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Personal Details :
Date of Birth : 29/04/1990 Age completed as on 20
01.12.2010 :
Gender : Female
Husband's Name / Ajay mittal Mother's Name : Sujata mittal
Father's Name :
Address for Correspondence : 31- jeevan dhara
appartment
Idgah hills bhopal
District : bhopal
State : Madhya Pradesh Pin : 462001
Permanent Address : 31- jeevan dhara
appartment
Idgah hills bhopal
District bhopal
State : Madhya Pradesh Pin : 462001
Contact Details:
Phone No : 0755-2738991 Mobile No : 9893701031
Email ID : pankh_4829@yahoo.com
Graduation / Equivalent
Others
DECLARATION:
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 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/services 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 the advised criteria in
respect of age, educational qualification and experience, etc.
I am also willing to serve anywhere in India. I agree that the Bank has the right to transfer me to any part
of the country and/or to any job position at its sole discretion in terms of applicable staff rules from time
to time.
I hereby agree that any legal proceeding in respect of any matter(s) or claims or disputes arising out of this
application or out of said advertisement can be instituted by me only at Mumbai and Courts/Tribunal/ Forums at
Mumbai only, shall have sole and exclusive jurisdiction to try any cause/dispute. I undertake to abide by all the
terms and conditions mentioned in the advertisement given by the Bank.
Place:
Date: 30/12/2010
Signature of Applicant:
Name :Ms mittal pankhuri
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.