Application Form

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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

101142391
Nationality Gender
Age as on 01/11/2010
YEAR MONTH DAYS

DOB
(DD/MM/YYYY) 19/07/1986

ASSISTANT ADMINISTRATIVE OFFICER(GENERALISTS)

101

INDIAN

FEMALE

24

3

13

1 . Candidate Name 2 . Father's/Husband's Name 3 . Mother's Name

ANUSHI JINDAL SH.SATISH JINDAL SMT. PARVEEN JINDAL

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 CHANDIGARH 06 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's/Husband's Address

: : :

ANUSHI JINDAL SH.SATISH JINDAL 521/2 HOUSEFED COMPLEX PAKHOWAL ROAD

SPACE FOR PHOTOGRAPH

District State

: :

LUDHIANA PUNJAB

Pin Code : Tel. No. Email ID. 2563629

141013

STD Code 0161 Contact Details : Mobile No. 8054924416

[email protected] Signature of Candidate

9. Details of Fee :
LIC Branch Code A/C Code No. Transaction Date Transaction No. Miscellaneous Collection Amount (Rs.)

336 10. Educational Qualification

114033

01/12/2010

92585

1563

400

Name of Examination 12th

Name of Examination Passed COMMERCE WITH MATHS

Name of University / Institute CENTRAL BOARD SCHOOL OF EDUCATION

Year of Passing % age of marks 2003 73.6

Graduation

B.COM

PUNJAB UNIVERSITY CHANDIGARH

2006

68.72

Post Graduation

Professional

C.A INTER

THE INSTITUTE OF CHARTERED ACCOUNTANTS OF INDIA THE INSTITUTE OF CHARTERED ACCOUNTANTS OF INDIA

2007

52.12

Other Examination

APPEARED IN C.A FINAL

2010

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

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