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  • National Insurance Company Ltd.

    RECRUITMENT OF ASSISTANTS

    Registration Number : 190121146Full Name : Parvinder SinghState/UT (to which centre of exambelongs)

    : Delhi- NCR

    Centre of Examination : Delhi-NCRCategory : URIf Person with Disability : NOType of Disability : -Percentage of Disability : -Are you suffering from cerebral palsyand your writing speed is affected?

    : -

    If Yes, Do you need compensatorytime ?

    : -

    Whether your dominant (Writing)hand affected ?

    : -

    If Yes, Do you need compensatorytime ?

    : -

    Do you intend to use the services of ascribe (only for VI or OH Candidates)?

    : -

    Whether Person domiciled in theState of Jammu & Kashmir during theperiod from 01.01.80 to 31.12.89 ?

    : NO

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

    : NO

    Are you Displaced persons from EastPakistan who have migrated to Indiaon or after 1.1.1964 ?

    : NO

    Are you seeking relaxation underwidow /divorced women / womenjudicially Separated from theirhusbands and who are not re-married

    : NO

    Recruitment of Assistants in National Insurance... http://ibps.sifyitest.com/nicastjan15/registration_...

    1 of 4 Tuesday 27 January 2015 07:39 PM

  • ?Religion to which you belong : SikhWhether you belong to ReligiousMinority Community ?

    : YES

    Do have passed in English as one ofthe subjects at SSC/ HSC/Intermediate/ Graduation level ?

    : YES

    Do have Knowledge of RegionalLanguage of the State ?

    : YES

    Are you an Ex-Serviceman ? : NOAre you a Disabled Ex - Serviceman(DISXS) ?

    :

    Period of Service (in months) : : -Have you joined a Government job onthe civil side after availing of thebenefits given as an ex-serviceman ?

    :

    Are you a Dependent of Servicemankilled in Action (DXS) ?

    : NO

    Are you Existing Employees of theCompany ?

    : NO

    Serial No. : -Office Code No. : -Nationality : : Indian

    Application Fee / Intimation Charges Details :Payment In : ONLINEAmount : 500.00Payment Status : PAIDReference ID : BSBJ3648011526Transaction Date : 27-01-2015

    Personal DetailsDate of Birth : 30-03-1993Age completed as on 30-11-2014 : 21Gender : MALEMarital Status : UnmarriedFather's Name in Full : Mukhtiar SinghMother's Name in Full : Satnam Kaur

    Recruitment of Assistants in National Insurance... http://ibps.sifyitest.com/nicastjan15/registration_...

    2 of 4 Tuesday 27 January 2015 07:39 PM

  • Languages Known Read Write

    Spouse Name in Full :Address for Correspondence : Wz-71 Ram Nagar

    : Tilak Nagar: New Delhi

    District : West ZoneState : DELHIPin code : 110018Permanent Address : Wz-71 Ram Nagar

    : Tilak Nagar: New Delhi

    District : West ZoneState : DELHIPin code : 110018

    Contact DetailsPhone No : 011-25995784Mobile No : +91 8826380949Email ID : [email protected]

    Educational Qualification Details (as on 30.11.2014) :

    Exam Passed Subject /Stream Date ofPassing

    % of Marks Class/Grade

    HSC/Equivalent (XIIpass)

    Science 28-05-2012 65.60 Pass Class

    Do you have operating /workingknowledge of computers ?

    : YES

    Details of computer knowledge : Computer Basics And Programming

    Work experience details (Start from present Employer) :

    Languages Details :

    Recruitment of Assistants in National Insurance... http://ibps.sifyitest.com/nicastjan15/registration_...

    3 of 4 Tuesday 27 January 2015 07:39 PM

  • Hindi YES YES YES English YES YES YES Punjabi YES YES YES

    Declaration I hereby declare that all statements made in this application are true, complete and correct to the best of my knowledge and belief. I understand that in theevent of any information being found untrue or incorrect at any stage/ in the event any circumstances which may impair my fitness for employment in organization/ Ido not satisfy any of the eligibility criteria stipulated, my candidature is liable to be cancelled.

    Date: 27-01-2015 Signature of Applicant

    Recruitment of Assistants in National Insurance... http://ibps.sifyitest.com/nicastjan15/registration_...

    4 of 4 Tuesday 27 January 2015 07:39 PM


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