ReserveBankofIndiaServicesBoard

RecruitmentforthepostofOfficersinGrade'B'(General)DirectRecruitment
(DR)

RegistrationNumber

: 592923

FullName

: AMITKUMAR
PATRA

Category

: SC

AreyouaPersonwithDisability

: NO

TypeofDisability

PercentageofDisability

Areyousufferingfromcerebralpalsyandyour
writingspeedisaffected:?

IfYes,Doyouneedcompensatorytimeatthe
timeofexamination?

Whetheryourdominant(Writing)handis
affected?

IfYes,Doyouneedcompensatorytimeatthe
timeofexamination?

Doyouintendtousetheservicesofascribe
(onlyforVHcandidatesandthecandidates
whosewritingspeedispermanentlyaffected)?
:

AreyouapersondomiciledintheStateof
Jammu&Kashmirduringtheperiod111980
to31121989:?

: NO

Religiontowhichyoubelong

: Hindu

WhetheryoubelongtoReligiousMinority
Community?:

: NO

DoyoufallunderthecategoryofRetrenched
: NO
fromGovt.OfficeorBankingInstitution/Ex
Servicemen/EmergencyCommissionedOfficer
orSSCOfficervidepara8(b)(ii),(iii)or(iv)of
theadvertisement?
Ifyes,selectthecategory:

AreyouReserveBankofIndiaEmployee(RBI
Staff)?(AspercircularCO.HRMD.No.G75/
5599/05.01.01/20132014datedDecember
20,2013).

: NO

IfYes,PFIndexNo/EmployeeIDNo

DoyoupossessM.Phil.qualification?

: NO

DoyoupossessofDoctoratedegree/Ph.D

: NO

Qualification?
HaveyouappearedsixtimesforPhaseI
ExaminationforthispostinRBIinthepast?
(applicableincaseofUnreserved/General
Candidatesonly)

Doyouhavepriorexperienceasanofficerin
CommercialBank/FinancialInstitutioninPublic
Sector/orpriorexperienceofworkingin
ReserveBankofIndia:?

: NO

Ifyes,yearsofexperience(incompleted
years),excludingprobationperiod

WhetheremployedinGovernmentService/
QuasiGovt.Organisation/Governmentowned
industrialundertakings/PSU/PSB/Public
SectorFinancialInstitutions,PublicEnterprises
orothersimilarorganisations?

: YES

Ifyes,haveyouinformedinwritingtoyour
HeadofOffice/Departmentthatyouare
applyingforthispost?:

: YES

State/UTwhichthecentreofPhaseI
Examinationbelongs

: WestBengal

CentreofPhaseIExamination

: Hooghly

CentreofPhaseIIExamination

: Kolkata

CentrecodePhaseIIExamination

: 15

NameofSubjectchosenforPaperIIIin
PhaseII

: Economics

Nationality:

: Indian

DoyouholdAadharCard

: NO

AadharCardNo.

ApplicationFee/IntimationChargesDetails:
Amount

: 100.00

PaymentStatus

: PAID

ReferenceID

: ESMP4078559327

TransactionDate

: 23102015

PersonalDetails
DateofBirth

: 03051991

Agecompletedason01.10.2015

: 24

Gender

: MALE

MaritalStatus

: Unmarried

Father'sNameinFull

: BALAICHANDRA
PATRA

Mother'sNameinFull

: ANITAPATRA

Spouse'sNameinFull

AddressforCorrespondence

: VILLMALLICKPUR
PORUDRANI

Address2

: PSDHANIAKHALI

District

: HOOGHLY

State

: WESTBENGAL

Pincode

: 712302

PermanentAddress

: VILLMALLICKPUR
PORUDRANI

Address2

: PSDHANIAKHALI

District

: HOOGHLY

State

: WESTBENGAL

Pincode

: 712302

ContactDetails
MobileNo

: +919933765987

AlternativeNumber
(MobileNo/LandlineNo)

: +919434564767

EmailID

: apatra01@gmail.com

EducationalQualificationDetails(ason01.10.2015)
ExamPassed

Degree
/Subject
/Stream

SSC/10th
Standard

Nameof
Board/University/Institute

Dateof
Passing

%ofMarks

Class/Grade

WBBSE

0705
2006

90.62

FirstClass

HSC/12th
Standard/
Diplomaor
equivalent

Science

WBCHSE

0304
2008

79.20

FirstClass

Graduation/
Bachelor's
Degree/
equivalent

Science

THEUNIVERSITYOF
BURDWAN

3007
2014

53.87

SecondClass

Workexperiencedetails(Ason01.10.2015)(StartfrompresentEmployer)
Nameofthe
employer

Designation
andRankif
any

From

To

Yearsof
Service(YY/MM/DD)

Natureofduties
performed

BANKOF
BARODA

SWO

01/07/2015

30/09/2015

0/2/29

CLERICALJOB

TotalExperience(inmonths):2
Declaration:
IherebydeclarethatallthestatementsmadeinthisapplicationareTrue,CompleteandCorrecttothebestof
myknowledgeandbelief.Iunderstandthatintheeventofanyinformationbeingfounduntrueorincorrectat
anystageorIamnotsatisfyinganyoftheeligibilitycriteriastipulated,andalsoincaseofcreating

influence/unduepressureregardingrecruitmentshalltantamounttocancellationofmycandidature.Incaseof
creatinganyinfluenceonanymattermycandidatureshallbecancelled.

Date:23102015

SignatureofApplicant