6/6/2019 RECRUITMENT OF APPRENTICE DEVELOPMENT OFFICERS

Life Insurance Corporation of India 310130

RECRUITMENT OF APPRENTICE DEVELOPMENT OFFICERS

Registration Number : 1760232126

Full Name : Utkarsh Sahu

Type of Applicant : : Others

Category : OBC
Are you a child/ family member of those who died in 1984 riots ? : NO
Are you a Person ordinarily domiciled in the State of Jammu & Kashmir : NO
during the period from 01.01.80 to 31.12.89 ?
Religion to which you belong : Hindu
Do you belong to Religious Minority Community ? : NO

Are you an Ex-Serviceman : ? : NO

Actual period of service rendered in defence services as an Ex-servicemen : -
(in Months)
Zone : North Central Zone
Choice of Division : KANPUR

Choice of Centre Phase-I: Preliminary Examination : JHANSI

Choice of Centre Phase-II : Main Examination : JHANSI
Applied for : : Urban
Nationality / Citizenship : Indian

Application Fee / Intimation charges

Payment In : ONLINE
Fees : 508.48
Tax : 91.52 (IGST)
Amount : 600.00
Payment Status : PAID
Reference ID : QHMP7620197952
Transaction Date : 06-06-2019

Personal Details
Date of Birth : 23-05-1992
Age completed as on 01.05.2019 : 26
Gender : MALE
Marital Status : Unmarried

Father's Name : Hari Ram Sahu

Mother's Name : Pushpa Sahu
Spouse's Name : -
Address for Correspondence : 53by1 Outside Laxmi Gate
District : Jhansi

https://ibpsonline.ibps.in/licadomay19/registration_print.php?q=YWE1Mjc5YTY4Y2VlMzQxMWU4ZjlmYjgyNzAzODNjMzF8MTc2MDIzMjEyNg== 1/3
6/6/2019 RECRUITMENT OF APPRENTICE DEVELOPMENT OFFICERS
State : UTTAR PRADESH
Pincode : 284002
Permanent address : 53by1 Outside Laxmi Gate

District : Jhansi
State : UTTAR PRADESH
Pincode : 284002
State for GST invoicing : Permanent Address (UTTAR
PRADESH)

Contact Details
Mobile No : +91 9450000538
Alternative Number : +91 8577000048
(Mobile No/Landline No)
Email ID : 9695971011u@gmail.com

Educational Qualification Details(as on 01.05.2019)

Exam Passed Degree/ Subject / Name of the Date of % of Marks Class / Grade
Stream Institution/College Passing

Graduation / Equivalent Others - Btech Dr APJ ABDUL KALAM 22-01-2016 69.00 First Class
UNIVERSITY

Sales Experience details (as on 01.05.2019) (Start from present Employer)

Total Period of Service Name and place of the institution

From To

Presently working? : YES

28/03/2016 06/06/2019 LIC JHANSI

If related to any Agent/Employee/Officer/Medical Examiner etc. of the LIC of India, Please state: :

His / Her Name : ANSUL SAXENA

Designation : DEVELOPMENT OFFICER

Place of : JHANSI
posting/working
Exact Relationship : Coworker

Other Details :

Whether desirous of : YES

taking Pre-Exam Training
(SC/ST/OBC) :

Languages Known Read Write Speak

ENGLISH YES YES YES

HINDI YES YES YES

https://ibpsonline.ibps.in/licadomay19/registration_print.php?q=YWE1Mjc5YTY4Y2VlMzQxMWU4ZjlmYjgyNzAzODNjMzF8MTc2MDIzMjEyNg== 2/3
6/6/2019 RECRUITMENT OF APPRENTICE DEVELOPMENT OFFICERS

Uploaded Document Details :

1. Thumb impression
2. Handwritten Declaration

Declaration:
I hereby declare that all the statements made in this application are True, Complete and Correct to the best of my knowledge and belief. I understand
that in the event of any information being found untrue or incorrect at any stage or I am not satisfying any of the eligibility criteria stipulated, and also in
case of creating influence/undue pressure regarding recruitment shall tantamount to cancellation of my candidature.

Date: 06-06-2019 Signature of Applicant

Thumb impression

Handwritten Declaration

https://ibpsonline.ibps.in/licadomay19/registration_print.php?q=YWE1Mjc5YTY4Y2VlMzQxMWU4ZjlmYjgyNzAzODNjMzF8MTc2MDIzMjEyNg== 3/3