<p> Annexure-I</p><p>TAMILNAD MERCANTILE BANK LIMITED HRD Department</p><p>57, V.E.Road, HEAD OFFICE, THOOTHUKUDI To be filled by the Applicant for the post of Deputy General Manager (Integrated Treasury) on contract basis. </p><p>Please paste your recent Passport Size Photograph here.</p><p>______</p><p>1. Name (Block letters) : 2. Father Name : 3. Date of Birth : 4. Age as on 31.08.2014. : Years Months 5. Community & Religion : 6. Category (SC/ST/OBC/GEN) : 7. Native Place : 8. Native District : 9. Permanent Address with Pin Code : : : : : 10.Present Address with Pin Code : : : : : : 11.Communication Address : : : : :</p><p>12.Phone Number (Residence) : 13.Phone Number (Office) : 14.Mobile Number : 15.Email Address : 16.Marital Status :</p><p>1/4 17.Occupation of Spouse: : 18.If employed, details thereof. : :</p><p>19.Academic Qualification (From Degree onwards).</p><p>S.No Course/ Major Institution/ Degree University</p><p>20.Mother Tongue 21.Proficiency in other languages Speak Read Write 1. Language 2. 3.</p><p>22. Details of Present Employment:</p><p>23.Last drawn Salary per Month: Rs.</p><p>24.Time required to join the Bank, if selected:</p><p>25.Previous Employment Experience as Banker. (Please report details relating to AGM Cadre and Above alone) </p><p>Period of Bank Name & Employment Designation/ Experience Place of Nature of work/Job Details handled date Cadre In months working From To</p><p>2/4 Period of Bank Name & Employment Designation/ Experience Place of Nature of work/Job Details handled date Cadre In months working From To</p><p>26.Any other experience or 1. Trainings undergone (specify)</p><p>2.</p><p>27.Particulars of Two respectable references knowing you.</p><p>Name & Communication Address Qualification Occupation Phone Number</p><p>28.Are you related in any way to any Director/ : Ex-Director of our Bank? If so, state the : name of the Director/ Ex-Director and : relationship. :</p><p>29.Have you any relative in the service of this : Bank? If so, give details and relationship. : : :</p><p>3/4 30.Furnish the details of Disciplinary : Proceeding/Vigilance cases in the : previous/present employment. : :</p><p>31.Have you got any award from institution : appreciating your work? Give particulars. : : :</p><p>32.Any other information that you have not : been able to provide in answer to our : above specific questions may be furnished : here. :</p><p>DECLARATION.</p><p>I hereby declare that the above statements are true and correct, and it is understood that if I am employed, the offer of employment will be based upon the truthfulness of the statements made herein, and in the event of any information being found false or incorrect, my appointment is liable to be terminated.</p><p>Signature of the Applicant Date: Place:</p><p>Note: The followings should be enclosed along with this application form.</p><p>1. Age Proof (Self attested Photo Copy of SSLC or Higher Secondary Mark Sheet or TC). 2. Self attested Photo Copy of Degree Certificate/Post graduation certificate, CAIIB certificate. 3. Experience Certificate and proof for Post held (last pay bill copy/Promotion orders etc).</p><p>4/4</p>