Format No-ACL/QF/HR/05 Version Date Effective 01 Aug-2015

HUMAN RESOURCE INFORMATION SHEET

PLEASE FILL ALL DETAILS IN CAPITAL LETTERS ONLY
EMPLOYEE DETAILS
Name
Date of Joining
Designation
PAN No.*
Aadhar Card No*
Blood Group
Previous ESIC No.(If applicable)
BANK ACCOUNT DETAILS
Do you have account with ICICI Bank If not with ICICI Bank, do you have bank account
Yes No with any other bank Yes No
(except HDFC) **

If yes, please specify If yes, please specify

Bank Name - ICICI Bank Bank Name
Bank Account No. Bank Account No.
Branch Name Branch Name
IFSC Code IFSC Code
*Kindly share one cancelled cheque for Bank A/C details provided above
FAMILY DETAILS
Name Gender Date of Birth
(dd/mm/yyyy)/Age
Father MALE
Mother FEMALE
Spouse
Child 1
Child 2
HR Details (to be filled by HR) Asset Details (to be filled by Admin/IT)
Employee Code Asset Issued Desktop Laptop

Project If Laptop issued, undertaking signed by Y N

Department employee
Location CUG Connection Y N
Official Email ID
Data Card Issued Y N

Note-: ** It is mandatory to open a Salary A/C with ICICI Bank. Salary transfer to NON-ICICI Bank
(excluding HDFC) can be considered for first month only.