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1/19/2015 Recruitment of Administrative Officer (Scale I) in AICIL Application Form Print http://ibps.sifyitest.com/aicilaojan15/registration_print.php?q=NDlhZjIwZmI3NjVmNTU3YTdmMDk0ZDc0NzIzNjAxNjF8MjEwMDI0NjI2 1/2 Recruitment of Administrative Officer Scale I Registration Number : 210024626 Full Name : Sunil Kumar Name of Discipline : : Generalist Code No.: : 06 Category : UR If Person with Disability : NO Type of Disability : Percentage of Disability : Are you suffering from cerebral palsy and your writing speed is affected? : If Yes, Do you need compensatory time ? : Whether your dominant (Writing) hand affected ? : If Yes, Do you need compensatory time ? : Do you intend to use the services of a scribe (only for VI or OC Candidates) ? : Whether domiciled in Kashmir Division of the State of Jammu & Kashmir during the period 111980 to 31121989 : ? : NO Do you belong to Religious Minority ? : NO Religion to which you belong : Hindu Are you seeking relaxation under widow /divorced women / women judicially Separated from their husbands and who are not remarried ? : NO Are you Existing Confirmed Employees of Agriculture Insurance Company of India Ltd. : ? : NO Are you Existing Confirmed Employees of GIPSA : ? : NO Are you Resident of Assam State during the period from 01.01.1980 to 15.08.1985 ? : NO Are you an Emergency Commissioned Officers (ECO), Short Service & Retrenched Commissioned Officers (SSCRO) : ? : NO Period of Service : Nationality : Indian State/UT (to which centre of exam belongs): * : Haryana Centre of Examination : Hisar Application Fee / Intimation Charges Details : Payment In : ONLINE Amount : 500.00 Payment Status : PAID Reference ID : BSBI3631060435 Transaction Date : 14012015 Personal Details Date of Birth : 07021985 Age completed as on 01.01.2015 : 29 Gender : MALE Marital Status : Married Father's Name in Full : : Sh Dharm Pal Mother's Name in Full: : Smt Pushpa Spouse Name in Full: : : Minakshi Address for Correspondence : H. No. 428 Ward No. 9 : Near Balmiki Mandir : Tohana District : Fatehabad State : HARYANA Pin code : 125120 Permanent Address : H. No. 428 Ward No. 9 : Near Balmiki Mandir : Tohana

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1/19/2015 Recruitment of Administrative Officer (Scale I) in AICIL ­ Application Form Print

http://ibps.sifyitest.com/aicilaojan15/registration_print.php?q=NDlhZjIwZmI3NjVmNTU3YTdmMDk0ZDc0NzIzNjAxNjF8MjEwMDI0NjI2 1/2

Recruitment of Administrative Officer Scale I

Registration Number : 210024626

Full Name : Sunil Kumar

Name of Discipline : : Generalist

Code No.:  : 06

Category : UR

If Person with Disability : NO

Type of Disability : ­

Percentage of Disability : ­

Are you suffering from cerebral palsy and your writing speed is affected? : ­

If Yes, Do you need compensatory time ? : ­

Whether your dominant (Writing) hand affected ? : ­

If Yes, Do you need compensatory time ? : ­

Do you intend to use the services of a scribe (only for VI or OC Candidates)?

: ­

Whether domiciled in Kashmir Division of the State of Jammu & Kashmirduring the period 1­1­1980 to 31­12­1989 : ?

: NO

Do you belong to Religious Minority ? : NO

Religion to which you belong : Hindu

Are you seeking relaxation under widow /divorced women / womenjudicially Separated from their husbands and who are not re­married ?

: NO

Are you Existing Confirmed Employees of Agriculture Insurance Company ofIndia Ltd. : ?

: NO

Are you Existing Confirmed Employees of GIPSA : ? : NO

Are you Resident of Assam State during the period from 01.01.1980 to15.08.1985 ?

: NO

Are you an Emergency Commissioned Officers (ECO), Short Service &Retrenched Commissioned Officers (SSCRO) : ?

: NO

Period of Service : ­

Nationality : Indian

State/UT (to which centre of exam belongs): * : Haryana

Centre of Examination : Hisar

Application Fee / Intimation Charges Details :

Payment In : ONLINE

Amount : 500.00

Payment Status : PAID

Reference ID : BSBI3631060435

Transaction Date : 14­01­2015

Personal Details

Date of Birth : 07­02­1985

Age completed as on 01.01.2015 : 29

Gender : MALE

Marital Status : Married

Father's Name in Full : : Sh Dharm Pal

Mother's Name in Full: : Smt Pushpa

Spouse Name in Full: : : Minakshi

Address for Correspondence : H. No. 428 Ward No. 9

: Near Balmiki Mandir

: Tohana

District : Fatehabad

State : HARYANA

Pin code : 125120

Permanent Address : H. No. 428 Ward No. 9

: Near Balmiki Mandir

: Tohana

1/19/2015 Recruitment of Administrative Officer (Scale I) in AICIL ­ Application Form Print

http://ibps.sifyitest.com/aicilaojan15/registration_print.php?q=NDlhZjIwZmI3NjVmNTU3YTdmMDk0ZDc0NzIzNjAxNjF8MjEwMDI0NjI2 2/2

 Languages Known Read Write Speak

 Hindi  YES  YES  YES

 English  YES  YES  YES

 Punjabi  YES  NO  YES

District : Fatehabad

State : HARYANA

Pin code : 125120

Contact Details

Phone No : ­

Mobile No : +91 9728019888

Email ID : [email protected]

     

Educational Qualification Details (as on 01.01.2015):

Exam Passed Degree / Subject / Stream Date ofPassing

% of Marks Class/Grade

Graduation BA 25­06­2006 50.00 Second Class

Post Graduation Others ­ MCA 27­02­2012 53.50 Second Class

Do you have operating/working knowledge ofcomputers

: YES

Details of Computer Knowledge : Done MCA MS Office Windows Inter

Have you passed your Graduation? : YES

Have you passed your Post Graduation? : YES

Have you acquired requisite qualifications afterpassing 10th & 12th Standard Examinations.?

: YES

Work experience details (Start from present Employer)

Name of theEmployer & Nature ofEmployment

Designationand Rank if any

From To Years ofService(YY/MM)

Nature of dutiesperformed

Industry Type RemarkReason forLeaving

OITM HISAR SystemAdministrator

06/2008 01/2015 6/8 Computer LANAdminWindows Inter

Education Working tilldate

Total Experience (in Months) :80

  

               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 orincorrect 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 anywherein India.

Date: 14­01­2015 Signature of Applicant