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STATE BANK OF INDIA 400134

RECRUITMENT OF PROBATIONARY OFFICERS ADVERTISEMENT NO: CRPD/PO/2021-


22/18

Registration Number : 2080040569

Full Name : DEEPAK KUMAR


Category : SC

SUB CASTE : CHAMAR


I confirm that I am in possession / will produce EWS certificate issued : -
based on annual income for Financial Year 2020-21

Are you a person with benchmark disability of 40% and above ? : NO


Type of Disability : -

Sub-Type of Disability for 'd' & 'e' : -


Sub-Type of Disability : -

Sub-Type of Multiple Disabilities : -

Are you suffering from cerebral palsy and your writing speed is affected ? : -
If Yes, Do you need compensatory time at the time of examination? : -

Whether your dominant (Writing) hand is affected? : -


If Yes, Do you need compensatory time at the time of examination? : -

Do you intend to use the services of a scribe ? : -

I accept the Guidelines for Scribe : -


Religion to which you belong : Hindu

Whether you belong to Religious Minority Community ? : NO

Are you an Ex-Serviceman (including ECOs/SSCOs) : NO

Period of Service (in months) : -


Please mention the number of occasions on which you have applied for : 00
the examination for recruitment of Probationary Officers in SBI (chances
will be counted from the examination held on 18.04.2010. Appearing in
Preliminary Examination will not be counted as a chance. Appearing in
Main Examination will be counted as a chance. In the years in which only
one written examination has been held (i.e. no Preliminary Examination
has been held), appearing in this examination will be counted as a
chance.
Do you have record of default in repayment of loans/credit card dues : NO
and/or against whose name adverse report of CIBIL or other external
agencies are available ?
Do you have adverse report regarding character & antecedents, moral : NO
turpitude ?

Are you an Employee of State Bank of India in the Clerical Cadre ? : NO


Are you an Employee of State Bank of India in the Officer Cadre ? : NO
Are you an Ex-Employee of State Bank of India and resigned from the : NO
Bank while in the Clerical Cadre ?

Are you an Ex-Employee of State Bank of India and resigned from the : NO
Bank while in the Officer Cadre ?

Please ensure that you are eligible to apply ? : -

PAN No. : FUDPK7254N

Nationality : Indian
Examination Centre for Preliminary Examination

State/UT (to which centre of exam belongs) : Haryana

State Code: : 20

Centre of Examination : Hissar


Examination Centre for Main Examination

State/UT (to which centre of exam belongs) : Haryana

State Code: : 20

Centre of Examination : Hissar

I intend to bring the following ID when appearing for the examination (I : YES
confirm my name on this ID and this application exactly match)
ID Proof : Aadhar Card

ID Proof No. : XXXXXXXX7933

Personal Details
Date of Birth : 15-06-1999

Age completed as on 01.04.2021 : 21


Gender : MALE
Do you have twin brother / sister ? : NO

Gender of the twin : -


Name of the twin : -
Marital Status : Unmarried

Father's First Name : SATYA NARAYAN


Father's Middle Name : -

Father's Last Name : -


Mother's First Name : RAJBALA
Mother's Middle Name : -

Mother's Last Name : -


Spouse's First Name : -

Spouse's Middle Name : -


Spouse's Last Name : -
Address for Correspondence

Address 1 : VPO BHARAN TEH MEHAM


DISTT ROHTAK

Address 2 : HARYANA
District : ROHTAK

State : HARYANA
Pincode : 124111
Permanent address
Address 1 : VPO BHARAN TEH MEHAM
DISTT ROHTAK
Address 2 : HARYANA

District : ROHTAK
State : HARYANA
Pincode : 124111

Contact Details
Mobile No : +91 9588509771
Alternative Number : +91 8059842356
(Mobile No/Landline No)
Email ID : [email protected]

Educational Qualification (as on 31.12.2021)

Exam Passed Degree/ Subject / Name of Institution Place of Institution Date of % of Marks Class / Grade
Stream / College / College Passing

Graduation 1/ Arts MDU MDU DISTENCE 10-11-2020 44.16 Second Class


Equivalent
Passed

Other Details :

Whether desirous of taking Pre-Exam : YES


Training (SC/ST/Religious Minority
Community)

State/UT (to which centre of Pre-Exam : Haryana


Training belongs) :
State Code : : 20
Centre for Pre-Exam Training (If conducted : Hissar
through physical classes OR by way of
Online tools) :

Languages Known Read Write Speak

HINDI YES YES YES

HARYANVI YES YES YES

ENGLISH YES YES YES

Uploaded Document Details :

1. Left Thumb impression

2. Hand Written Declaration

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 in the event of any information being found untrue or incorrect at any stage or I am not satisfying any of the eligibility criteria
stipulated, and also in case of creating influence/undue pressure regarding recruitment shall tantamount to cancellation of my candidature.
I will follow all the Guidelines regarding Social Distancing Mode of Exam given in advertisement and subsequently. Any violation may result in
cancellation of my candidature.

I confirm that my name as filled by me in the application form exactly matches with the name in my ID proof

Date: 05-10-2021 Signature of Applicant

Left Thumb impression

Hand Written Declaration

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