APPLICATION FOR APPOINTMENT OF

EXPERT – INFORMATION TECHNOLOGY ON CONTRACT BASIS

(Kindly tick the post you wish to apply)

1. Chief Data Officer

2. Head - Program Management & IT Compliance
3. Deputy Chief Technology Officer Channels
4. Deputy Chief Technology Officer Digital

To,

IDBI Bank Ltd., Affix recent

Human Resource Department (HRD) passport
IDBI Tower, WTC Complex, size photo
Cuffe Parade,
Mumbai - 400 005

With reference to your advertisement on Bank’s website dated __________, I submit my

application in prescribed form for the post of _______________________.

1) Full Name
2) Address for
Correspondence
State: Pin:
3) Contact Telephone:
Information:
Mobile:
E-mail:
4) Permanent Address:
State: Pin:
5) Date of Birth: Age as on:
6) Place of Birth: District: State:
7) Other Information: Nationality: Religion:
Gender:
8) Marital Status:
9) Category
(General/ SC/ST OBC/
PWD/ Ex. Servicemen)
1
10. Details of Educational and Professional Qualification:

Qualification Year of Passing Subject / Specialization

Graduation

Post Graduation

Professional Qualification

Others

11. Particulars of Experience: Total (in years): __________________________

Sr. Post / Organisation details Period Scale of pay Details of

No From To responsibilities

(Additional details of qualification and experience, if any, may be enclosed separately along
with certificates in support of age, qualification and experience)

12. Brief details of experience (Period of experience to be indicated).

13. Significant Achievement (if any) in respect of above assignments –

14. Details of last pay drawn:

15. Pension drawn, if any:

16. Name address and contact number of referees:

1) 2)

2
 Declaration:

1. I hereby certify that the information furnished above is correct to the best of my
knowledge and belief. I have not suppressed any material fact or factual information in
the above statements. I am aware, that, in case, I have given wrong information or
suppressed any material facts 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 appointment as Expert/ Professional on contract without giving
any notice or reason thereof.
2. I hereby certify that I am satisfying the eligibility criteria for the engagement as Expert
(on contract) in terms of advertised criteria in respect of age, educational qualification
and experience, etc.
3. I agree that the Bank has a right to post me to any part of the country.
4. I undertake to abide by all the terms and condition in the advertisement given by the
Bank. I hereby agree that any legal proceedings in respect of any matter(s) or claims or
disputes arising out of this application and/ or out of said advertisement can be
instituted by me only at Mumbai and courts/ Tribunals/ Forums at Mumbai only, shall
have sole the exclusive jurisdiction to try any cause/ dispute.

Place:
Signature
Date: Name ________________________

Enclosures: