Haryana Gramin Bank

HO: Near Bajrang Bhawan, Delhi Road- Rohtak-124001. Tel. 01262-252605, 252622, Fax. 01262-271206
PROFORMA OF APPLICATION FOR WRITTEN TEST / FAST TRACK FOR PROMOTION FROM MMG SCALE-II TO MMG-III & FROM OJM SCALE-I TO MMG SCALE-II IN TERMS OF CIRCULAR NO. 17/2011 DATED 27.05.2011

LAST DATE FOR RECEIPT OF APPLICATION:

30.06.2011

(Those who wish to apply under normal channel and Fast Track channel both are required to apply separately for each channel)

APPLICATION FOR PROMOTION FROM:

Normal Channel Fast Track Channel

MMG SCALE-II TO MMG-III OJM SCALE-I TO MMG SCALE-II (Please tick () whichever is applicable) PF No. Present Place of Posting District Region

Name in full: . 03 Category:

2 PF No.: .. Mobile No.: . Age: . Date of Birth: . Designation: .. 09 06

Landline No.: . Gender: ..

Scale.Since.

Date of joining in the Bank: . As . 11 Date of placement in present scale & No. of years of service in present scale as on 01.04.2011 12 Seniority No. . in Seniority List as on 01.04.2010.

13
onwards):

Educational/professional

qualification

including

CAIIB

(Graduation

Examination Passed

Year of Passing

Division

Subject Studied

14 Experience in the Bank (full particulars of service in officer cadre must be furnished): Designation Place of Posting Period From To Nature of Duties

(Please indicate (in the separate sheet) the details of branches where you have worked.) Training Undergone: Designation Training Name of the Institution Duration

16 (i) (ii)

Please tick () whichever is applicable : YES/NO

Are you under suspension

Is any charge sheet(s) pending against you? If yes, please give details YES/NO ___________________________________________________________ ___________________________________________________________

(iii)

Have you been imposed Major / Minor penalty during the preceding 6/5 years, YES/NO (as the case may be ) if yes, please give details ___________________________________________________________ _____________________________________________________ Have you ever been debarred for promotion to MMG Scale-III/II (If yes, give details) YES/NO ___________________________________________________________ _____________________________________________________ Do you belong to the category of SC/ST/PH YES/NO (If yes, please enclose a copy of the Certificate Issued by the Competent Authority i.e. Caste/ Disability Certificate). Any health problem which may affect your mobility? YES/NO

(iv)

(v)

(vi)

UNDERTAKING The above particulars given are true to the best of my knowledge. I confirm that I have submitted the PAF for last six/five/three years to the Assessing Authority. I understand my application is liable to be rejected in case any of the above information is not found correct. Date: Place: Signature

INFORMATION TO BE FILLED BY HEAD OFFICE 1. A. AWARDS AWARDS AND PUNISHMENTS:

B.

PUNISHMENTS/DISCIPLINARY ACTION CASE SINCE THE DATE OF JOINING Particulars Details of Punishment Type Date Disciplinary Authority

Date of Charge Sheet

2.

VIGILANCE CASE:

We confirm that the officer/Employee is eligible for promotion to MMG-III/MMG-II in terms of Promotion Policy of 2010 and further guidelines received from NABARD/GOI/Sponsor Bank from time to time for the current promotion. Further, all the particulars furnished by the candidates have been verified and found correct including the particulars relating to educational qualification or the following information which have not been found correct along with the correct information is furnished below:

REGIONAL MANAGER/ GENERAL MANAGER

Haryana Gramin Bank

HO: Near Bajrang Bhawan, Delhi Road- Rohtak-124001. Tel. 01262-252605, 252622, Fax. 01262-271206

PROFORMA OF APPLICATION FOR WRITTEN TEST / FAST TRACK FOR PROMOTION

FROM OFFICE ASSISTANT (MULTIPURPOSE) TO OFFICER JUNIOR MANAGEMENT (SCALE-I) IN TERMS OF CIRCULAR NO. 17/2011 DATED 27.05.2011
(TO BE SUBMITTED THROUGH CONCERNED REGIONAL OFFICE )

LAST DATE FOR RECEIPT OF APPLICATION:

30.06.2011

(Those who wish to apply under normal channel and Fast Track channel both are required to apply separately for each channel)

APPLICATION FOR PROMOTION FROM:

Normal Channel Fast Track Channel

OFFICE ASSISTANT (MULTIPURPOSE) TO OJM SCALE-I

(Please tick () whichever is applicable) PF No. Present Place of Posting District Region

Name in full: . Category: .. Mobile No.: . Landline No.: . 05 Gender:

Age: . .. 06 07 08 09 10 Date of Birth: .

Date of joining in the Bank: . As . Date of appointment: .. (in Clerical Cadre) Service in Clerical Cadre ... Date of placement in present scale & No. of years of service in present scale as on 01.04.2011 9 Seniority No. . in Seniority List as on 01.04.2010.

(Please tick () whichever is applicable) 12. Has your increment in clerical cadre ever been deferred on account of availing leave on loss of pay? : Yes/No (If yes, please give details) 13. Has your increment in clerical cadre ever been withheld as a result of Disciplinary Action? : Yes/No Educational/Professional qualifications including CAIIB qualification (Matric onwards): Examination Passed Year of Passing Divisio n Subject Studied

14.

(Please enclosed true copies of Certificates in support of your qualifications) 15. Training Undergone: Designation Training Name of the Institution Duration

Do you belong to the category of SC/ST/PH: Yes/No (If yes, please enclose a copy of the latest Certificate issued by the Competent Authority). 17. Have you ever Letters/Awards during your service? (if yes, details be given below) Year Awards/Appreciation received Yes/No Appreciation

Have you ever been awarded any punishment: Yes/No (If yes, give details below any punishment received outside the service be also mentioned). 18. Year Punishment

19. Have you ever been debarred for promotion as officer in OJM Scale-I: Yes/No (If yes, when and for what period) 20. Is there any departmental enquiry or charge sheet pending against you for any misconduct? Yes/No (If yes, please give details) 21. 22. Are you under suspension? Yes/No

Do you know typing: Yes/No (If yes, please mention typing Hindi/English

speed)w.p.m.

language

The above particulars are true to the best of my knowledge and belief.

Place:

Date:

Signature

Information to be filled by Regional Office: 1. A. AWARDS & PUNISHMENTS: AWARDS:

B.

PUNISHMENTS/DISCIPLINARY ACTION CASE SINCE THE DATE OF JOINING /DISCIPLINARY ACTION CONTEMPLATED: Date of Charge Sheet Particulars Details of Punishment Type Date Disciplinary Authority

2.

VIGILANCE CASE:

All the particulars furnished by the candidate have been verified and found correct including the particulars relating to educational qualification and eligibility/or the following information which have not been found correct along with the correct information is furnished below:

REGIONAL MANAGER REGIONAL OFFICE

Haryana Gramin Bank

HO: Near Bajrang Bhawan, Delhi Road- Rohtak-124001. Tel. 01262-252605, 252622, Fax. 01262-271206
PROFORMA OF APPLICATION FOR WRITTEN TEST / FAST TRACK FOR PROMOTION

FROM OFFICE ATTENDENT (MULTIPURPOSE) TO OFFICE ASSISTANT (MULTIPURPOSE) IN TERMS OF CIRCULAR NO. 17/2011 DATED 27.05.2011
(TO BE SUBMITTED THROUGH CONCERNED REGIONAL OFFICE )

LAST DATE FOR RECEIPT OF APPLICATION:

30.06.2011

(Those who wish to apply under normal channel and Fast Track channel both are required to apply separately for each channel)

APPLICATION FOR PROMOTION FROM:

Normal Channel Fast Track Channel

OFFICE ATTENDANT (MULTIPURPOSE) TO OFFICE ASSISTANT (MULTIPURPOSE)

(Please tick () whichever is applicable) PF No. Present Place of Posting District Region

Name in full: .

Category: .. Mobile No.: . Landline No.: . 05 Gender:

Age: . .. 06 07 08. 09 10 Date of Birth: .

Date of appointment as Messenger (Regular): Service in years: Present Designation: . Basic Pay: .. Special Allowance (if any): Seniority No. . in Seniority List as on 01.04.2010. (Please tick () whichever is applicable)

11.

Has your increment in present cadre ever been deferred on account of availing leave on loss of pay? : Yes/No (If yes, please give details)

12.

Has your increment in present cadre ever been withheld as a result of Disciplinary Action? : Yes/No Educational Qualification (Matriculation onwards): Examination Passed Year Passing of Divisio n Subject Studied

13.

(Please enclosed true copies of Certificates in support of your qualifications) Do you belong to the category of SC/ST/PH: Yes/No (If yes, please enclose a copy of the latest Certificate issued by the Competent Authority). 15. Have you ever Letters/Awards during your service? received Yes/No Appreciation

(if yes, details be given below) Year Awards/Appreciation

Have you ever been awarded any punishment: Yes/No (If yes, give details below any punishment received outside the service be also mentioned). Year Punishment

17. Have you ever been debarred for promotion as Office Assistant (multipurpose) Yes/No (If yes, when and for what period) 18. Is there any departmental enquiry or charge sheet pending against you for any misconduct? Yes/No (If yes, please give details) Are you under suspension? Yes/No

Do you know typing: Yes/No (If yes, please mention typing speed) w.p.m. language Hindi/English The above particulars are true to the best of my knowledge and belief.

Place:

Date:

Signature

Information to be filled by Regional Office: 1. AWARDS & PUNISHMENTS:

A.

AWARDS:

B.

PUNISHMENTS/DISCIPLINARY ACTION CASE SINCE THE DATE OF JOINING /DISCIPLINARY ACTION CONTEMPLATED: Date of Charge Sheet Particulars Details of Punishment Type Date Disciplinary Authority

2.

VIGILANCE CASE:

All the particulars furnished by the candidate have been verified and found correct including the particulars relating to educational qualification and eligibility/or the following information which have not been found correct along with the correct information is furnished below:

REGIONAL MANAGER REGIONAL OFFICE