New Rec Form

,

BANKOFBARODA,BARODA

./E.CNO

FORMOFDECLARATIONOFFIDELITYANDSECRECY

/ / / / , / | / , , , / //.__________________________

::

I__________________________________dohereby declare that I will faithfully, truly and to the best of my skill and ability execute and perform the duties required of me as Director/member of Board/member of Local Committee/Auditor/Adviser/Officer or other employee of the Bank of Baroda and which properly relate to the office or position in the saidBankofBarodaheldbyme.I further declare that I will not Communicate or allow to be Communicated to any person not legally entitled there to any information relating to the affairs of the Bank of Baroda or the affairs of any person having any dealing with the Bank of Baroda nor will I allow any such person to inspect or have access to any books or documents belonging to or in the possession of the Bank of Baroda and relating to business of the Bank of Baroda or to the business of any person having any dealing withtheBankofBaroda.Datedat_________________________ This_______________________________dayof

__________________

SignaturePlace:Date:

1

Jan2013,HRMDept,BankofBaroda,ZONALOFFICE(Karnataka&AP):2ndFloor#72,BrigadeRoad,Bangalore560025

ATTESTATIONFORM

, ,The furnishing of false information o suppression of any factual information in the attestation form would be disqualification and is likely to render the candidate unfit for the appointment in the Bank. If the fact that false information has been furnished or there has been suppression of any factual information in the attestation form comes to notice any time during the service of a person, his services would be liabletobeterminated.. /Details1 ()

Name in full ( in Block Capital) with aliases of any (Please indicate if you have added or dropped at any stage any yournameorsurname

1 Name Surname

2)(,,,//PresentAddressinfull

3.a.(,,,/PermanentAddressinfull

HouseNo Lane/Street/Road

Town/Village,

ThanaandDistrict

State Pin 3b.,IforiginallyaresidentofcountryotherthanIndia,theaddressinthatcountryandthedateofmigrationtoIndianUnion

From

To

/ResidentialAddressinfull,(detailsasabove)

Name of the Distt Headquarters of the place mentioned Precedingcolumn

2


4.1!Particularsofplaces(withperiodofresidence)whereyouhaveresidedformorethanoneyearatthetimeduringtheprecedingfiveyears 5.1(a) ()FathersNameinFullwithalias,ifany

(b) (,)PresentPostalAddress(ifdead,givelastaddress)

(c) PermanentHomeaddress

(d) Profession (e) ,

Ifinservice,givedesignationandOfficialAddress

5.2(a) ()Spousesnameinfull

(b) Profession (c)

DesignationandOfficeAddress

6 /Nationalityof(a)Father (c)/Spouse

(b)Mother

7 ExactDateofBirth

PresentAge

AgeatMatriculation

8

(a)PlaceofBirth()(Distt&Stateinwhichsituated)

(b)Distt&Statetowhichyoubelong

9 (a)YourReligion

(b)

Are you a member of Scheduled Caste/ Scheduled Tribe? yesstatethenamethereof.(Tick)

YES/NO

3


Ifyes,Nameofthecaste/tribe

10 15Educational Qualification showing place of education with years in Schools and Colleges since 15th year age.

/NameofSchool/Collegewithfulladdress

DateofEntering

Dateofleaving

YearofPassing

a.

b.

c.

d.

11.,Ifyouhave,atanytime,beenemployedgivedetails

,Designofpostheld/descriptionofwork.

Period ,FullAddressoftheOffice,FirmorInstitution

Reasonsforleavingthejob.

From To

12. , / , , ,,

Have you ever been arrested, or kept under detention/was imprisoned or bound down/fined/convicted Court of Law for any offence or FIR lodged/complaint registered/charges framed against you or any criminal case pending against you before any Court of Law/authority or debarred/ disqualified by the Public Service Commission from appearing at its examination selection or debarred from taking any examination or restricted by any authority/ any institution/terminated from service by any previous employer for any criminal offence/indiscipline/oranyact/sofmisconduct,etc.If YES, state full particulars of the case/s, misconduct/s, offence/s, detention, imprisonment, fine, conviction, sentence,FIR,chargesframedagainstasthecasemaybe.Further, nondisclosure/suppression of part information of any of the above circumstances/instances FIR/complaint or pending case or conviction, prior to/post your appointment/selection in the Bank will also render candidature/appointmentineligibleandinvalid,atthediscretionoftheBank

4


DECLARATION / / , (/ ) I certify that the foregoing information is correct and complete to the best of my knowledge and belief . I am not aware of any circumstance which might impair my fitness for employment in the Bank. I have /will have no objection to the Bank making enquiries at any time (immediately/ in the near future) regarding the statements made by me in the application in any manner they decide to do so inclusive of policeenquiryintomyantecedents.

:

Signature

Place:

Date:

./E.CNO

5


FORMOFNOMINATION

BranchCodeNo.:Nameoffund:BankofBarodaGratuityFund

Details

1 ()Nameofemployees

Surname

2 .Emp.P.FCodeNo

3 Sex

4 Religion

5 FathersName

6 HusbandsName

7 (,,,)Whetherunmarried,married,widoworwidower

8 DateofBirth Day Month Year

9PermanentAddressNAME

FlatNo Village Thana /Taluka/SubDvision

PO /District/State 10 / I hereby nominate the person(s) mentioned below to receive the amount that may stand to my credit in the provident fund in the event of my death before that amount becomes payable, or having become payable, has not been paid and direct that the said amount shall be distributed among the said person(s) in the manner againsttheirnames:

Nameandaddressofnomineeornominees(NameinCapital)

Nomineesrelationshipwiththeemployee

Ageofnominee

AmountorshareofaccumulationintheP.F

,CertifiedthatIhavenofamilyandshouldIacquireafamilyhereaftertheabovenominationshouldbedeemedascancelled.//()/Certifiedthatmyfather/mother/sister(s)/minorbrother(s)isaredependentuponme.

________________2012_______________ Datedthis______________________dayof___________________20_________at

Twowitnesstosignature 1.Signatureofemployee 2../E.CNo

6


/CertifiedthattheabovedeclarationhasbeensignedbyMs/Mrbeforemeafterhe/shehasreadtheentries.dateSignatureofBranchManagerNAME: ROLLNO.

(A) STATEWHYYOUPREFERTOJOINBANKINGSECTOR?

(B) WHATQUALITIESOFYOURSSHALLHELPINWHATYOUHAVESTATEDABOVE?

1.

2.

7


3.

4.

5.

8


Documents

New Rec Form