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Percentage of Disability : --
Do you intend to use the --
services of a scribe :
Whether you belong to Yes
Religious Minority Community :
Religion to which you belong: Christian
Others: --
Ex-Serviceman : No
Total Period of Service : (in --
Months)
Disabled Ex-Serviceman No
(DISXS) :
Dependent Ex-Serviceman No
(DXS) :
Domiciled in Kashmir Division: No
Nationality : INDIAN
Centre of Examination : Ernakulam
Centre code : 13
Personal Details :
Date of Birth : 30/11/1987 Age completed as on 23
01.01.2011 :
Gender : Male
Husband's Name / AUGUSTIN Mother's Name : ALICE
Father's Name :
Address for Correspondence : KODIAMKUNNEL (H)
NELLAPPARA
KARIAMKUNNAM P.O.
District : IDUKKI
State : Kerala Pin : 685586
Permanent Address : KODIAMKUNNEL (H)
NELLAPPARA
KARIAMKUNNAM P.O.
District IDUKKI
State : Kerala Pin : 685586
Contact Details:
Phone No : - Mobile No : 9605861351
Email ID : varundecker11@gmail.com
Professional --
Qualification
Others 1 Degree --
Others 2 Degree --
Other Details:
Pre-Examination Training : No
Centre for Pre-Examination Training : No
Knowledge of the local language of the State / Union Territory for which he / she is applying
Languages Known Read Write Speak
TAMIL No No Yes
DECLARATION:
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/ service 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 advised criteria in respect of age, caste,
educational qualification etc.
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 PAIRD and courts/ Tribunal/ forums atPAIRD only, shall have sole and exclusive
jurisdiction to any cause/ dispute. I undertake to abide by all the terms and conditions in the advertisement given by the Bank.
Place:
Date: 18/05/2011
Signature of Applicant:
Name :VARUN DECKER
Note: Please retain your registration No. Password emailed to you and copy of printout carefully for further reference. Please DO
NOT SEND application print-out to the Bank.
Please retain your Registration No. and Password carefully for future reference.