Application Form
Content
LIFE INSURANCE CORPORATION OF INDIA
CENTRAL OFFICE, "YOGAKSHEMA", JEEVAN BIMA MARG, MUMBAI 400 021 Recruitment for the Post of ASSISTANT ADMINISTRATIVE OFFICER (Generalists / Chartered Accountants / Company Secretary/ Legal)
Unique Application Registration Number :
Post Applied Post Code Category
(GENERAL/ OBC/SC/ST) GENERAL
101017553
Nationality Gender
Age as on 01/11/2010
YEAR MONTH DAYS
DOB
(DD/MM/YYYY) 20/09/1988
ASSISTANT ADMINISTRATIVE OFFICER(GENERALISTS)
101
INDIAN
MALE
22
1
12
1 . Candidate Name 2 . Father's/Husband's Name 3 . Mother's Name
S NARAYANAN N.SUBRAMANIAN M.LALITHAMBAL
4. Choice of Examination City :
Name of City City Code
5. Sub-Category
PH Please write : Yes/No, if ECO/SSRCO required Scribe LIC Employee
VH
OH
No COIMBATORE 08 No No
No
6. Are you a member of Institute of Chartered Accountants of India ?
Are you a member of ICAI Membership No. Membership Date
No 7. Are you a member of Institute of Company Secretaries of India ?
Are you a member of ICSI Membership No. Membership Date
No 8. Candidate Address
Name Father/Husband Address
:
S NARAYANAN
: N.SUBRAMANIAN :
NO.3 FIRST STREET M.K.P.COLONY GANAPATHY PO
SPACE FOR PHOTOGRAPH
District State
: :
COIMBATORE TAMIL NADU
Pin Code Tel. No. Email ID.
:
641006
Contact Details STD Mobile No.
0422
2535454 [email protected]
Signature of Candidate
9442334835
9. Details of Fee :
LIC Branch Code A/C Code No. Transaction Date Transaction No. Miscellaneous Collection Amount (Rs.)
91C 10. Educational Qualification
114033
27/11/2010
87360
2226
400
Name of Examination 12th
Name of Examination Passed MATHS PHYSICS CHEMISTRY
Name of University / Institute BOARD OF HIGHER SECONDARY EDUCATION TAMILNADU ANNA UNIVERSITY CHENNAI
Year of Passing % age of marks 2005 80.2
Graduation
B.E (MECHANICAL)
2009
67.0
Post Graduation
Professional
Other Examination
11. Post Qualification Experience :
*********************************************************************************************** DECLARATION
I hereby declare that all statements made in this application are true and correct to the best of my knowledge and belief. I understand that in the event of any information being found false or incorrect or not satisfying the prescribed eligibility criteria for the post applied for, my candidature is liable to be cancelled / rejected at any stage of selection.
Place : Date :
Signature of the Applicant
CENTRAL OFFICE, "YOGAKSHEMA", JEEVAN BIMA MARG, MUMBAI 400 021 Recruitment for the Post of ASSISTANT ADMINISTRATIVE OFFICER (Generalists / Chartered Accountants / Company Secretary/ Legal)
Unique Application Registration Number :
Post Applied Post Code Category
(GENERAL/ OBC/SC/ST) GENERAL
101017553
Nationality Gender
Age as on 01/11/2010
YEAR MONTH DAYS
DOB
(DD/MM/YYYY) 20/09/1988
ASSISTANT ADMINISTRATIVE OFFICER(GENERALISTS)
101
INDIAN
MALE
22
1
12
1 . Candidate Name 2 . Father's/Husband's Name 3 . Mother's Name
S NARAYANAN N.SUBRAMANIAN M.LALITHAMBAL
4. Choice of Examination City :
Name of City City Code
5. Sub-Category
PH Please write : Yes/No, if ECO/SSRCO required Scribe LIC Employee
VH
OH
No COIMBATORE 08 No No
No
6. Are you a member of Institute of Chartered Accountants of India ?
Are you a member of ICAI Membership No. Membership Date
No 7. Are you a member of Institute of Company Secretaries of India ?
Are you a member of ICSI Membership No. Membership Date
No 8. Candidate Address
Name Father/Husband Address
:
S NARAYANAN
: N.SUBRAMANIAN :
NO.3 FIRST STREET M.K.P.COLONY GANAPATHY PO
SPACE FOR PHOTOGRAPH
District State
: :
COIMBATORE TAMIL NADU
Pin Code Tel. No. Email ID.
:
641006
Contact Details STD Mobile No.
0422
2535454 [email protected]
Signature of Candidate
9442334835
9. Details of Fee :
LIC Branch Code A/C Code No. Transaction Date Transaction No. Miscellaneous Collection Amount (Rs.)
91C 10. Educational Qualification
114033
27/11/2010
87360
2226
400
Name of Examination 12th
Name of Examination Passed MATHS PHYSICS CHEMISTRY
Name of University / Institute BOARD OF HIGHER SECONDARY EDUCATION TAMILNADU ANNA UNIVERSITY CHENNAI
Year of Passing % age of marks 2005 80.2
Graduation
B.E (MECHANICAL)
2009
67.0
Post Graduation
Professional
Other Examination
11. Post Qualification Experience :
*********************************************************************************************** DECLARATION
I hereby declare that all statements made in this application are true and correct to the best of my knowledge and belief. I understand that in the event of any information being found false or incorrect or not satisfying the prescribed eligibility criteria for the post applied for, my candidature is liable to be cancelled / rejected at any stage of selection.
Place : Date :
Signature of the Applicant
