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Please paste your recent
passport size photograph
and sign across it. Please
retain atleast 5 copies of
same photograph with you
for subsequent use.

Registration # : 594726
Full Name : Sruthy C
Category : GENERAL
If Person with Disability : NO
Type of Disability : -- Percentage of Disability : --
Do you intend to use the services of a scribe(only for VC and OC
candidates whose writing speed has been affected by cerebral palsy)? :
Are you a candidate who had ordinarily been domiciled in Kashmir
Division of the State of J & K during the period 1-1-1980 to 31-12-1989 ? :
Whether you belong to Religious Minority Community? NO

Minority Religion : --
Are you an Ex-Serviceman ? NO
Are you a Disabled Ex-Serviceman (DISXS)? : NO
Period of Service (in months) : --
Are you a Dependent of an Ex-Serviceman (DXS)? : NO
Have you passed in Armed force Examination with a
minimum of 60% marks which is equivalent to Civil Examination of NO
HSC / Pre - University? :
IAF Educational Test for promotion to the Rank of Corporal : NO
Percentage of marks : --

Passing Out (Indian Navy) Examination conducted by Boys Training

Establishment, Visakhapatnam :
Percentage of marks : --

Whether children / family members of those

who died in 1984 riots ? :

Are you seeking relaxation under widow / divorced women / women

judicially Separated from their husbands and who are not re-married? :
Nationality : Indian

State / Union Territory for which you are applying : Kerala

State / UT code : 26

Centre of Examination : Ernakulam

Centre code : 62

Application Fee / Postal Charges Details :

Transaction No : AA248355
Branch Name : Thalasserry

Branch SOL ID : 39030

Deposit Date : 16-12-2010 Amount : 300

Personal Details :
Age completed as on
Date of Birth : May 26,1987 23
01.11.2010. :
Gender : FEMALE

Father's Name/ Husband's Name : M C Rajan

Mother's Name : C Shanthilatha

Address for Correspondence : Yogimadathil House

(PO) Peringadi
New Mahe

District Kannur
State : KERALA Pin : 673312

Permanent Address : Yogimadathil House

(PO) Peringadi

New Mahe
District Kannur

State : KERALA Pin : 673312

Contact Details:
Phone No : 0490-2337788 Mobile No : 9544470468
Email ID :

Qualification Details (as on 01.11.2010):

Exams Passed Subject/Stream Year Of Passing % of Marks

HSC / Equivalent : Science 2004 69.10

Graduation : Bsc 2007 75.00

Others : MCA 2010 77.00

Working Knowledge of Computer : YES

Details of computer Knowledge : Java,C,C++

Do you know to read write and speak the language of the State / UT for
which you are applying :

Languages Known Read Write Speak

Malayalam YES YES YES




Other Details :
Whether the candidate has undergone prior Pre-Examination Training for Clerical
Cadre? :

Would You like to undergo Pre-Exam Training (SC/ST/Minority Communities) : --

If Yes Centre for Training : --


I hereby certify that the above information furnished is correct to the best of my knowledge and belief. I have not suppressed any material fact or
factual information in the above statement. I am aware that in case I have given wrong information or suppressed any material fact or factual information or I do not
satisfy the eligibility criteria according to the advertisement, then my candidature will be rejected/services terminated even after permanent employment without
giving any notice or reasons thereof.

I hereby certify that I am satisfying the eligibility criteria for the post applied for in terms of the advised criteria in respect of age, educational qualification
and experience etc.

I am also willing to serve anywhere in India. I agree that the Bank has the right to transfer me to any part of the country and/or to any job
position at its sole discretion in terms of applicable staff rules from time to time.
I hereby agree that any legal proceeding in respect of any matter or claims or disputes arising out of application or out of said advertisement can be
instituted by me only at Mumbai only, shall have sole and exclusive jurisdiction to try any cause/dispute. I undertake to abide by all the terms and conditions in the
advertisement given by the Bank.

Date: 16-12-2010 Signature of Applicant

Sruthy C
Please retain your Registration No. and Password emailed to you carefully for further reference
NOTE: Please DO NOT SEND application print-out to the Bank