Primary details/

*Post Applied For/

: SWEEPER-CUM-PEON

Surname/ : KOLLURI

*First Name/ : GANESH

Middle Name/ :

*Father's Name/ / : K SANKARAM

*Date of Birth (DD-MM-YYYY)/ : 10-04-1996

20 year(s), 8 month(s), and 6 day(s) as on 16-12-2016

*Gender/ : MALE

*Nationality/Citizenship/ / : INDIAN

*Religion/ : HINDU

*Caste Category/ : SC

*State of Origin/ : ANDHRA PRADESH

*Whether Physically Handicapped? (Percentage of Disability >= 40)/

: NO
? ( >= 40)

*Are you suffering from cerebral palsy and your writing speed is affected?/
: NO
?

*Do you need compensatory time at the time of examination?/

: NO
?

*Whether are you Children/family members of those who died in 1984 riots?/
: NO
/ 1984 ?

*Are you a person domiciled in the State of Jammu & Kashmir during the period
1-1-1980 to 31-12-1989?/ 1-1-1980 31-12-1989 : NO
?

* Are You an Ex-Serviceman?/ - ? : NO

* Are You still serving in Defence and applying as an Ex-Serviceman?/

: NO


?

*Have you joined a Government job on the civil side after availing of the
benefits given as an ex-serviceman?/ : NO
?

*Are you Regular employees of the Union Carbide Factory, Bhopal retrenched
from service (Applicable to Madhya Pradesh State only)/
: NO
, (
)

Details for Communication/

Permanent Address/ Address for Correspondence/

Same as Permanent Address/

*Address Line 1/ 1 : KOLLURU GANESH *Address Line 1/ 1 : KOLLURU GANESH

Address Line 2/ 2 : S/O SAMKARAM Address Line 2/ 2 : S/O SAMKARAM

Address Line 3/ 3 : BODDUVANI GUDEM Address Line 3/ 3 : BODDUVANI GUDEM

Address Line 4/ 4 : AGINIPARRU VILLAGE Address Line 4/ 4 : AGINIPARRU VILLAGE

*City/Village/ / : PAMIDIMUKKALA MANDAL *City/Village/ / : PAMIDIMUKKALA MANDAL

*District/ : KRISHNA *District/ : KRISHNA

 *State/ : *State/ :
ANDHRA PRADESH ANDHRA PRADESH

*Pin code/ : 521250 *Pin code/ : 521250

Aadhar No./ : 263486110847

*Email ID/ : ganeshkolluri917@gmail.com

*Confirm Email ID/

: ganeshkolluri917@gmail.com

*Mobile No./ : 9848556702 Do not prefix '0' or '+91' before the mobile no.

*Confirm Mobile No./ : 9848556702 Do not prefix '0' or '+91' before the mobile no.

Landline No./ . :

I confirm that the Address and Communication details given above are correct./

Educational Qualifications (From 10th Onwards):/

(10 )

School/College/Institute/Board/ / / Percentage/ Year of Passing/

Class/Course/ / Degree/
/

*Matriculation/SSC/ /
-- Z P HIGH SCHOOL PAMIDIMUKKALA 88.90 2011

10+2/HSC/ 10+2/ -- N R I JUNIOR COLLEGE VIJAYAWADA 90.09 2013

Graduation/ Select

Post-Graduation/ Select

Other Degree 1/ 1 Select

Other Degree 2/ 2 Select

Other Degree 3/ 3 Select

Languages Known: :

*Local Language of the State to be mentioned/

: Read/ Write/ Speak/
TELUGU

Hindi/ : Read/ Write/ Speak/

English/ : Read/ Write/ Speak/

If Other(Please Specify)/ ( )
: Read/ Write/ Speak/

*Whether registered with District Employment Office/

: NO

Experience Details/

Name of Organisation/ Nature of job/ From/ Till/ Reasons For Leaving/

Additional Information:/

*Have you ever been arrested, or kept under detention/was imprisoned or

bound down/fined/convicted by a Court of Law for any offence for any offence
or FIR lodged / complaint registered/ charges framed against you or any
criminal case pending against you before any Court of Law/authority or
debarred /disqualified by the Public Service Commission from appearing at its
examination selection or debarred from taking any examination or restricted by
any authority / any institution / terminated from service by any previous
employer for any criminal offence/indiscipline or any other acts/s of
misconduct etc./ , / : NO

/ /
/

/


/

/

/ / /
?.

45.115.1.230

Declaration/ :

I declare that the information as given above is true and correct to the best of my knowledge and belief. If any information is found to be partially or fully
wrong/incomplete or fabricated and/or if any information is not fully disclosed and is fully or partially withheld, then Bank shall have the right to cancel the
candidature without notice / .
/ /

,

.

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