PHOENIX TECH Q SOLUTIONS

NAME

:Bharath Chandran

FATHERS NAME

:Chandrasekhar.G

FULL ADDRESS

:ambady ,kuthiathode p.o, cherthala

DISTRICT

:Alappuzha

STATE

:Kerala

PIN

:688533

SEX

:Male

D.O.B

:25-5-1993

AGE

:22

EDUCATIONAL
QUALIFICATION

:Btech

Occupation

:student

HOW DO YOU KNOW ABOUT US?

:Quikr ad

Languages known to speak fluently

:Malayalam, English, hindi

Your Contact number

8281605869

Email Id

DEPOSIT AMOUNT

bcemailid@gmail.com

DEPOSIT DATE :
DEPOSITED BANK AND BRANCH :

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ACCOUNT NO

A/C HOLDER

BANK NAME

BRANCH NAME :
IFSC CODE

YOUR REFERRAL NAME &CODE :PHOENIX TECH Q SOLUTIONS 007

(You should fill reference name & code in case where you are
referred from our staff or promoter)

2014, PHOENIX TECH Q SOLUTIONS All Rights Reserved

Mail us on dataentryplacements007@gmail.com
I hereby, solemnly declare that the information given is true to best of my knowledge. I have
read & understood the term &conditions applicable, as overleaf & agree to them in total.
Date

15-09-2015

Place

: kuthiathode
Signature
Bharath chandran