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ON-LINE APPLICATION FOR SINGLE WINDOW OPERATOR(SWO)

32037

Registration #: 3219872

Full Name: Bijeta Mishra

Category : GENERAL

If Person with Disability : NO

Type of Disability : -- Percentage of Disability : --
Do you intend to use the services of a scribe?( only for VH and OH
NO
candidates whose writing speed is affected by cerebral palsy)? :

Are you candidate who had ordinarily been 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

Period of Service in months : --
Are you a dependent of an Ex-Serviceman (DXS)? : NO
Are you seeking relaxation under widow/divorced women/
women judicially Separated from their husbands and who are NO
not re-married :
Nationality : Indian
State / Union Territory for which you are applying : Orissa
State code : 19
Centre of Examination : Bhubaneswar

Centre code : 56

Application Fee / Postal Charges Details :

Receipt Number (TSL No.) : 382

Branch Name : suryanagar

Branch Code No : 2119

Date of Deposit : 25-04-2011

Amount : 200

Personal Details :
Date of Birth : 15-07-1986

Age as on 31.03.2011: 24
Gender : FEMALE

Father's Name / Husband's Name : Dr Bijay Kumar Mishra

Mother's Name : Baijayanti Mishra

Address for Correspondence : Qrs 3r 74 O U A T Colony
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Unit 8 Bhubaneswar
Orissa

District Khurdha
State : ORISSA

Pin : 751003
Permanent Address : Qrs 3r 74 O U A T Colony

Unit 8 Bhubaneswar

Orissa
District Khurdha

State : ORISSA
Pin : 751003

Contact Details:
Phone No : 0674-2561968
Mobile No: 9090333192

Email ID : bijeta.hm08@gmail.com

Qualification Details (as on 31.03.2011):

Exams Passed Subject/Stream Year of Passing % of Marks Class / Grade

Graduation : Bsc Home Sc 2008 76.80 First Class

Others : MBA 2010 80.50 First Class

working knowledge of computers : YES

Details of Computer Knowledge : DCA internet Ms off

Other Details :

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

--
Servicemen/Minority Community/DISXS/DXS) :

If Yes Centre for Training : --

Languages Known Read Write Speak

English YES YES YES

Hindi YES YES YES

Oriya YES YES YES

DECLARATION:
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 etc.

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 Mangalore and courts/ Tribunal/ forums at Mangalore 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: 25-04-2011 Signature of Applicant

Please retain your Registration No. and Password emailed to you carefully for further reference
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NOTE: Please DO NOT SEND application print-out to the Bank