5/17/2020 Recruitment of Officer Grade A (Assistant Manager) - General, Legal, Information Technology , Engineering , Research and Official …

SECURITIES AND EXCHANGE BOARD OF INDIA 270135

Recruitment of Officer Grade A (Assistant Manager) - General, Legal, Information Technology ,
Engineering , Research and Official Language Stream 2020

Registration Number : 1870024436

Full Name : Dushyant Mudgal

Post: : Officer Grade A (Assistant

Manager)- General Stream
Category : UNRESERVED

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

Type of Disability : -

Nature of disability : -
Do you need compensatory time at the time of examination : -

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 ? : -

Religion to which you belong : Hindu

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

Period of Service ( in months) : -

Do you belong to Religious Minority Community ? : NO

Nationality / Citizenship : Indian

Centre of Examination (Phase -I) Preference 1 : Delhi NCR

Centre of Examination (Phase -I) Preference 2 : Jaipur

Centre of Examination (Phase -I) Preference 3 : Agra

Centre of Examination Phase II : Jaipur

Application Fee / Intimation charges

Payment In : ONLINE
Amount : 1000.00
Payment Status : PAID

Reference ID : SHD48804019737
Transaction Date : 17-05-2020

Personal Details

Date of Birth : 20-10-1995

Age completed as on 29.02.2020 : 24

Gender : MALE

https://ibpsonline.ibps.in/sebioflmar20/registration_print.php?q=NGM2OGNlYzllMWFhZjk0MDE1NGM2YWI4MmE1NWY2ZTZ8MTg3MDAyNDQz… 1/3
5/17/2020 Recruitment of Officer Grade A (Assistant Manager) - General, Legal, Information Technology , Engineering , Research and Official …
Marital Status : Unmarried

Father's Name : Mata prasad sharma

Mother's Name : Kamlesh Mudgal
Spouse's Name : -

Address for Correspondence

Address 1 : ADARSH NAGAR COLONY
Address 2 : NEAR 220 K.V. G.S.S. BARI
ROAD
District : DHOLPUR
State : RAJASTHAN

Pincode : 328001
Permanent address
Address 1 : ADARSH NAGAR COLONY

Address 2 : NEAR 220 K.V. G.S.S. BARI

ROAD
District : DHOLPUR
State : RAJASTHAN

Pincode : 328001

Contact Details
Mobile No : +91 7742388046

Alternative Number : +91 9711391992

(Mobile No/Landline No)
Email ID : connectdushyant@gmail.com

Educational Qualification (as on 29.02.2020)

Exam Passed Degree/ Subject / Stream Appearing / Passed Date of % of Marks Class / Grade
Passing

Graduation Commerce Passed 10-07-2016 75.30 First Class

Master Management Appearing -- -- --
Degree/Post
Graduation Degree

Other Details

Whether desirous of availing : -

Pre-Exam Training (Only for
SC/ST/PwBD)
If Yes ,Centre for Training : -

Languages Known Read Write Speak

English YES YES YES

Hindi YES YES YES

Uploaded Document Details :

1. Left thumb impression

https://ibpsonline.ibps.in/sebioflmar20/registration_print.php?q=NGM2OGNlYzllMWFhZjk0MDE1NGM2YWI4MmE1NWY2ZTZ8MTg3MDAyNDQz… 2/3
5/17/2020 Recruitment of Officer Grade A (Assistant Manager) - General, Legal, Information Technology , Engineering , Research and Official …
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.

Date: 12-03-2020 Signature of Applicant

Left thumb impression

Hand written declaration

https://ibpsonline.ibps.in/sebioflmar20/registration_print.php?q=NGM2OGNlYzllMWFhZjk0MDE1NGM2YWI4MmE1NWY2ZTZ8MTg3MDAyNDQz… 3/3