12/2/2014

CWEFORRECRUITMENTOFSPECIALISTOFFICERSINPARTICIPATINGORGANISATIONS(CWESPLIV)ApplicationFormPrint

CWEFORRECRUITMENTOFSPECIALISTOFFICERS(CWESPLIV)
RegistrationNumber

: 1370005929

FullName

: BASUKIKUMARTHAKUR

Post

: I.T.Officer(ScaleI)

PostCode:

: 01

Category

: OBC

IfPersonwithDisability

: NO

TypeofDisability

Areyousufferingfromcerebralpalsyandyourwritingspeedisaffected?

ifyes,Doyourequirecompensatarytimeatthetimeofonlineexamination?

PercentageofDisability

Doyouintendtousetheservicesofascribe(onlyforVIandOCwhosewritingspeedis
affectedbycerebralpalsy)?:

WhetherareyouChildren/familymembersofthosewhodiedin1984riots?:

: NO

WhetherdomiciledinKashmirDivisionoftheStateofJ&Kduringtheperiod111980to31
121989:?

: NO

WhetheryoubelongtoReligiousMinorityCommunity?:

: NO

Religiontowhichyoubelong

: Hindu

AreyouanExServiceman

: NO

PeriodofServiceasanExServiceman(inmonths):

AreyoustillservinginDefenceandapplyingasanExServiceman?:

Ifyes,DateofRelease/RetirementfromService:

HaveyoujoinedaGovernmentjobonthecivilsideafteravailingofthebenefitsgivenasan

http://ibps.sifyitest.com/cwesplnov14/registration_print.php?q=ZTAyMzIzOWJlNjQ2YmYzMWQ5MzA3ZmNiMDAwMDEyODN8MTM3MDAwNTkyOQ==#

1/5

12/2/2014

CWEFORRECRUITMENTOFSPECIALISTOFFICERSINPARTICIPATINGORGANISATIONS(CWESPLIV)ApplicationFormPrint

exserviceman?
WhetherservinginGovt./quasiGovt./PublicSectorUndertakings(includingNationalised
Banks&FinancialInstitutions)?:

: NO

HaveyouappearedfortheCWESPLheldinyearMarch2012:?

: NO

HaveyouappearedfortheCWESPLheldinyearMarch2013?

: NO

HaveyouappearedfortheCWESPLheldinyearFEB2014?

: NO

Nationality/Citizenship

: Indian

State/UTtowhichcentreofexambelongs

: Delhi

StateCode:

: 20

CentreofExamination

: Delhi

ApplicationFeeDetails:
PaymentMode:

: ONLINE

Amount

: 600.00

PaymentStatus

: PAID

ReferenceID

: BSMP3577581256

TransactionDate

: 02122014

PersonalDetails
DateofBirth

: 05081990

Agecompletedason01.11.2014

: 24

Gender

: MALE

SpouseName

Father'sName

: HARINARAYANTHAKUR

Mother'sName

: JITODEVI

AddressforCorrespondence

: BASUKIKUMARTHAKUR
: BHAUWARAMAHTHASAGAR
WARDNO14
: MADHUBANI847212BIHAR

http://ibps.sifyitest.com/cwesplnov14/registration_print.php?q=ZTAyMzIzOWJlNjQ2YmYzMWQ5MzA3ZmNiMDAwMDEyODN8MTM3MDAwNTkyOQ==#

2/5

12/2/2014

CWEFORRECRUITMENTOFSPECIALISTOFFICERSINPARTICIPATINGORGANISATIONS(CWESPLIV)ApplicationFormPrint

District

: MADHUBANI

State

: BIHAR

Pincode

: 847212

PermanentAddress

: BASUKIKUMARTHAKUR
: BHAUWARAMAHTHASAGAR
WARDNO14
: MADHUBANI847212BIHAR

District

: MADHUBANI

State

: BIHAR

Pincode

: 847212

ContactDetails
PhoneNo

MobileNo

: +917053714252

EmailID

: bkthakur99@gmail.com

QualificationDetails(ason09.12.2014):
AreyouaGraduate?

: YES

ExamPassed

Subject/Stream

DurationOfCourse
(inyears)

Dateof
Passing

%ofMarks

Class/Grade

Graduation

InformationTechnology

26062013

65.00

FirstClass

HaveyoupassedDOEACC'B'levelExamination:

: NO

DoyouhaveOperatingandworkingknowledgein
computersystemsi.eCertificate/Degree/Diplomain
ComputerOperations/Language:

: YES

http://ibps.sifyitest.com/cwesplnov14/registration_print.php?q=ZTAyMzIzOWJlNjQ2YmYzMWQ5MzA3ZmNiMDAwMDEyODN8MTM3MDAwNTkyOQ==#

3/5

12/2/2014

CWEFORRECRUITMENTOFSPECIALISTOFFICERSINPARTICIPATINGORGANISATIONS(CWESPLIV)ApplicationFormPrint

DoyouhavestudiedComputer/Information
TechnologyasoneofthesubjectsintheHigh
School/College/Institute?

: YES

DetailsofComputerKnowledge

: Degreein

: Computerlanguage

RegistrationNumberAllotedbyBarCouncil:

DateofEnrolmentwithBarCouncil:

DetailsofPreference

:
1:ECGC
2:PunjabNationalBank
3:IndianBank
4:BankofIndia
5:BankofBaroda
6:OrientalBankofCommerce
7:IndianOverseasBank
8:SyndicateBank
9:UCOBank
10:UnionBankofIndia
11:UnitedBankofIndia
12:DenaBank
13:AllahabadBank
14:AndhraBank
15:CanaraBank
16:CentralBankofIndia
17:CorporationBank
18:IDBIBank
19:Punjab&SindBank
20:BankofMaharashtra
21:VijayaBank
22:BharatiyaMahilaBank

Whetheranyprosecution/detention/fine/conviction/
sentenceagainstyouhasbeenawardedbyany
courtoflawforanyoffence?

: NO

Ifyes,particularsofthesame

LanguagesKnown

Read

Write

Speak

ENGLISH

YES

YES

YES

http://ibps.sifyitest.com/cwesplnov14/registration_print.php?q=ZTAyMzIzOWJlNjQ2YmYzMWQ5MzA3ZmNiMDAwMDEyODN8MTM3MDAwNTkyOQ==#

4/5

12/2/2014

CWEFORRECRUITMENTOFSPECIALISTOFFICERSINPARTICIPATINGORGANISATIONS(CWESPLIV)ApplicationFormPrint

HINDI

YES

YES

YES

DECLARATION
Iherebydeclarethatallstatementsmadeinthisapplicationaretrue.Completeandcorrecttothebestofmyknowledgeandbelief.Iunderstandthat
intheeventofanyinformationbeingfounduntrueorincorrectatanystageorIamnotsatisfyinganyoftheeligibilitycriteriastipulated,mycandidatureisliable
tobecancelled

Date:02122014

http://ibps.sifyitest.com/cwesplnov14/registration_print.php?q=ZTAyMzIzOWJlNjQ2YmYzMWQ5MzA3ZmNiMDAwMDEyODN8MTM3MDAwNTkyOQ==#

SignatureofApplicant

5/5