APPLICATION FORM

(Please fill up the name and address in capital letters in English only since the
procesing is computerized)
The Director
Institute of Banking Personnel Selection,
P.B.No. 7501
Goregaon (West)    
MUMBAI 400 104.

Paste here your recent, recognizable passport size Photograph & sign across it
With reference to the UCO Bank advertisement, I submit my application in the prescribed format.
1. Post applied for   ________  2. Centre of Examination ____________Centre Code _______
[Separate application and separate Demand Draft of Fees and Postal Charges for each post]
3.
Name in full:
                                                                  
(Mr./Mrs./Km.)
as it appears on your Certificate (IN BLOCK LETTERS IN ENGLISH)
(Leave one space blank between two parts of your name)
4. Correspondence Address: (IN BLOCK LETTERS IN ENGLISH)fsf
                                                                
                                                                
                                                                
                                                                
PIN            

fdg
Tel.No__________________________________   email: ______________________________
 
5. (a) Category

SC

ST

OBC

 OTHERS
Indicate Category to which you belong by marking "Tick" in the appropriate Box
(b) If SC/ST/OBC, please mention name of Caste :__________________________
Name of the State to which you belong :               _______________________________
(Please attach self-attested Photostat copy of Caste Certificate of SC/ST/OBC as applicable)
(c) If Physically Handicapped Candidate, Please tick mark appropriate box showing :
(i) Category of disability i.e.Orthopaedically Handicapped/Hearing Impairment/Visually Handicapped

OH

HI

VH
(ii)
Percentage of disability:
 
(Please attach self-attested Photostat copy of Medical Certificate issued by Medical Board at District level)
(iii)
Do you intend to use the service of a scribe at your cost?
Yes
No
(d) Are you an Ex-serviceman?
Yes
No
(e) Are you a candidate who had ordinarily been domiciled in Kashmir Division of the State of J & K during the period of 01.01.80 to 31.12.89.
Yes
No
 

 

 

6.
Date of Birth
   
D D
M M
Y Y Y Y
Age (as on 01/01/2003)
       
Years
       
Months

 
7. Details of Application Fee :-
Demand Draft No. _________________ Dated_____________ Amt.___________
Name of the Bank ___________________________________________________
8. Permanent Address :
                                                                
                                                                
                                                                
                                                                
PIN            
9.
Sex:
Male
 
Female
 
10. Father's Name: (IN BLOCK LETTERS IN ENGLISH)
                                                                
11.
Age relaxation, if any:
Yes
No
(Specify basis and enclose relevant certificate) Please mark tick ()
12. Educational Qualification : (As on the date of application) Matriculation/SSLC onwards).
Examination passed Name of the Institution/University Subjects studied in detail Date, Month & Year of Passing Percentage of aggregate marks
         
         
         
13. Particulars of Post Qualification Experience including the Present Occupation/Job(as on the date of application).
Name of the employer(s) etc. and the nature and details of activities carried out by the employers

Designation

Period of Service

From            To

Length of Service

Nature of duties performed in detail

Remarks (Reasons for leaving service)
1 2 3 4 5 6 7
               
               
               
 

 

 

  

14. Any other information ______________________________________________________________

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 false or incorrect at any stage or not satisfying the eligibility criteria according to the requirements of the relative advertisement, my candidature/appointment is liable to be cancelled/terminated. I am willing to serve any where in India. I agree that Bank has the right to transfer me to any part of the country at its discretion.

I hereby agree that any legal proceedings in respect of any matter(s) or claims or disputes arising out of this application and/or out of said advertisement can be instituted by me only in Kolkata and Courts/Tribunal/Forums at Kolkata only shall have sole and exclusive jurisdiction to try any cause/dispute. I undertake to abide by all the terms & conditions mentioned in the advertisement given by the Bank.

PLACE: ___________________
DATE: ___________________

(SIGNATURE OF CANDIDATE)