10/11/2014

Welcome to NIA - Application Form Print

The New India Assurance Company Ltd. [NIA]

RECRUITMENT OF ADMINISTRATIVE OFFICERS (SCALE-I)
Registration Number

: 84000641

Full Name

: Ankita Bharti

Name of Discipline

: Engineering

Category

: UR

If Person with Disability

: NO

Type of Disability

: -

Percentage of disability

: -

Do you wish to use the services of a scribe(only for VI

and OC candidates whose writing speed is affected by
cerebral palsy) :

: -

Are you suffering from cerebral palsy and your writing

speed is affected : ?

: -

Whether domiciled in Kashmir Division of the State of

J&K during the period 1-1-1980 to 31-12-1989 : ?

: NO

Do you belong to Religious / Linguistic Minority ? :

: NO

Religion to which you belong

: Hindu

Whether are you a Defence service personnel disabled

in operation during the hostilities with any foreign
countriey or in a disturbed area and released as
consequence thereof : ?

: NO

Are you Existing Confirmed Employees of Public Sector

General Insurance Companies (including GIC &
Agriculture Insurance Company of India Ltd.) : ?

: NO

Are you an Ex-Serviceman ?

: NO

Are you a Disabled Ex-Serviceman (DISXS) ?

: NO

Period of service :

: -

Have you joined a Government job on the civil side after

availing the benefits given as an Ex-Serviceman ?

Nationality :

: Indian

State/UT (to which centre of exam belongs):

: Bihar

Centre of Examination

: Patna

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10/11/2014

Welcome to NIA - Application Form Print

Application Fee / Intimation Charges Details

Payment In

: ONLINE(using only Master/Visa Debit or

Credit Cards or Internet Banking)

Amount

: 50.00

Payment Status

: PAID

Reference ID

: ACNB3514608170

Transaction Date

: 11-10-2014

Personal Details
Date of Birth

: 17-06-1990

Age completed (As on 01.10.2014) :

: 24

Gender

: FEMALE

Marital Status

: Unmarried

Husband's Name in Full

: -

Father's Name in Full

: Subhash Chandra Shrivastava

Mother's Name in Full

: Manju Shrivastava

Address for Correspondence

: 441 Nehru Nagar

: P O Patliputra
: Patna

District

: Patna

State

: BIHAR

Pincode

: 800013

Permenant Address :

: 441 Nehru Nagar

: P O Patliputra
: Patna

District

: Patna

State

: BIHAR

Pincode

: 800013

Contact Details
Phone No.

: -

Mobile No

: +91 8292605657

Email ID

: anki356@gmail.com

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Welcome to NIA - Application Form Print

Educational Qualification Details (As on 01.10.2014) :

Note: All the educational qualifications mentioned should be from a University/ Institution/ Board recognized
by Govt. of India/ approved by Govt. Regulatory Bodies and the result should have been declared on or before
(Cutoff Date) with suitable documentary proof.
Exam Passed

Degree

Subject /Stream

Duration
Date of
Of Course Passing

% of
Marks

Class/Grade

Graduation/equivalent : B.Tech

Communication
Engineering

59.01

Second Class

Do you have operating /working

knowledge of computers :

: YES

Details of Computer Knowledge :

: c windows ms office

28-062013

Language Details
Languages
Known

Read

Write

Speak

English

YES

YES

YES

Hindi

YES

YES

YES

Place:

Date: 11-10-2014

Signature of Applicant

I hereby declare that all 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/ in the event any circumstances which may impair my fitness for employment in organization/ I do not
satisfy any of the eligibility criteria stipulated, my candidature is liable to be cancelled.

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