Annexure-A
ASSAM FINANCIAL CORPORATION
VITTIYA BHAVAN, M.D. SHAH ROAD
PALTANBAZAR, GUWAHATI-781008, ASSAM
Latest self-
attested photo of
candidate
APPLICATION FORM FOR THE POST OF JUNIOR ASSISTANT
Notification No.: AFC/H.O./Estt./551 Date: 06.12.2023
1 Name (In BLOCK letters)
2 Father’s Name
3 Age & Date of birth (Age Proof to be
attached) Age as on 30-11-2023
Date of Birth :
4 Sex(Male/Female)
5 Nationality
6 Religion
7 Whether SC/ST/OBC
Yes/No.
(Caste Certificate to be enclosed)
Caste:
8 Marital status (Married/Single)
9 Contact Number Landline:
Mobile No.
10 Email ID(should be legible)
NB: All future correspondence, if any
will be made through email ID only)
11 Permanent Address
1
12 Address for
Communication
13 Total post qualification
Experience(in number of Total experience in years: years
Years)
14 Academic (Self-attested copies to be enclosed)
Qualification(HSLC
onwards)
Qualifica Name of Name of University/ Board Year of Class/Div. % of Marks
tion Institution Passing obtained
A
15 In Case of Experience
Sl No Date From Date To Period Designation Organization worked for
& Nature of Works
2
Total
Experience
in
Numbers of
years
16 Any other information ( Please attach separate sheets if required)
Self-attested copies of academic qualifications, experience and proof of age etc. are to
be enclosed along with the application form. The application form should be complete
in all aspects. Incomplete/ Ineligible/ Defective applications will be summarily rejected
without any notice to the applicant.
DECLARATION
1. I hereby declare that all information furnished in the application form are true,
complete and correct to the best of my knowledge and belief. I also agree that
my candidature/appointment shall be cancelled at any stage/time if it is found
that the information furnished are wrong.
2. I agree to receive all correspondence through e-mail ID given in my application.
3. Proof of application fee as detailed in the notification is attached herewith.
Place:
Date:
Signature of the candidate