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ALLAHABAD BANK - DOC 11

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					                                                          ALLAHABAD BANK                                                                 Affix your recent
                                                 BIO DATA CUM DECLARATION FORM                                                          stamp size colour
           (Please fill up the Bio Data Form and make 4 copies of it. Bring all the 5 copies at the time of interview)                    photograph &
                                                                                                                                            sign(similar)
 1. Post Applied for: AGRICULTURE FIELD OFFICER            Roll No : ……………………                                                            across so that a
 2. Date of Interview: ………………………                       Interview Centre: ……………………                                                           part of the
 3. Full Name (in Block Letters leaving one box blank between the parts of your name):                                                        signature
    Shri/ Smt/ Kum :                                                                                                                    spreads over the
                                                                                                                                        application form



 4. Father’s/Husband’s Name:



 5. Father’s Occupation ( Service/Business):                           If service, give details : Post :

                                                                                                   Designation :
                                                           SINGLE           MARRIED
 6. Sex:        M          F      7. Marital status                                                Full address of the Office with PIN Code
                                                                                                   ……………………………………………………
 8. (a) Date of Birth :                                                                            ………………………………………………………
                                  (Date)            (Month)                  (Year)                ………………………………………………………

     (b) Age as on 01.01.2010 :             _____ Years       ______ Months       ______ Days.

     (i) Relaxation of Age ( if claimed) : _________ No of Years, Under Category _____________________________
          ( SC/ST/OBC/PC/EXSM/Dependent of EXSM/Disabled EXSM/Widow, Divorcee not remarried/Domiciled IN KASHMIR DIVISION )
                                     (Please attach self attested Photostat copy)

 9 .Category [PLEASE MENTION YES/ NO ] :

          SC        ST                        OBC                       General    Whether MC( Sikh/Muslim/Christian/Neo-Buddhist/ Zoroastrian etc.)
                           Creamy Layer        Non-Creamy Layer                                       (please write community)


   (a) If SC/ ST/ OBC, please mention name of sub caste : _____________________________________________
       (Please attach self attested copy of Caste Certificate on prescribed proforma as applicable, issued by Competent Authority)

  (b) If OBC, Date of issuance of relevant certificate : …………………….
         ( OBC Certificate on prescribed proforma should not be more than one year old as on the date of application i.e. issued on or
         after 09.12.2008.)

   (c) If physically challenged (PC), [ PLEASE MENTION YES/NO ] :

         Orthopaedically Challenged (OC)                         Hearing Impaired (HI)                                Visually Impaired (VI)
                                                              Deaf          Hearing impairment                    Blindness           Low vision


   (i)   Percentage of Disability : _____        ( for OC candidates ), (ii) Hearing Impairment : …………. decibels ( for HI candidates )

   (iii) Visual acuity : -------- Snellen and Limitation of the Field of vision subtending an angle of : ………… Degree ( for VI candidates)
         (Please enclose self attested Photostat copy of medical certificate issued by competent authority/Medical Board)

   (d) If EX-Serviceman : (i) Date of Discharge :                    (ii) No objection certificate :
                          (iii) Whether Fit for Civil Employment [ PLEASE MENTION YES/NO ] :
                          (iv) Whether re-employed after discharge [ PLEASE MENTION YES/NO ] :
 10. Educational Qualifications: (As on 01.01.2010)

             Name of                                                            Date,
Examination/ Exam/
                                            Subjects Studied
                                                                               Month &       % of Marks           Name of Board/              Whether
   Degree    Degree                                                            Year of        obtained           University ( Whether      recognised?
             passed                                                            Passing                           Govt./Autonomous)          ( Yes/No)

    12th

Graduation

    Post
 Graduation


                                                                        Signature of the candidate ……………………………………..
                                                                         (2)
11. Computer Knowledge:
         Name of the            Subject/Area                 Duration              Date of          Name & address of           Whether
           Course             covered/Exposed             From      To           completion           the Institution         recognised
                                                                                                                               (Yes/No)



12. Particulars of Previous Employment (as on 01.01.2010) :
   (Please attach copies of relevant certificates and No Objection Certificate from Employer)

   Name & address of the        Designation         Period of           Length of            Monthly          Nature of         Remarks
      Organisation               /post held          Service             Service             Salary             duties        (reasons for
                                                 From      To         Years   Month                          Performed in      leaving), if
                                                                                                                 detail       applicable
   1.
   2.

13.Languages Known :
  [ PLEASE MENTION YES/NO ]                 Language                      Read                Write                   Speak
                                      1.
                                      2.
                                      3.
14. Particulars of relative, if any, serving with Allahabad Bank :

    Sl. No                     Name                             Designation                Place of posting                 relationship
    1.
    2.

14. Extra curricular Activities (Games/Membership/Association etc.) :
15. Hobbies:

16. Achievements, if any         :
17. Permanent Address: …………………………………………………………………………………………………………………
                             …………………………………………………………………………………………………………………
    Please mention H No, Lane/street/Road/Town, Village, Post, Via, Thana, District, State, PIN Code etc)

18. Address for Correspondence: ………………………………………………………………………………………………………
                                        -…………………………………………………………………………………………………….
    (Please mention H No, Lane/street/Road/Town, Village, Post, Via, Thana, District, State, PIN Code etc)
19. Name of the State/UT to which you belong: District …………………………… State/UT………………………………………
20. Mobile No. …………………….………. Tel. No…………………………….. E-mail ID: ……………………………………..
21. Nationality : …………………….                                     22. Religion : ………………………..
23. Have you already been called for Interview/ selected in any other Bank/Organization, give details:
    ……………………………………………………………………………………………………………………………………………..
24. Have you ever been arrested, or kept under detention or bound down/fined/convicted by a court of Law for any offence or a
    case against you is pending in respect of any criminal offence/charge/is under investigation, inquiry or trial.

[ PLEASE MENTION YES/NO                               . If “Yes” full particulars of the case should be given:

    Case/Suit No. ……………………..  Thana/Court………………….   Section/Act…………………………….
    Summary of case:………………………………………………………………………………………………………………………
                                        Declaration
          I hereby declare that all the statements made above are true, complete and correct to the best of my knowledge and
belief. I understand and agree that misrepresentation, falsification or omission of material facts if found at any stage or not satisfying
the eligibility criteria (as on 01.01.2010) according to the requirements of the advertisement for the post, my candidature/
appointment is liable to be cancelled/ terminated.

         I am wiling to serve anywhere in India. I agree that the Bank has the right to transfer me to anywhere in India at its
discretion. I am agreeable to execute a financial Bond of Rs.50,000/- as per terms of advertisement.

        I undertake to abide by all the terms & conditions mentioned in the advertisement/Service Regulation of the Bank for the
post given by the Bank.
Date:                                                                                 _______________________________________
Place:                                                                         (Signature of the Candidate as in written test call letter)
                                                                                Name:
AFO                                                                             Roll No

				
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posted:5/21/2010
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