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ON-LINE APPLICATION FOR ANDHRA BANK CLERKS RECRUITMENT PROJECT

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Please paste your recent
passport size photograph
and sign across it. Please
retain atleast 5 copies of
same photograph with you
for subsequent use.

Registration # : 3330974
Full Name : MANMADHA RAO.M
Category : SC
If Person with Disability : NO
Type of Disability : -- Percentage of Disability : --

Do you intend to use the services of a scribe( only for VI and

--
OC candidates whose writing speed is affected by cerebral palsy) :
Whether domiciled in Kashmir
NO
Division of the State of J&K during the period 1-1-1980 to 31-12-1989?
Whether you belong to Religious Minority Community NO
Religion to which you belong : --
Are you an Ex-Serviceman? NO
Are you a disabled Ex-Serviceman (DISXS) NO
Are you a dependent of an Ex-Serviceman (DXS) NO
Are you Children / family members of those who died in 1984 riots ?: NO

Are you seeking relaxation under window / divorced women / women

NO
judicially Separated from their husbands and who are not re-married?
Are you an employee of Andhra Bank : NO
If yes, Staff Code No:
Nationality : INDIAN
State / Union Territory for which you are applying : Andhra Pradesh

State / UT code : 24
Centre of Examination : Hyderabad
Centre code : 63

Application Fee / Postal Charges Details :

Payment in : Andhra Bank Branch

Transaction ID : 00105755

Branch Name : SABASTIAN ROAD

Branch SOL ID : 529

Deposit Date : 15-02-2011

Amount : 75

Personal Details :
Date of Birth : 05-06-1982 Age as on on 31.12.2010. : 28

Gender : MALE
Father's Name/ Husband's Name : LAKSHMANA RAO

Mother's Name : TULASIRATNAM

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Email ID : manmadha.hai123@yahoo.com

Address for Correspondence : MANMADHARAO M S/O LAKSHMANARAO

C/O UPPEVIJAYANAND 4TH FLOOR FLOTNO

403 TULJABHAVANI APPARTMENTS

District SECUNDERABAD
State : ANDHRA PRADESH

Pin : 500017
Permanent Address : MANMADHARAO S/O LAKSHMANARAO

D NO 2 5 285 PUVVALAMMA COLONY

CHINNABONDILIPURAM

District SRIKAKULAM
State : ANDHRA PRADESH

Pin : 532001

Contact Details:
Phone No : -
Mobile No: 9440726854

Qualification Details (as on 31.12.2010):

Exams Passed Subject/Stream Year Of Passing % of Marks

HSC / Equivalent : SCIENCE April/1999 58.00

Graduation : SCIENCE COMPUTERS March/2007 49.00

Knowledge of Computers : YES

Details of Computer Knowledge : QBASIS SAD PHOTRAN HTML MSOFFICE

Other Details :

Whether desirous of taking Pre-Exam Training (SC/ST/Minority

NO
Community) :

If Yes Centre for Training : --

Languages Known Read Write Speak

ENGLISH YES YES YES

HINDI YES YES YES

TELUGU YES YES YES

DECLARATION:

I hereby certify that the above information furnished 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/ service 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 advised criteria in respect of age, caste, 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 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 or claims or disputes arising out of application or out of said advertisement can be
instituted by me only at Hyderabad and courts/ Tribunal/ forums at Hyderabad only, shall have sole and exclusive jurisdiction to any cause/ dispute. I undertake
to abide by all the terms and conditions in the advertisement given by the Bank.

Place:
Date: 22-02-2011 Signature of Applicant
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MANMADHA RAO.M
Please retain your Registration No. and Password emailed to you carefully for further reference
NOTE: Please DO NOT SEND application print-out to the Bank