APPLICATION FOR THE POST OF
MULTI-TASKING STAFF ON DIRECT RECRUITMENT BASIS
DD No: ______ ___ Date:______ _Rs.______ Name of the Bank: ______ _________
1. Post Code : __________; Advt. No. 01/2025
Affix a recent
2. Name (as per SSC/10th class): Passport size
Photograph
3. Father’s Name: (Not older than 03
Months) &
sign in the space
4. Mother’s Name :
provided
below
5. Email ID:
6. Mobile No:
7. Date of Birth (as per SSC/10th class):
Age as on 28th July, 2025: Years : Months : Days :
8. Address:
(A) Address for Correspondence:
(B) Permanent Address:
9. Gender:
10. Nationality:
11. Aadhaar No.:
12. Marital Status: If Married Spouse Name:
13. Category (OBC-NCL/EWS):
(Enclose self-attested photocopy of the certificate)
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14. Whether Person with Disability (PWD)/ Ex-Servicemen (ESM)/ Widowed/ Divorced Women/
Women judicially separated:
(Enclose self-attested photocopy of the certificate)
15. Educational Qualifications:-
Whether educational & other qualifications required for the post as per the notification are satisfied
(if any qualification has been treated as equivalent to the one prescribed in the rules, state the
authority for the same).
Essential:
Sl. Educational Name of the Board Year of Marks/ GPA/
No. Qualifications Passing Percentage
Obtained
1 SSC / 10th /
Equivalent
2 Certificate Course in
Computer / IT
3 Any Other relevant
information
Enclose a separate sheet, duly authenticated with your signature, if the space is insufficient:
16. Please state clearly whether in the light of the entries made by you above, you meet the
requirements of the post or not:
17. Details of employment in chronological order. Enclose a separate sheet, duly authenticated with
your signature, if the space below is insufficient (If applicable):
Sl. Office/Institution/ Post From To Nature of Scale of Nature of
No. Organization Held appointment pay and Duties
whether Basic performed
Regular/Adhoc/ Pay
Deputation/Private therein
1.
2.
3.
18. Nature of present employment i.e., Govt./PSU/Autonomous Institutions/ Private/ Ad-hoc/
temporary/quasi-permanent (If applicable)
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19. In case present employment is held on deputation / contract basis, please state (If applicable):
a) The date of initial appointment:
b) Period of appointment on deputation / contract:
c) Name of the Parent Office / Organization to which you belong:
20. Please state whether working under:
a) Central Government
b) State Government
c) Universities
d) Autonomous or Statutory Organizations
e) Recognized Research Institutions
f) Private Organizations
21. Are you in a revised scale of pay? If yes, give the date from which the revision took place and also
indicate the pre-revised scale:
22. Total emoluments drawn per month with break up or Basic Pay, GP, DA etc.
23. In case the applicant belongs to an Organization which is not following the Central Government
Pay-scales, the latest salary slip issued by the Organization showing the following details may be
enclosed:
Basic Pay with Scale of Pay Dearness Pay/interim relief / other Total Emoluments
and rate of increment Allowances etc., (with break-up details)
24. Additional information, if any, which you would like to mention in support of your suitability for
the post. Enclose a separate sheet, duly authenticated with your signature, if the space below is
insufficient:
25. Name & Addresses of two references along with address, mobile and email:-
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26. Language fluency:
[Link]. Language Read Write Speak
1.
2.
3.
27. Any other information not covered in the above columns:
28. List of enclosures:
Certificate
I hereby declare and certify that all the statements made in this application are true and correct
to the best of my knowledge and belief. If any of the particulars furnished by me are found to be
incorrect or suppressed, my candidature is liable to be rejected at any stage during or after
selection process and abide by any disciplinary action by the Competent Authority.
Date: Signature of the Candidate
Place:
Certificate
(To be issued by the forwarding Authority)
It is certified that the particulars furnished above are correct and no disciplinary case is
either pending or contemplated against the officer and no penalty, major or minor, was imposed
on the officer during the last 5 years and his integrity is beyond doubt.
Date: Signature of the Head of
Department with date & Stamp
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