7/9/2016

RecruitmentofProbationaryOfficersJMGSI(PGDBF)ApplicationFormPrint

UnitedBankofIndia
RecruitmentofProbationaryOfficersJMGSI(PGDBF)

RegistrationNumber

: 410137488

FullName

: PavankumarK

Category

: GENERAL

IfPersonwithDisability

: NO

TypeofDisability

Percentageofdisability

Areyousufferingfromcerebralpalsyandyourwritingspeedis
affected?

IfYes,Doyouneedcompensatorytimeatthetimeof
examination?

Whetheryourdominant(Writing)handisaffected?

IfYes,Doyouneedcompensatorytimeatthetimeof
examination?

Doyouintendtousetheservicesofascribe(onlyforVI
candidatesandthecandidateswhosewritingspeedis
permanentlyaffected)?

WhetherPersonsordinarilydomiciledintheStateofJammu&
Kashmirduringtheperiodfrom01.01.1980to31.12.1989?

: NO

Areyouseekingrelaxationunderwidow/divorcedwomen/
womenjudiciallySeparatedfromtheirhusbandsandwhoare
notremarried?

: NO

Religiontowhichyoubelong

: Hindu

WhetheryoubelongtoReligiousMinorityCommunity?

: NO

AreyouanExServiceman(includingECOs/SSCOs)?

: NO

PeriodofService(inmonths)

HaveyoujoinedaGovernmentjobonthecivilsideafter
availingthebenefitsgivenasanExServiceman?

Nationality

: Indian

DoyouholdAadharCard?

: YES

AadharCardNo.

: 355034054798

State/UT/NCR(towhichcentreofexambelongs)

: AndhraPradesh

StateCode

: 12

CentreofExamination

: Tirupati

ApplicationFee/PostalChargesDetails
Amount

: 700.00

PaymentStatus

: PAID

ReferenceID

: GIC24596936526

TransactionDate

: 09072016

PersonalDetails
DateofBirth

: 15051992

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RecruitmentofProbationaryOfficersJMGSI(PGDBF)ApplicationFormPrint

Agecompletedason01.06.2016

: 24

Gender

: MALE

MaritalStatus

: Unmarried

SpouseName

Father'sName

: Knarasimhulu

Mother'sName

: krajini

AddressforCorrespondence

: 18137khadhicolony

Address2

: annaraocircle

Address3

: tirupati

District

: Chittoor

State

: ANDHRAPRADESH

Pincode

: 517507

Permanentaddress

: 18137khadhicolony

Address2

: annaraocircle

Address3

: tirupati

District

: Chittoor

State

: ANDHRAPRADESH

Pincode

: 517507

ContactDetails
MobileNo

: +917022889005

AlternativeNumber
(MobileNo/LandlineNo)

: +919642332230

EmailID

: pavankumar.kothenti@gmail.com

EducationalQualificationDetails(ason01.06.2016)
ExamPassed

Subject/Stream

Dateof
Passing

%ofMarks

Class/Grade

Graduation

Othersbtech

31052013

71.79

FirstClass

PostGraduation

pgdm

01042015

71.00

FirstClass

PostQualificationworkexperiencedetails(StartfrompresentEmployer)
Nameofthe
Employer

Designation
and
Rankifany

From

To

Natureofduties
performed

Industry
Type

Reasonfor
Leaving

Yearsof
Service
(YY/MM/DD)

shoppersstop

management
trainee

04/05/2015

15/06/2016

operations

retail

health

1/1/12

TotalExperienceinnotifiedfields(inmonths):13

OtherDetails
WhetherdesirousoftakingPreExamination
Training(ApplicableOnlyforSC/ST/MINORITY
COMMUNITIESCANDIDATES):

IfYes,CentreforTraining

OtherDetails:
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RecruitmentofProbationaryOfficersJMGSI(PGDBF)ApplicationFormPrint

LanguagesKnown

Read

Write

Speak

English

YES

YES

YES

Telugu

YES

YES

YES

Hindi

YES

YES

YES

Declaration:
IherebydeclarethatallthestatementsmadeinthisapplicationareTrue,CompleteandCorrecttothebestofmyknowledgeandbelief.I
understandthatintheeventofanyinformationbeingfounduntrueorincorrectatanystageorIamnotsatisfyinganyoftheeligibility
criteriastipulated,andalsoincaseofcreatinginfluence/unduepressureregardingrecruitmentshalltantamounttocancellationofmy
candidature.

Date:09072016

SignatureofApplicant

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