ divorced women/ women judicially separated from husband and not remarried Yes/ No ke̳ee DeeHe pecceg SJeb keÀMceerj jep³e kesÀ keÀMceerj #es$e ceW 01. (If so the discharge certificate should clearly mention this) (ie) ke̳ee DeeHe ³eg× ces Menero/iecYeerj ªHe mes DeMekeÌle YetleHetJe& mewefvekeÀ kesÀ DeeefÞele nw leLee Ssmes DeeefÞeleeW keÀes GHeueyOe Deej#eCe keÀesìs kesÀ Devleie&le DeeJesove efkeÀ³ee nw? (c) neB/veneR Are you a dependant of Ex-Serviceman killed in Action/severly disabled and applied under reservation available to such dependents (Dep-XS)  ³eefo neB lees. (keÀ) ke̳ee DeeHe YetleHetJe& mewefvekeÀ nQ Deewj YetleHetJe& mewefvekeÀ Deej#eCe keÀesìe kesÀ Devleie&le DeeJesove efkeÀ³ee nw? neB /veneR (a) Yes/ No Are you an Ex-serviceman and applied under Ex-servicemen reservation quota : ³eefo neB. ke̳ee GkeÌle YetleHetJe& mewefvekeÀ kesÀ efkeÀmeer DeeefÞele ves HetJe& ceW Deej#eCe keÀe ueeYe efue³ee nw?  If yes.1980 Yes/ No 9. then ________________ keÀe³e&cegeqkeÌle/mesJeeefveJe=efÊe/mHesefmeefHeÀkeÀ Heerefj³e[ Dee@HeÀ DemeeFveceWì kesÀ HetCe& nesves keÀer efleefLe ë Date of discharge/ retirement/ date of completion of specific period of assignment : (Ke) ke̳ee DeeHe YetleHetJe& mewefvekeÀ nQ SJeb MeeefjjerkeÀ ªHe mes DeMekeÌle YetleHetJe& mewefvekeÀ ÞesCeer kesÀ Devleie&le DeeJesove efkeÀ³ee nw? (³eefo neB. (keÀ) Mew#eefCekeÀ ³eesi³eleeSb ë (a) Educational Qualifications : éùäÇô ÍÓäÜâ#ú Examinations Passed 1 Öï»âÒ »â élÔë¼ »Óëï »âúÔëÁ s»èÔ Indicate College / Faculty:Arts/ School Science/Comm. 10. lees keÀe³e&cegeqkeÌle ÒeceeCeHe$e ces FmekeÀe GuuesKe nesvee ®eeefnS) neB/veneR (b) Yes/ No Are you a disabled Ex-serviceman and applied under reservation available to Disabled Ex-servicemen category (Dis-XS).1980 to 31. has availed resrvation benefits  Hegefä kesÀ efueS Òemlegle omleeJespeeW keÀe GuuesKe keÀjW  Details of documents Submitted in support of the claim Yes/ No neB/veneR Yes/ No neB/veneR (1) (2) 7. 8.1989 kesÀ oewjeve efveJeemeer Les neB/veneR Are you a person domiciled in Kashmir division of Jammu & Kashmir state during the period from 01. (») ÑâÈö ÐâØâ (a) Mother Tongue : (¼) áï½ýëÁä »ë áãÈãÓkÈ ánÒ ÐâØâáâïë »â ÞâÌ (ÖÚä »â (✓ )ã¿nÚ Ô½â#ë) (b) Knowledge of Languages Other than English (Indicate by a ( ✓ ) tick mark) : ÐâØâ ÏâëÔ Ö»Èë Úì Language Speak ÍÆ‘ Ö»Èë Úì ãÔ¼ Ö»Èë ÚE éùäÇô ÍÓäÜâÒë.1980 mes 31.12. whether any other dependent of the Ex-serviceman. 3.01.6.01. if any Read 1. of attempts 7 Class & Rank 8 ÍýâpÈâï»âë »â ÍýãÈ×È Percentage of marks 9 .12. 2 3 áÕãË / Period ÍÓäÜÇ ÖïsÉâ Examining body Öë ÑçKÒ ãÕØÒ Principal Subjects È» From to 4 5 »Üâ Class X »Üâ Class XII sÌâÈ» Graduation sÌâÈ»âëùÓ Post Graduation ánÒ (ãÕÕÓÇ Êëï) Other (specify) 2 6 ã»Òë ½Òë ÍýÒâÖâë »ä ÖïKÒâ ÙëÇä áâìÓ ÍýâpÈ sÉâÌ ®Ñ No. 2. lees / If yes. ÒãÊ »âëæ Úâë Èâë Write Examination Passed.

Sector) met®evee ë DeHeveer YetleHetJe& mewefvekeÀ efmLeefle keÀe GHe³eesie keÀj efmeefJeue #es$e ceW mejkeÀejer veewkeÀjer ÒeeHle keÀj ®egkesÀ YetleHetJe& mewefvekeÀ/MeeefjjerkeÀ ©He mes DeMekeÌle YetleHetJe& mewefvekeÀ keÀes oesyeeje mejkeÀejer /yeQkeÀ veewkeÀjer kesÀ efueS ³eesi³e veneR ceevee peeSiee. Note : Ex-servicemen /Disabled Ex-servicemen candidates who have availed reservation benefits for his Re-employment and joined a Government job on the civil side will not be eligible for the benefits of reservation for ex-servicemen in Government/Bank jobs. ÍÝ vÒÕÚâÓ »ë ãÔ# ÍèÇô (ÕÈôÑâÌ) ÍÈâ 14. Particulars of any prosecution / detention / fine conviction sentence against you awarded by any court of law for offence. ÒãÊ ã»Öä nÒâÒâÔÒ Ìë áâÍ»ë ãÕr} ã»Öä áÍÓâË »ë ãÔ# áãÐÒâëÁÌ/ ãÚÓâÖÈ/ÊNÅ/ÊâëØãÖ}ä »â ãÌÇôÒ ãÊÒâ Úâë Èâë éÖ» ãÕÕÓÇ.please read the note furnished below) ãÌÒâëÁ» »â ÌâÑ #Õï ÍÈâ Name & Address of employer áÕãË / Period Öë È» From To ÍÊ ÈÉâ »âÑ »â ãÕÕÓÇ ãÌÒçãkÈ »â sÉâÌ Position and Nature of Duties Place of Posting »çÔ ÕëÈÌ ÀâëÅÌë »â »âÓÇ Total Emoluments ×çr Ñëï áïÈ Ñëï ÍýâpÈ Starting Last Drawn Reasons for leaving (¼) ÕÈôÑâÌ ãÌÒâëÁ» »ä ãsÉãÈ (ÖÓ»âÓä/á©ô ÖÓ»âÓä/ÖâÕôÁãÌ» ÜëÝ/ãÌÁä ÜëÝ) (b) Status of present employer (Govt. ãÁÖÑëï áâÍÌë Ðâ½ ãÔÒâ Úì. 15. éÌ sÉâÌâë »â ãÕÕÓÇ ÁÚâû áâÍ ãÍÀÔë Íâï¿ ÕØâëô »ë ÊâìÓâÌ #» ÕØô Öë áãË» ÖÑÒ È» ÓÚë Úâë Particulars of places where you have resided for more than 1 year during the last 5 years : Öë From È» To ãÌÕâÖ sÉâÌ »â ÍèÓâ ÍÈâ Residential address in full ÏâïÒë »úâÔÑ Ñë ãÊ# ½# sÉâÌ »â ãÁÔâ ÑçKÒâÔÒ District Head quarter of the place mentioned in the left column 17. ÍýâpÈ ½âìÓÕ ÈÉâ ãÕã×wà ÒâëgÒÈâ (a) Particulars of sports and other extracurricular activities in which you participated.efvecve GuuesefKele met®evee keÀer peevekeÀejer ues.11. (») ¼ëÔ ÈÉâ ÍâÄÒ®ÑëÈÓ ã®Òâ»ÔâïÍâë »â ãÕÕÓÇ. (») ÕÈôÑâÌ ÈÉâ ÍÚÔë »ë ãÌÒâëÁÌ »â ãÕÕÓÇ (a) (YetleHetJe& mewefvekeÀ DeYeLeea. / Pub / Pvt. / Semi-Govt. Ïìã»ï½ Ñïë ãÕ×ëØ ×ìÜãÇ» ÒâëgÒÈâ/Íýã×ÜÇ »â ãÕÕÓÇ Particulars of any special qualification / training in Banking 14. ÍèÇô sÉâÒä ÍÈâ Present address in full for communication Permanent address in full : ãÍÌ »âëÅ ãÍÌ »âëÅ PIN CODE PIN CODE 16. 3 .) Particulars of present and previous employment : (Ex-servicemen candidates . Credits & Distinctions obtained : (¼) áãÐrã¿Òâû #Õï ánÒ rã¿Òâû (b) Hobbies & other interests : 13. ÍýâpÈ ÍçÓs»âÓâëï/ÍÊ»âëï/ÀâÝÕöãùÒâëï »â ãÕÕÓÇ Particulars of prizes/medals/scholarships obtained : 12.

I Certify that the particulars furnished above are true. Particulars of any case (s) of disciplinary action instituted / pending against you by your present or previous employer (s).18. The above details are submitted in reference to State Bank Of India advertisement No. ³eefo cesjs Üeje Òemlegle efkeÀ³ee ie³ee efJeJejCe ieuele ³ee Demel³e Hee³ee peelee nw Deewj/³ee HeÀece& Òemlegle keÀjles mece³e JeemleefJekeÀ leL³eeW keÀe efíHee³ee peevee yeeo keÀer efleefLe ceW Helee ®euelee nw lees yeQkeÀ keÀes cesjer efve³egeqkeÌle. Particulars of cases pending against you in any court of law including case (s) for non-payment of any loan from Banks/ Financial Institution : 19.07. áâÍ»ë ÕÈôÑâÌ áÉÕâ ÍÚÔë ãÌÒâëÁ» (»âë) ]âÓâ áâÍ»ë ãÕr} ÍýâÓïÐ ã»# ½#/ãÕ¿âÓâËäÌ áÌç×âÖÌâtÑ» »âÒôÕâÚä »â ãÕÕÓÇ. Please also state whether you were debarred from appering in any promotion examination. No. which may be of use to the Bank : ceQ ÒeceeefCele keÀjlee ntB efkeÀ GHe³eg&keÌle efJeJejCe cesjer Hetjer peevekeÀejer leLee efJeMJeeme kesÀ Devegmeej mel³e. ÌâÑ ÍÈâ Name Address 1. examining body at their selection / examination : 20. or any criminal offence under any other law. efve³egeqkeÌle kesÀ ÒemleeJe meefnle. I declare that I have never been convicted for offence under the Dowry Prohibition Act. if any.2012 & my online application thereto. Particulars of disqualification / debarment by any Service Commission. ceQ Ssmeer efkeÀmeer Yeer yeele mes DeJeiele vener ntB pees cegPes yeQkeÀ keÀer veewkeÀjer kesÀ efueS GHe³egkeÌle nesves ceW yeeOekeÀ efme× nes mekeÀleer nw. ÖïÔgÌ ¿ãÓÝ ÍýÑâÇÍÝâïë »â ãÕÕÓÇ Particulars of character certificates enclosed 2 22. Further. ÍÓäÜÇ ÖïsÉâ Ìë áÍÌë ¿çÌâÕ ÍÓäÜâ Ñëï áÒâëgÒ ¾âëãØÈ ã»Òâ Úâ ë/ Óâë» Ô½â Êä Úâë Èâë éÖ»â ãÕÕÓÇ. ãÊÌâï» Date : sÉâÌ Place : ÊâÒïë ÚâÉ »ë áï½èÄë »â ãÌ×âÌâ Right Thumb Impression 4 áBÒÉäô »â ÚsÈâÜÓ Signature of the candidate .25. 1961. 25. ceQ ³en Yeer Iees<eCee keÀjlee/keÀjleer ntB efkeÀ cegPes onspe Òeefle<esMe DeefOeefve³ece 1961 kesÀ Debleie&le DeLeJee efJeefOe kesÀ Devegmeej oC[veer³e efkeÀmeer DeHejeOe kesÀ ceeceues ces keÀYeer Yeer oefC[le vener efkeÀ³ee ie³ee nw. jodo keÀjves keÀe DeefOekeÀej nesiee. correct and complete to the best of my Knowledge and belief. the Bank shall have the right to cancel the appointment including the offer for appointment. 23. I am not aware of any cirumstance which might impair my fitness for employment under the Bank. as the case may be. GkeÌle efJeJejCe Yeejleer³e mìsì yeQkeÀ kesÀ efJe%eeHeve mebK³ee meerDeejHeer[er/SyeermeerSue/2012-13/01 efo. ánÒ ãÕÕÓÇ Áâë Ïìï» »ë ãÔ# éÍÒâë½ä Úâë Ö»Èë Úâëï. Additional particulars. Êâë ÍýãÈãwÄÈ ÍãÓ¿âÒ»âëï »ë ÌâÑ. In case the particulars submitted by me are found to be false or not true and/ or suppression of material facts by me while submitting the form is revealed at a latter date. occupations and address of two respectable referees : ®Ñ ÖïKÒâ Sr. vÒÕÖâÒ #Õï ÍÈë Name.2012 Deewj cesjs Dee@veueeF&ve DeeJesove-He$e kesÀ meboYe& ceW Òemlegle efkeÀ³es ie³es nQ. 2. 1 21. ÒãÊ ã»Öä nÒâÒâÔÒ Ìë áâÍ»ë ãÕr} »âëæ ÑâÑÔâ (Ïìï»/ánÒ ãÕùäÒ ÖïsÉâáâë »ä ±Ç áÊâÒ½ä ÌÚä »ÓÌë Öë ÖïÏïãËÈ ÑâÑÔë ÖãÚÈ) ãÕ¿âÓËäÌ Úâë Èâë éÖ»â ãÕÕÓÇ. pewmee Yeer ceeceuee nes. mener Je HetCe& nQ. ÒãÊ áâÍ»âë ã»Öä ÍÊâënÌãÈ ÍÓäÜâ Ñëï ÏìÄÌë ÍÓ Óâë» Ô½âæ ½Òä Úâë Èâë êÖ»â Ðä ãÕÕÓÇ Êëï. ÒãÊ ã»Öä ÖëÕâ áâÒâë½.07. CRPD/ ABCL/2012-13/01 dt.

/Kum. sÉâÌ Place : ÚsÈâÜÓ Signature : ÍÊÌâÑ Designation : ãÊÌâï» Date : ÍÈâ Address : SEAL »âÒâôÔÒ »ë éÍÒâë½ ÚëÈç (1) ÖâÜât»âÓ Ñëï ÖãmÑãÔÈ ÚâëÌë »â ãÊÌâ» ð / FOR OFFICE USE ONLY Date of appearing in interview (2) ÒâëgÒÈâ/ÍýÑâÇÍÝâë »â ÖtÒâÍÌ Ùä. son/wife/daughter of Ùä »âë ãÍÀÔë Shri for the past ÕØâëô ÑÚäÌâë Öë ÁâÌÈâ/ÁâÌÈä Úèû ÈÉâ ÑëÓä ÁâÌ»âÓä years month/s and that to the best of my ÈÉâ ãÕSÕâÖ »ë áÌçÖâÓ éÌ»ë ©âÓâ ãÊÒâ ½Òâ éÍÒçkÈ ãÕÕÓÇ ÖÚä Úìó Knowledge and belief the particulars furnished above by him/her are correct.ÍãÓ¿Ò »â ÍýÑâÇ ÍÝ IDENTITY CERTIFICATE ÍýÑâãÇÈ ã»Òâ ÁâÈâ Úì ã» Ñì Ùä/ÙäÑÈä/»çÑâÓä áâtÑÁ/ÍtÌä/áâtÑÁâ Certified that I have Known Shri / Smt. (3) »ãÑÒâï ÈÉâ ÍýâpÈ ãÕÖï½ãÈÒâï ð Deficiencies and Discrepancies found : 5 ./ÙäÑÈä ÍÊÌâÑ Designation : Eligibility/Certificates verified by Shri/Smt.

09.B mLeeve ë efoveebkeÀ ë (GcceeroJeej kesÀ nmlee#ej) 6 .1993 ceW meceeefJeä DeeosMeeW kesÀ Devegmeej mesJeeDeeW ceW Deej#eCe kesÀ Òe³eespeve nsleg SkeÀ efHeíæ[s Jeie& kesÀ ©He ceW ceev³elee oer ieF& nw. Hereby declare that I belong to the ____________________________________________ Community which is recognised as a backward class by the Government of India for the purpose of reservation in services as per orders contained in Department of Personnel and Training Office Memorandum No. It is also declared that as on the date of interview.09. I do not belong to persons / sections (Creamy Layer) mentioned in column 3 of the Schedule to the above referred Office Memorandum dated 08. ³en Yeer Iees<eCee keÀer peeleer nw efkeÀ ceQ mee#eelkeÀej keÀer efleLeer keÀes GHe³egk& eÌle meboefYe&le keÀe³ee&ue³e %eeHeve efoveebkeÀ 08.1993. 36012/22/93-Estt.DECLARATION TO BE SUBMITTED BY THE OTHER BACKWARD CLASSES CANDIDATES SEEKING RESERVATION AS OBC I______________ _____________________________________________________ Son/daughter of Shri ____________________________________________________ Resident of village/ town/city ___________________ District ______________________ State _____________________________________________ .09.1993 keÀer Devegmet®eer kesÀ mlebYe 3 ceW GefuueefKele J³eeqkeÌle³eeW /KeC[esn (ef¬eÀceer ues³ej) kesÀ oe³ejs ceW veneR nt.09.1993.(SCT) dated 08. Place : Dated (Signature of the candidate) Dev³e efHeíæ[s Jeie& kesÀ ªHe ceW Deej#eCe keÀer ceebie keÀjvesJeeues Dev³e efHeíæ[s JeieeX kesÀ GcceeroJeejeW Üeje Òemlegle keÀer peevesJeeueer Iees<eCee ceQ ______________ ___________________________________________________ Heg$e/Heg$eer Þeer __________________________________________________________ efveJeemeer _______________________________________________________________ ieebJe/keÀmyee/Menj ____________________________ efpeuee _______________________ jep³e ________________________________________ SleodÜeje Iees<eCee keÀjlee/keÀjleer ntB efkeÀ ceQ ____________________________________________ peeefle mes mebyebeOf ele ntB efpemes Yeejle mejkeÀej Üeje keÀeefce&keÀ SJeb ÒeefMe#eCe keÀe³ee&ue³e %eeHeve ¬eÀceebkeÀ 36012/22/93-F&Smeìerìer (Sme meer ìer) efoveebkeÀ 08.

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