Yeejleere ms yeQke

eneB HeemeHees& Deekeej kee

neue ner ceW eEKeee ngDee
Heeses efeHekeeeW leLee Gme
Hej efoveebke meefnle HetCe&
nmlee#ej kejW

STATE BANK OF INDIA

kesvere Yeleea SJeb HeoesVeefle efJeYeeie
CENTRAL RECRUITMENT & PROMOTION DEPARTMENT

Paste a recent
passport size
photograph here and
sign across it in full
with date

GcceeroJeej kee DeelcekeLe SJeb meleeHeve Heece&

CANDIDATE'S BIO-DATA-CUM-ATTESTATION FORM

(ke=Heee Heece& DeHeveer nmleefueefHe ceW Yejs)

(Please fill in the form in your own handwriting)

Yeejleere ms yeQke kes meneesieer yeQkees ceW efueefHeke esCeer ceW Yeleea
Recruitment to Clerical Cadre in Associate Banks of State Bank of India

mee#eelkeej kes efueS kesv / Centre for Interview :

Devegeceebke / Roll No. :

GeerCe& /Qualified Under :__________________ eJeie&/Category

(pewmes efke yegueeJee He$e ceW GefuueefKele nw/As shown in the Call Letter)

Heo kee veece / Name of Post :

mee#eelkeej nsleg Yee<ee kee efJekeuHe efnvoer/Debiespeer (jepeYee<ee DeefOeefveece ces HeefjYeeef<ele `ke` #es$e kes GcceeroJeejeW keeW mee#eelkeej nsleg efnvoer efJekeuHe GHeueyOe nw)
Choice of Language for Interview : Hindi/ English (Hindi option available for candidate appearing for Interview in Region A states only,
as defined in the Official Languages Act)
1.

(ke) Hetje veece megmHe De#ejeW ceW

(a)

Name in full, in block letters :

eer/eerceleer /keg. Shri/Smt./Kum. : ______________________________________________________________

(Ke) JewJeeefnke efmLeefle efJeJeeefnle / DeefJeJeeefnle

(b)
2.

Marital Status : Married / Unmarried

(ke) pevce efleefLe

(a)

Date of Birth

(Ke) 01-08-2012 kees Gce

(b)

efoveebke /Date
Je<e&

Age as on 01-08-2012

cenervee / Month
cenervee

Year

/ Year

Month

(ie) pevce kee mLeeve

efpeuee

jepe

(c)

District

State

Place of Birth

Je<e&

(Ie) efpeuee leLee jepe peneB kes DeeHe efveJeemeer nQ.

(d)
3.

(a)

4.

District and State to which you belong :

(ke) je^erelee :
Nationality :

(Ke) Oece& :

(ie) keee DeeHe DeuHemebKeke mecegoee mes nQ

neB /veneR

(b)

(c) Do you belong to Minority Community

Yes / No

Religion :

(ke) efHelee /Heefle kee veece SJeb JeJemeee /Heoveece :

(a)

Father's / Husband's name and occupation/profession/designation : _______________________________________

______________________________________________________________________________________________

(Ke) ceeB kee veece

(b)
5.

Mother's name : ________________________________________________________________________________

(ke) esCeer Jeie& (eLeesefele Deeele ceW mener kee efevn ueieeSW)
(a)

De.pee.

De.pe.pee.

meeceeve

Deve efHe[s Jeie&

SC

ST

GEN

OBC

Category (Tick the appropriate box)

(Ke) Devegmetefele peeefle / Devegmetefele pevepeeefle / Deve efHe[s Jeie& kes GcceeroJeej
peeefle/pevepeeefle /mecegoee kee veece oW
(b)

If SC / ST / OBC state the name of

CASTE / TRIBE / COMMUNITY

(ie) eefo DeeHe Meeefjjerke He mes efJekeueebie nQ lees ke=Heee eLeesefele Deeele ceW
DeeefmLe efJeke.
mener kee efevn ueieeSB. pewmes DeeefmLe efJekeueebie ee ef efJekeueebie ee eJeCe efJekeueebie
(c)

If you are physically handicapped, please tick appropriate box.

i.e. OH or VH or HI

OH

(Ie) eefo DeeHe Meejerefjke He mes efJekeueebie nQ lees ke=Heee DeHeves efJekeueebielee kee efJeJejCe GuuesKe kejW
(d)

If you are a Physically Handicapped person, please give details of your handicap.

ef efJeke.

eJeCe efJeke.

VH

HI

6.

(ke) keee DeeHe YetleHetJe& mewefveke nQ Deewj YetleHetJe& mewefveke Deej#eCe keese kes Devleie&le DeeJesove efkeee nw?

neB /veneR

(a)

Yes/ No

Are you an Ex-serviceman and applied under Ex-servicemen reservation quota :

eefo neB, lees / If yes, then
________________

keee&cegeqkele/mesJeeefveJe=efe/mHesefmeefHeke Heerefje[ Dee@He DemeeFveceW kes HetCe& nesves keer efleefLe

Date of discharge/ retirement/ date of completion of specific period of assignment :

(Ke) keee DeeHe YetleHetJe& mewefveke nQ SJeb Meeefjjerke He mes DeMekele YetleHetJe& mewefveke esCeer kes Devleie&le DeeJesove efkeee nw?
(eefo neB, lees keee&cegeqkele eceeCeHe$e ces Fmekee GuuesKe nesvee eeefnS)

neB/veneR

(b)

Yes/ No

Are you a disabled Ex-serviceman and applied under reservation available to

Disabled Ex-servicemen category (Dis-XS). (If so the discharge certificate should clearly mention this)

(ie) keee DeeHe eg ces Menero/iecYeerj He mes DeMekele YetleHetJe& mewefveke kes Deeefele nw leLee Ssmes DeeefeleeW kees GHeueyOe
Deej#eCe keess kes Devleie&le DeeJesove efkeee nw?
(c)

neB/veneR

Are you a dependant of Ex-Serviceman killed in Action/severly disabled and applied under reservation
available to such dependents (Dep-XS)

eefo neB lees, keee Gkele YetleHetJe& mewefveke kes efkemeer Deeefele ves HetJe& ceW Deej#eCe kee ueeYe efueee nw?

If yes, whether any other dependent of the Ex-serviceman, has availed resrvation benefits

Hegef kes efueS emlegle omleeJespeeW kee GuuesKe kejW

Details of documents Submitted in support of the claim

Yes/ No

neB/veneR
Yes/ No

neB/veneR

(1)
(2)
7.

8.

keee DeeHe efJeOeJee/leueekeMegoe m$eer/ keevetveer He mes Heefle mes Deueie nw leLee HegveefJe&Jeen vener efkeee nQ

neB/veneR

Are you a widow/ divorced women/ women judicially separated from husband and not remarried

Yes/ No

keee DeeHe pecceg SJeb keMceerj jepe kes keMceerj #es$e ceW 01.01.1980 mes 31.12.1989 kes oewjeve efveJeemeer Les

neB/veneR

Are you a person domiciled in Kashmir division of Jammu & Kashmir state during the period
from 01.01.1980 to 31.12.1980

Yes/ No

9. ()
(a)

Mother Tongue :

() k n ( ( )n #)
(b)

Knowledge of Languages Other than English (Indicate by a ( ) tick mark) :

Language

Speak

Write

Examination Passed, if any

Read

1.
2.
3.

10. (ke) Mew#eefCeke eesieleeSb

(a) Educational Qualifications :

#
Examinations
Passed

Indicate
College /
Faculty:Arts/ School
Science/Comm.
2
3

/ Period

s
Examining
body

K
Principal
Subjects

From

to
4

Class X

Class XII

s
Graduation

s
Post Graduation

n ( )
Other (specify)

p
s

No. of
attempts
7

Class &
Rank
8

Percentage
of marks
9

11. p s//
Particulars of prizes/medals/scholarships obtained :

12. () ,

, p w g
(a)

Particulars of sports and other extracurricular activities

in which you participated, Credits & Distinctions obtained :

() r # n r
(b)

Hobbies & other interests :

13. g/
Particulars of any special qualification / training in Banking

14. ()
(a)

(YetleHetJe& mewefveke DeYeLeea- efvecve GuuesefKele metevee keer peevekeejer ues.)

Particulars of present and previous employment : (Ex-servicemen candidates - please read the note furnished below)

#
Name & Address of
employer

/ Period

From

To

k
s

Position and
Nature of Duties

Place of
Posting

Total Emoluments

Starting

Last Drawn

Reasons for
leaving

() s (/ / / )
(b) Status of present employer (Govt. / Semi-Govt. / Pub / Pvt. Sector)

metevee DeHeveer YetleHetJe& mewefveke efmLeefle kee GHeeesie kej efmeefJeue #es$e ceW mejkeejer veewkejer eeHle kej egkes YetleHetJe& mewefveke/Meeefjjerke He mes DeMekele YetleHetJe&
mewefveke kees oesyeeje mejkeejer /yeQke veewkejer kes efueS eesie veneR ceevee peeSiee.
Note : Ex-servicemen /Disabled Ex-servicemen candidates who have availed reservation benefits for his Re-employment
and joined a Government job on the civil side will not be eligible for the benefits of reservation for ex-servicemen
in Government/Bank jobs.

15. v # ()

14. s

Present address in full for communication

Permanent address in full :

PIN CODE

PIN CODE

16. s #
Particulars of places where you have resided for more than 1 year during the last 5 years :

From

To

s
Residential address in full

# # s
K
District Head quarter of the place
mentioned in the left column

17. n r} # /

/N/} .
Particulars of any prosecution / detention / fine
conviction sentence against you awarded by any court of law for offence.

18. n r} (/n

s )
.
Particulars of cases pending against you in any court of law
including case (s) for non-payment of any loan from Banks/
Financial Institution :

19. , s

g / .
Particulars of disqualification / debarment by any Service
Commission, examining body at their selection / examination :

20. () ]

r} # #/ t
, n
.
Particulars of any case (s) of disciplinary action instituted /
pending against you by your present or previous
employer (s). Please also state whether you were debarred
from appering in any promotion examination.

21. g
Particulars of character certificates enclosed

22. w , v #
Name, occupations and address of two respectable referees :

K
Sr. No.

Name

Address

1.
2.
23. n # .
Additional particulars, if any, which may be
of use to the Bank :

ceQ eceeefCele kejlee ntB efke GHeeg&kele efJeJejCe cesjer Hetjer peevekeejer leLee efJeMJeeme kes Devegmeej mele, mener Je HetCe& nQ. ceQ Ssmeer efkemeer Yeer yeele mes DeJeiele vener ntB pees cegPes yeQke
keer veewkejer kes efueS GHeegkele nesves ceW yeeOeke efme nes mekeleer nw. ceQ en Yeer Iees<eCee kejlee/kejleer ntB efke cegPes onspe eefle<esMe DeefOeefveece 1961 kes Debleie&le DeLeJee efJeefOe kes
Devegmeej oC[veere efkemeer DeHejeOe kes ceeceues ces keYeer Yeer oefC[le vener efkeee ieee nw.
eefo cesjs eje emlegle efkeee ieee efJeJejCe ieuele ee Demele Heeee peelee nw Deewj/ee Heece& emlegle kejles mecee JeemleefJeke leLeeW kee efHeeee peevee yeeo keer efleefLe ceW Helee
euelee nw lees yeQke kees cesjer efveegeqkele, efveegeqkele kes emleeJe meefnle, pewmee Yeer ceeceuee nes, jodo kejves kee DeefOekeej nesiee. Gkele efJeJejCe Yeejleere ms yeQke kes efJe%eeHeve mebKee
meerDeejHeer[er/SyeermeerSue/2012-13/01 efo.25.07.2012 Deewj cesjs Dee@veueeF&ve DeeJesove-He$e kes meboYe& ceW emlegle efkees iees nQ.
I Certify that the particulars furnished above are true, correct and complete to the best of my Knowledge and belief. I am not
aware of any cirumstance which might impair my fitness for employment under the Bank.
Further, I declare that I have never been convicted for offence under the Dowry Prohibition Act, 1961, or any criminal
offence under any other law.
In case the particulars submitted by me are found to be false or not true and/ or suppression of material facts by me while
submitting the form is revealed at a latter date, the Bank shall have the right to cancel the appointment including the offer for
appointment, as the case may be. The above details are submitted in reference to State Bank Of India advertisement No. CRPD/
ABCL/2012-13/01 dt. 25.07.2012 & my online application thereto.

Date :
s Place :

Right Thumb Impression

B s
Signature of the candidate


IDENTITY CERTIFICATE

//

t/t/t

Certified that I have Known Shri / Smt./Kum.

son/wife/daughter of

Shri

for the past

years

month/s and that to the best of my

S k
Knowledge and belief the particulars furnished above by him/her are correct.

s Place :

s Signature :

Designation :
Date :

Address :
SEAL

(1) t m

/ FOR OFFICE USE ONLY

Date of appearing in interview

(2) g/ t

./

Designation :

Eligibility/Certificates verified by Shri/Smt.

(3) p
Deficiencies and Discrepancies found :

DECLARATION TO BE SUBMITTED BY THE OTHER BACKWARD CLASSES

CANDIDATES SEEKING RESERVATION AS OBC

I______________ _____________________________________________________
Son/daughter of Shri ____________________________________________________
Resident of village/ town/city ___________________ District ______________________
State _____________________________________________ . Hereby declare that I
belong to the ____________________________________________ Community which
is recognised as a backward class by the Government of India for the purpose of reservation
in services as per orders contained in Department of Personnel and Training Office
Memorandum No. 36012/22/93-Estt.(SCT) dated 08.09.1993. It is also declared that as
on the date of interview, I do not belong to persons / sections (Creamy Layer) mentioned
in column 3 of the Schedule to the above referred Office Memorandum dated 08.09.1993.

Place :
Dated

(Signature of the candidate)

Deve efHe[s Jeie& kes He ceW Deej#eCe keer ceebie kejvesJeeues Deve efHe[s JeieeX kes
GcceeroJeejeW eje emlegle keer peevesJeeueer Iees<eCee
ceQ ______________ ___________________________________________________
Heg$e/Heg$eer eer __________________________________________________________
efveJeemeer _______________________________________________________________
ieebJe/kemyee/Menj ____________________________ efpeuee _______________________
jepe ________________________________________ Sleodeje Iees<eCee kejlee/kejleer ntB efke
ceQ ____________________________________________ peeefle mes mebyebeOf ele ntB efpemes Yeejle mejkeej
eje keeefce&ke SJeb eefMe#eCe keeee&uee %eeHeve eceebke 36012/22/93-F&Smeerer (Sme meer er) efoveebke 08.09.1993
ceW meceeefJe DeeosMeeW kes Devegmeej mesJeeDeeW ceW Deej#eCe kes eeespeve nsleg Ske efHe[s Jeie& kes He ceW ceevelee oer ieF& nw. en
Yeer Iees<eCee keer peeleer nw efke ceQ mee#eelkeej keer efleLeer kees GHeegk& ele meboefYe&le keeee&uee %eeHeve efoveebke 08.09.1993 keer
Devegmeteer kes mlebYe 3 ceW GefuueefKele JeeqkeleeeW /KeC[esn (efeceer uesej) kes oeejs ceW veneR nt.B

mLeeve
efoveebke

(GcceeroJeej kes nmlee#ej)

6