uiicl_205318

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ON-LINE APPLICATION FOR UNITED INDIA INSURANCE CO. LTD. 19026 Please paste your recent passport size photograph and sign across it. Please retain atleast 5 copies of same photograph with you for subsequent use.  Registration # : 205318 Full Name : BOMMAGALLA PRATHAP Group Appl ied for : Group E Group Code : 05 Category : SC If Physical l y Chal l enged : NO Type of Di sability : -- Percentage of Disabi lity: -- Do you intend to use the services of a scr ibe(onl y for VH and OH candidates whose writi ng speed has been affected by c erebral palsy) : -- Whether domiciled in Kashmir Division of the State of J&K during the period 1-1-1980 to 31-12-1989? NO Whether you belong to Rel igi ous Mi nori ty Community NO Minori ty Rel i gion : -- Are you an Ex-Servi ceman (ECO/SSRCO)? NO Are you Resident of Assam State during the period from 01.01.1980 to 15.08.1985 ? : YES Are yo u Per manent Employees of Uni ted I ndia Insurance Co. Ltd? : NO Please enter Your empl oyee number : -- Desi gnation : -- pl ace of work : -- Are you c onfirmed employees of General Insurance Corporation of Indi a, Publi c Sector General Insurance Compani es, Tar iff Advisory Committe e , AICIL? : NO Pl ease enter name of company: -- pl ace of work : -- Nationali ty : Indian Centre of Examinati on : Bengal ooru Centre code : 73 Application fee details :  Transaction ID / Journal No. : -- Branch Name : -- Branch Code : -- Deposi t Date : -- Amount : --  Personal Details :  Date of Birth : 01-05-1982 Age as on 31.12.2010. : 28 Gender : MALE Father's Name / Husband's Name : B YEBU Mother's Name : B MARIYAMMA Address for Correspondence : S UPPALAPADU 1/2

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Page 1: UIICL_205318

8/7/2019 UIICL_205318

http://slidepdf.com/reader/full/uiicl205318 1/2

ON-LINE APPLICATION FOR UNITED INDIA INSURANCE CO. LTD.

1902

Please paste your recent

passport size photograph

and sign across it. Please

retain atleast 5 copies of 

same photograph with you

for subsequent use.

 

Registration # : 205318

Full Name : BOMMAGALLA PRATHAP

Group Applied for : Group E

Group Code : 05

Category : SC

If Physically Challenged : NO

Type of Disability : --

Percentage of Disability: --

Do you intend to use the services of a scr ibe(only for VH and OH

candidates whose writing speed has been affected by cerebral palsy) :--

Whether domiciled in Kashmir Division of the State

of J&K during the period 1-1-1980 to 31-12-1989?NO

Whether you belong to Religious Minority Community NO

Minority Religion : --

Are you an Ex-Serviceman (ECO/SSRCO)? NO

Are you Resident of Assam State during the period from 01.01.1980 to

15.08.1985 ? :YES

Are you Permanent Employees of United India Insurance Co. Ltd? : NO

Please enter Your employee number : --

Designation : --place of work : --

Are you confirmed employees of General

Insurance Corporation of India, Public Sector General

Insurance Companies, Tar iff Advisory Committee , AICIL? :

NO

Please enter name of company: --

place of work : --

Nationality : Indian

Centre of Examination : Bengalooru

Centre code : 73

Application fee details :  

Transaction ID / Journal No. : --

Branch Name : --

Branch Code : --

Deposit Date : --

Amount : --

 

Personal Details :  

Date of Birth : 01-05-1982 Age as on 31.12.2010. : 28

Gender : MALE

Father's Name / Husband's Name : B YEBU

Mother's Name : B MARIYAMMA

Address for Correspondence : S UPPALAPADU

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Exams Passed Name of Degree Date of Passing % of Marks Class/Grade

Graduation / Equivalent : B.Com 01-04-2004 54.00 Second Class

Post Graduation : MCA 01-06-2007 65.00 First Class

No Experience

Total relavant years (in months) :

Languages Known Read Write Speak

ENGLISH YES YES YES

HINDI YES YES YES

TELUGU YES YES YES

JAMMALAMADUGU

KADAPA

District KADAPA

State / UT: ANDHRA PRADESH

Pin : 516431

Permanent Address : S UPPALAPADU

JAMMALAMADUGU

KADAPA

District KADAPA

State / UT: ANDHRA PRADESH

Pin : 516431

Contact Details:  

Phone No : -

Mobile No: 9490730531

Email ID : [email protected]

Qualification Details(as on 31.12.2010):

Have you passed in atleast three papers of 

the examination conducted Actuarial Society of India ?:NO

Select the papers out of : --

Working Knowledge of Computers: YES

Details of Computer Knowledge : MCA

Post Qualification work experience details (Start from present Employer):

 

DECLARATION:

  I hereby declare that all the 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, my candidature for the post applied is liable to be cancelled / rejected at any stage without giving any notice

to me. I am willing to serve anywhere in India. I agree that the Company has the right to transfer me to any part of the country at its discretion.

 

Place:

Date: 09-02-2011 Signature of Applicant

BOMMAGALLA PRATHAP

Please retain your Registration No. and Password emailed to you carefully for further reference

 

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