ON-LINE APPLICATION FOR THE POST OF OFFICER IN GRADE 'B' ( GENERAL)-DR as per Advt. No.

4A/2012-2013

24038
Registration # : 437361
Full Name : IMKUM AIER
Category : ST
If Person with Disability : NO
Type of Disability : -
Whether requires Services of Scribe (Only for those candidates who have physical limitation to write including that of speed.) : NA
Whether domiciled in Kashmir Division of the State of J&K during the period 1-1-1980 to 31-12-1989 ? : NO
Do you possess of M.Phil. Qualification ? : NO
Do you possess of Doctorate Degree/ Ph.D. Qualification ? : NO
Do you fall under the category of Ex-serviceman / Retrenched from Government Office / Banking Institution ? : NO
If Yes, Select the Category : -
Do you have experience as an Ex-Servicemen for more than 5 years ? :
Are you Reserve Bank of India Employee (RBI Staff) ? : NO
If Yes, PF Index No :
Have you appeared four times for 'WE' for Officers in Grade 'B' in RBI in the past ?
( applicable in case of Unreserved/General Candidates only) :

Do you have experience as an officer in Commercial Bank/Financial Institution in Public Sector? : NO
Years of Experience (in Years) :
State/ UT which the Centre of Examination Belongs : Nagaland
Centre of Examination for Objective Type Test (Phase I): Kohima
Centre code : 69
Centre of Examination for Descriptive Type Test (Phase II): Guwahati
Centre code : 18
Application Fee Details :
Payment In : NO FEE
Amount : 0.00
Personal Details :
Date of Birth : 08-07-1985
Age completed as on 01.06.2013 : 27
Gender : MALE
Father's Name : TALINUNGSANG
Mother's Name : TEMSULEMLA
Address for Correspondence : HOUSE NO. 10-GB-402
NAHARBARI VILLAGE
District DIMAPUR
State : NAGALAND
Pin code : 797112
Contact Details :
Phone No : -
Mobile No : 8794176698
Email ID : kmumaier@yahoo.com
Qualification Details (as on 01.06.2013) :
Exam Passed Subject /Stream Date of Passing % of Marks Name of
University /
Institute
Class / Grade
Graduation /
horticulture 19-06-2010 78.70
Central Agricultural
First Class
1/2
Bachelor's Degree :
horticulture 19-06-2010 78.70
University
First Class

DECLARATION:
I hereby declare that all the statements made in this application are true, complete and correct to the best of my knowledge and belief. I understand that if at any stage, it is found that any information given in this
application is false/incorrect or that I do not satisfy the eligibility criteria according to the Board, my candidature /appointment is liable to be cancelled/terminated. I have read and understood the stipulations given in the advertisement
and hereby undertake to abide by them.
Place:
Date: 05-07-2013 Signature of Applicant

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NOTE: Please DO NOT SEND application printout to IBPS


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