New Employment Data Form (2) | Labour | Employment

Employment Data Form

Please affix recent passport size photograph



(First name)

(Middle name)

Position applied for Name of the Group Company / Business Function Location


: : :

Page 1 of 8

Sr. No Name Relationship Date of Birth Occupation Name of Employer Dependent Yes/No 1. Telephone No: (M)________________ Landline: Office_______ Resi. 2. E-mail Address: ________________________________________________________________ 7. Present Address Permanent Address 5. Personal data 1. Religion: ________________________ 14. 3. No Name(s) of child / Children Date of Birth Sex Std. Board Medium Any other Information 2. Marital Status: _________________ Date of Marriage: _____________________ 16. Identification Mark: _____________________________________________________________ 13. Name: _______________________________________________________________________ Place of Birth: _____________________________ Date of Birth: __________________ 3._________________ 6. Blood Group: _________________________________________________________________ 4. Page 2 of 8 . Details of family members Sr. Permanent Account Number: (PAN Card) _______________________________________ 8. Nationality: ____________________________________________________________________ 10. 2.A. Children’s Details 1. Passport Number: ____________________________ Valid up to: _______________________ 9. Domicile Details: State of origin: _______________________ (Indian Nationals) State of domicile: ____________________Since: __________ yrs. 12.. Category: _______________ General ST SC OBC Other 15. 3.

Please mention physical challenges. No.15. Educational Record: (starting with SSC/ equivalent). Institute / Organization Name of Course / Certificate Period From To Subject(s) Percentage/ Grade 3. Degree/Diploma Certificate Year of Passing School/College Board/University No. Please mention “PT” for part-time and “DL” for distance learning courses in the second column Sr. if any B. Education and training 1. Languages Known: Hindi English Mother Tongue: Regional / Vernacular / Other Pl. Institute / Organization Type of membership Remarks Page 3 of 8 . mention: ________ ________ ________ Read: Speak: Write: 16. Hobbies & Interests: _______________________________________________________ 17. No. No. Specialized Training/ Certification/s: Sr. Extra-curricular activities: __________________________________________________ 18. of Attempts Duration of course Principal Subjects Percenta ge/ Grade : __________________________________ 2. Details of membership in professional bodies / institutions: Sr.

Present organization structure: Kindly circle your position and indicate your reporting relationship i. Your present job responsibilities: 3. Particulars of employment (starting from current employer): Name & Location of employer Period of Service From (dd/mm/yy) To (dd/mm/yy) Designation Initial Last Broad / Major Responsibilities Please use additional sheets if required. person to whom you report and who reports to you. misrepresented or false. Page 4 of 8 .e. I shall be responsible for the resultant consequences and shall render myself liable to disciplinary action. Employment History 1. Please give your current remuneration details on the last page of this form. I have got Relieving Letter & Experience Letter from all the Previous Employers and will submit the same at the time of my Joining. Full Name: _____________________________________ Place: __________________ Date: _______________ Signature: __________________ 2. I hereby declare that the information and details furnished herein regarding Employment History are true and complete to the best of my knowledge and belief.C. If any information is found to be suppressed.

according to you.D. Reason for contemplating a change from the present job. are your strengths and areas for improvement? Strengths: Area for improvement: 3. Are you prepared to relocate to any of our businesses / locations in India / Abroad? Yes No Page 5 of 8 . 4. including other / personal details / special achievements. What. Any other information you would like to offer. if any 6. General Information: 1. Reason for seeking appointment in the Adani Group 5. Significant achievements: distinctions/ honor/ awards received / Books / Papers published Year Details 2.

give below details: No Position: _____________________ ____________________________________ Department / Function: _____________________________________________ Location: ________________________________________________________ Company: ________________________________________________________ 9. Are you related to any employee / associate of Adani Group? Yes If yes. requiring hospitalization / prolonged treatment. 8.7. Pl give details of any illness / major surgery you may have suffered / undergone during last 5 yrs. Nature of illness Period of hospitalization / treatment Name & Address of Hospital / Doctor Page 6 of 8 .. give details Below : No Name(s) :__________________________________________________________ Company /Business & Location: __________________________________________ Department: ____________________________________________________________ Designation: ____________________________________________________________ Nature of Relationship/Acquaintance: ___________________________________________ Note: Please furnish full details of all persons related or known to you. Have you been interviewed by us / any of our group companies in the past? Yes If yes. Attach/use additional sheet if required.

Particular Name Address Occupation Mobile / Office Tel. Superior in Current org.No. E Mail Tel. I shall be responsible for the resultant consequences and shall render myself liable to disciplinary action including termination of service without any compensation/ notice. No. (Resi. If any information is found to be suppressed. (at least. misrepresented or false. Name Relationship 11.g. one professional and personal reference) Superior in previous org. give below details: No Shifting family members within________ (in months) which includes Sr.) I hereby declare that the information and details furnished herein are true and complete to the best of my knowledge and belief. Place: _________________ Date: ______________ Signature: _________________ Page 7 of 8 . References: Please give references of at least three persons who are not your relatives / friends. Doctor/ lawyer /CA/Teacher etc. Professional (e.10. If appointment given will you be shifting your family to new location? Yes If yes.

Canteen Allowance Other Allowance Any Other Reimbursements Retrals Petrol Expenses Car Hiring Driver’s Salary Entertainment Exp.m. Remuneration offer p. Information Update LTA / LTC Any Other PF (Co. Children Edu.’s Contri.a. p.Current Remuneration details: Name: Please give details of your current remuneration in the first blank column: Current Remuneration p.) Superannuation Pension Gratuity Any Other Bonus Ex-gratia Performance Bonus Perf.m p. All. Medical Reimb. Linked Incentive ESOP Any Other Total Annual / Deferred Payments Joining time required: ________________ Compensation Expected (Cost To Company): ________________________ (Per annum) Page 8 of 8 . For office use only Details Fixed Basic Salary HRA Dearness Allowance Conveyance All.a.

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