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4/26/2015

RecruitmentofProbationaryOfficersinStateBankofIndiaApplicationFormPrint

RECRUITMENTOFPROBATIONARYOFFICERSINSTATEBANKOFINDIA

RegistrationNumber

: 1390905342

FullName

: CHAUDHARIJATINKUMAR
DHIRAJLAL

Category

: ST

IfPersonwithDisability

: NO

TypeofDisability

PercentageofDisability

Whetheryourdominant(writing)handaffectedandyourwritingspeed
affected?

IfYes,Doyouneedcompensatorytimeatthetimeofexamination?

Doyouintendtousetheservicesofascribe(ApplicableonlyforVHor
OHCandidates)?

Categorycode

: 4

WhetherdomiciledintheStateofJammu&Kashmirduringtheperiod
111980to31121989:?

: NO

Religiontowhichyoubelong

: Hindu

WhetheryoubelongtoReligiousMinorityCommunity?:

: NO

AreyouanExServiceman

: NO

PeriodofService(inmonths)

Nationality

: Indian

Pleasementionthenumberofoccasionsonwhichyouhaveappeared : 0
fortheexaminationforrecruitmentofProbationaryOfficersinSBI
(chanceswillbecountedfromthelastexaminationwhichwasheldon
18.04.2010)
State/UT(towhichcentreofexambelongs)

: Gujarat

StateCode

: 19

CentreofExamination

: Surat

ApplicationFee/IntimationChargesDetails:
PaymentMode

: ONLINE

Amount

: 100.00

PaymentStatus

: PAID

ReferenceID

: CSBI3766473592

TransactionDate

: 26042015

PersonalDetails
DateofBirth

: 26081988

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4/26/2015

RecruitmentofProbationaryOfficersinStateBankofIndiaApplicationFormPrint

Agecompletedason01.04.2015

: 26

Gender

: MALE

MaritalStatus

: Unmarried

Husband's/Father'sFirstName

: CHAUDHARI

Husband's/Father'sMiddleName

: DHIRAJLAL

Husband's/Father'slastName

: NIJARUBHAI

Mother'sFirstName

: CHAUDHARI

Mother'sMiddleName

: NILIMABEN

Mother'sLastName

: DHIRAJLAL

AddressforCorrespondence

: 750KANANCO.OP
SOCIETY
: RAJANNAGARNEAR
OVERBIRDGE
: ABRAMA

District

: VALSAD

State

: GUJARAT

Pincode

: 366001

PermanentAddress

: 750KANANCO.OP
SOCIETY
: RAJANNAGARNEAR
OVERBIRDGE
: ABRAMA

District

: VALSAD

State

: GUJARAT

Pincode

: 366001

ContactDetails
PhoneNo

MobileNo

: +919428883703

EmailID

: jatinchaudhari@hotmail.com

EducationalQualificationDetails(ason01.09.2015):
ExamPassed

Degree/Subject/Stream

DateofPassing(Datementionedin %ofMarks
marksheetorcertificatewhichever
isearlier)

Graduation/Equivalent
Passed

Engineering

16062011

57.80

PostGraduation

MASTERINENGINEERING

04082014

82.60

Other

DIPLOMAINELECTRONICSAND
COMMUNICATION

10092008

61.92

OtherDetails:
WhetherdesirousoftakingPreExamTraining : YES
(SC/ST/ReligiousMinorityCommunity)
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4/26/2015

RecruitmentofProbationaryOfficersinStateBankofIndiaApplicationFormPrint

IfYesCentreforTraining

: Vadodara

LanguageDetails:

NameoftheLanguage

Read

Write

Speak

ENGLISH

YES

YES

YES

HINDI

YES

YES

YES

GUJARATI

YES

YES

YES

DECLARATION
IherebydeclarethatallstatementsmadeinthisapplicationareTrue.Completeandcorrecttothebestofmyknowledgeandbelief.I
understandthatintheeventofanyinformationbeingfounduntrueorincorrectatanystageorIamnotsatisfyinganyoftheeligibility
criteriastipulated,mycandidatureisliabletobecancelled.Incaseofcreatinginfluencecandidatureofthecandidateshallbecancelled

Date:26042015

SignatureofApplicant

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