1/4 Common Written Examination for Recruitment of Clerks - (CWE - Clerks-III) 54032 Registration # : 1251678888 Full Name : Mukesh Kumar Category : GENERAL If Person with Disability : NO Type of Disability : - Percentage of disability : - Do you intend to use the services of a scribe NA (only for VI and OC whose writing speed is affected by cerebral palsy) ? : Whether are you a Children/Family Members of those who died in 1984 Riots? : NO Whether domiciled in Kashmir Division of the State of J&K during the period 1-1-1980 to 31-12-1989 ? : NO Do you belong to a Religious Minority Community? : NO Religion : Muslim Are you an Ex-Serviceman? : NO Are you a Disabled Ex-Serviceman (DISXS)? : NO Have you joined a Government job on the civil side after availing of the benefits given as an ex-serviceman?: Are you a Dependent of Serviceman killed in Action (DXS) ? : NO Are you seeking relaxation under widow / divorced women / women judicially Separated from their husbands and who are not re-married?: NO Whether Regular Employees of the Union Carbide Factory, Bhopal, retrenched from service (applicable to Madhya Pradesh state only)? : NO Have you applied for the CWE for Clerical Cadre held in November/ December 2011? : NO Have you applied for the CWE for Clerical Cadre held in December 2012? : NO Nationality / Citizenship : Indian State/ UT applied for: Uttarakhand State code : 44 Centre of Examination : Dehradun Personal Details : First Name : Mukesh 2/4 Middle Name : - Last Name : Kumar Date of Birth : 12-03-1988 Age completed as on 01.08.2013 : 25 Gender : MALE Husband's Name : - Father's Name : Bacchu Sharma Mother's Name : Uganta Devi Address for correspondence : At-Shihti P.O-Dharampur P.S-Kako District : Jehanabad State : BIHAR Pin code : 804408 Permanent Address : At-Shihti P.O-Dharampur P.S-Kako District Jehanabad State : BIHAR Pin code : 804408 Contact Details : Phone No. : - Mobile No. : 8757151779 Email ID : mukeshexpo1@gmail.com Educational Qualification (as on 01.08.2013) : Exam Passed Degree Subject /Stream Date of Passing % of Marks Class / Grade Graduation / Equivalent : B.Sc Science 01-08-2013 70.00 First Class Professional Qualification : AME 30-10-2010 75.00 First Class Mechenical Do you have Operating and working knowledge in computer systems : YES Details of Computer Knowledge : Studied Computer/IT as a Subject in High School/College/Institute Computers as a subject Do you have work experience? : NO Other Details : Whether desirous of taking Pre-Exam Training (Only for SC/ST/Religious Minority Communities/Ex-Servicemen/PWD): If Yes, Centre for Training : Details of Preference : 1.Punjab National Bank 2.Bank of Baroda NA 3/4 3.Bank of India 4.Corporation Bank 5.Canara Bank 6.Union Bank of India 7.Syndicate Bank 8.Oriental Bank of Commerce 9.Indian Overseas Bank 10.Indian Bank 11.Dena Bank 12.Central Bank of India 13.Bank of Maharashtra 14.Andhra Bank 15.Punjab & Sind Bank 16.UCO Bank 17.United Bank of India 18.Vijaya Bank 19.Allahabad Bank Whether any prosecution/ detention/ fine/conviction/ sentence against you has been awarded by any court of law for any offence? : NO If yes, particulars of the same : Languages Known : Languages Known Read Write Speak English YES YES YES Hindi YES YES YES Application Fee / Intimation charges : Payment In : ONLINE Amount : 600.00 Reference ID : MSPD3099050813 Transaction Date : 07-09-2013 DECLARATION : I understand that in the event of any information being found untrue or incorrect at any stage/in the event any circumstances which may impair my fitness for employment in Banks/ organisation/ I do not satisfy any of the eligibility criteria stipulated, my candidature is liable to be cancelled. 4/4 Place: Date: 07-09-2013 Please retain your Registration No. and Password emailed to you carefully for further reference NOTE: Please DO NOT SEND application printout to IBPS Signature of Applicant