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TAMILNAD MERCANTILE BANK LIMITED

Regd.Office: 57, V.E.Road,
THOOTHUKUDI 628002.
Interview No:













Do not sign on the
photograph

1. Name (Block letter) :

2. Father Name :

3. Sex :

4 a) Date of Birth :
(Copy of Secondary School
Leaving certificate showing the
date of birth and personal marks of
Identification etc., should be
attached)

b) Age (in completed years) :

5. a) Religion :

b) Community OBC/SC/ST/Others :

6 a) Native Place :

b) District :

7 a) Permanent address with Pin code :





b) Present address with Pincode :





c) Phone / Mobile No :



8 a) Marital Status :

b) If married, Occupation of Spouse :

c) If spouse is employed, details thereof :

Please affix here
a copy
of your recent
passport
size photograph



TO BE FILLED BY THE CANDIDATE FOR THE POST OF CLERKS.

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9. Academic Qualification


S.No

Course/Degree


Institution/University

Month &
Year of passing

% of
Marks

Grade/
Class
1. S.S.L.C

2. H.Sc.

3.

4.

5.


10. Technical / Additional Qualification


Course


Institution
Period
of
study
Year
of
passing
%
of
Marks

Grade/Class




11. Particulars of participation in Sports and :
other Extra-Curricular activities.

12. Hobbies and other Interest. :


13..Mother Tongue

Proficiency in other languages Speak Read Write
Language
1.
2.
3.

14. Employment Experience (Past & Present)

Name & Place of
the Organization
Designation & Nature of
work/Job Details handled
Period of
Employment
(Date)
Experience
In months
Reason for
leaving
From To








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[
15. Details of Present Employment:



16. Last drawn Salary per Month:



17. Family Background: Father/ Husband / Guardian

i) a) Name b) Age

c) Occupation d) Yearly Income

ii) Particulars of other members of the family (Mother, Brothers, Sisters, etc)

Name

Age Relationship Qualification Occupation








iii) Particulars of two close relatives:

Name

Age Qualification Occupation








18. Business profile: In case any of your family
members are in business

a) Details of dealings with our Bank/ Other bank

b) Whether directly or indirectly interested in the
business

19. Are you related in any way to any
Director / Ex-Director of our Bank?
If so, state the name of our Director / Ex-Director
and the relationship

20. Have you any relative in the service of this Bank?
If so, give details and state relationship

21. Have you ever appeared for any written test or
interview for any post in our Bank? If so, when?

22. Whether you are orthopedically handicapped
(Please state the nature of physical defect)

23. a) Have you ever been arrested, kept under
detention or bound down/fined, convicted by
court of law for any offence involving moral
turpitude? If yes, give full details.
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b) Have you ever been debarred / disqualified
by any institution from appearing for its
examination / selection or debarred from any
examinations, conducted by any university or
any other educational authority / institution?
If yes, give full details.

24. a) Is any case pending against you in any court of
law involving moral turpitude? If yes, give
full details.

b) If any case is pending against you in any
university or any other educational authority,
Institution at the time of filling of this form? If
yes, give full details.

25. Are you registered on the live registers of any
Employment Exchange? If so, mention the name
Of Exchange and the Registration Number.

26. Are you a member of any social Organisation /
Political party? Give Particulars.

27. Have you got any award from School / College/
present working institution?
Give particulars

28. Names, occupations and addresses of TWO
respectable persons not related to you but knowing
you (to be used for referral opinion)


Reference 1 Reference - 2
Name

Occupation

Communication
Address



Phone/Mobile
No.


29. Any other information that you have not been able
to provide in answer to our above specific
questions may be furnished here.

I1(/)/I1O) I1(/)/I1O) I1(/)/I1O) I1(/)/I1O)

I hereby declare that the above statements are true and correct, and it is understood that if
I am employed, the offer of employment will be based upon the truthfulness of the statements
made herein, and in the event of any information being found false or incorrect my appointment
is liable to be terminated. I agree, if selected, to serve anywhere India.



Date : Signature of the applicant.

Place :