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Annexure B - Bio-Data Tech

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ANNEXURE B - BIODATA (FOR COAL INDIA LIMITED)

1. (A) NAME OF THE INSTITUTE : (B) DISCIPLINE : 2. DATE OF INTERVIEW : 3. POST : 4. NAME OF APPLICANT (IN BLOCK LETTER) : 5. FATHERS NAME : 6. MARITAL STATUS : 7. (A) DATE OF BIRTH (IN FIGURE) : (B) DATE OF BIRTH (IN WORDS) (ATTACH MATRICULATION CERTIFICATE) : Affix Passport size Photograph (attested by TPO / HOD / Gazetted Officer) & Another photograph should be stapled

8. PRESENT ADDRESS (WITH PIN CODE) (WHERE APPOINTMENT TO BE SENT) :

9. TELEPHONE NO. : 10. E-MAIL ADDRESS :

MOBILE NO. :

11. FAX NO (IF ANY) : 12. PERMANENT ADDRESS (WITH PIN CODE) :

13. RELIGION : 14. CASTE GENL./SC/ST/OBC (NON-CRAMY LAYER) /PH : (ENCLOSE CERTIFICATE ISSUED BY THE COMPETENT AUTHORITY)

15. IF SERVING IN GOVT. / PSU PLEASE INDICATE IN DETAIL THE FOLLOWING INFORMATION : (NAME OF ORGANIZATION / DESIGNATION / GRADE ETC.)

16. EDUCATIONAL QUALIFICATION : Name of the University Marks Year of passing Percentage of Marks SGPA CGPA / CPI Overall % of Marks after converting SGPA/CGPA

Name of the Course Matriculation / SSC / 10th HSC / 12th Std. Graduation/ B.Tech / BTech & MTech dual

1st Semester 2nd Semester 3rd Semester 4th Semester 5th Semester 6th Semester 7th Semester 8th Semester 9th Semester 10th Semester

Overall Aggregate of the Result published so far MTech (with specialization) 1st Semester 2nd Semester 3rd Semester 4th Semester 5th Semester 6th Semester 7th Semester 8th Semester Overall Aggregate of the Result published so far

In case of SPI/SPA/CGPA/CPI, equivalent % of marks should be mentioned and in support of the documentary evidence from the University/ Institute should be enclosed. Kindly note that overall aggregate should be mentioned as per final result in Degree based on which Division/Class is maintained

DECLARATION : I,_________________________________________________ hereby declare that the information as furnished above is correct to be best of my knowledge and belief. If any of the information as furnished above is found to be incorrect, my candidature for the post applied is liable to be cancelled.

Date_________________ _________________________ Signature of the candidate

List of Enclosures : 1. Certificate in support of date of birth, 2. Caste certificate (complete address of the issuing Authority should be mentioned 3. Certificate of educational / professional qualification along with mark-sheets of all the years, date of publication of the result & percentage of marks(in case of marks is CGPA/SGPA, the same may be converted into percentage duly certified by the Instt./University 4. Certificate in support of extra curricular activities at National/International level/NCC.

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