** All columns starts with ' * ' are mandatory ( Blue Highlighed Columns )

** Please Provide Bank Details for Faster Salary Credit

*Associate_Name
SL No *Gender *Date of Birth *Father Name
as per ID Proof

SHAILESHBHAI
1 Male Avinesh kumar 24.07.2000
ISHVARBHAI PATEL

2
3

4
 MotherName *Designation *Mobile Number

ANANDIBEN
OPERATOR 9659546153
SHAILESHBHAI PATEL
 Email ID Qualification Marital Status

PA427502@gmail.com I.T.I UNMARRIED

 *Associate Permanent Address
*Pincode *Job Location

NAVAPURA ROAD, BOKARVADA, BOKARWADA, MAHESANA,

384120 MMTCL-AHEMDABAD
VISNAGAR, GUJARAT, 384120
*Contract From ( DOJ ) *Contract End Date *Courier Receiver Name

18.03.2019 17.03.2020 ARUN SHARMA

 * Dispatch Address

MURUGAPPA MORGAN THERMAL CERAMICS LTD. PLOT NO. 681, VILL : MOTI BHYONE, SANAND -
KALOL HIGHWAY, TALUKA: KALOL, DIST : GANDHINAGAR GUJARAT: 382721
*Dispatch Pincode *Salary Type ( CTC / Gross / Net )

384120 Gross
*Salary per Month(Hand) *Reporting Manager Name Department

11000 ARUN SHARMA operations & Maintenance

Branch Grade Cost Ce PO No PreviousPrevious UAN Numbe

General engineering semiskilled

Aadhaar No PAN No Bank Name

233203775817 STATE BANK OF INDIA

Account Number IFSC Code Remarks ( If Any )

20272890843 SBIN0000494
SL NO E Code Associate Name Gender (M / F) DOJ (DD-MMM-YY) DOB (DD-MMM-YY) Job-location

1 Avinesh kumar MALE 18.03.2019 24.07.2000 AHEMDABAD

Add Family Par

Sl No* E-code * ESI Number* Name*

SHAILESHBHA
I ISHVARBHAI
1 PATEL
ANANDIBEN
SHAILESHBHA
2 I PATEL
 Marital Status
(Married / Father Name DOB Mother Name DOB
Unmarried)

SHAILESHBHAI ANANDIBEN SHAILESHBHAI

UNMARRIED 01.04.1972 01.01.1973
ISHVARBHAI PATEL PATEL

Add Family Particulars

Date of Birth* Relationship
Adhaar Card No. with the Aadhar details
( DD/MM/YYYY ) Employee*

01.04.1972 746308747129 FATHER

01.01.1973 905356141116 MOTHER

Husband / Wife Name (If married) DOB Children (If any) DOB Child 2 DOB Child 3

_ _ _ _ _ _ _
 Present Address with PIN Code (Do not mention Permanent Address with PIN Code (Do not
DOB Mobile No.
Teamlease or Client Address) mention Teamlease or Client Address)

NAVAPURA ROAD, BOKARVADA,

_ BOKARWADA, MAHESANA, 9659546153
VISNAGAR, GUJARAT, 384120
 Nominee's
Relationship
Email ID Name of the Nominee with
Employee

SHAILESHBHAI
PA427502@gmail.com FATHER
ISHVARBHAI PATEL
 Address of the Nominee Dispansary Address Aadhar details

NAVAPURA ROAD,
BOKARVADA, BOKARWADA,
_
MAHESANA, VISNAGAR,
GUJARAT, 384120
 Add Family Particulars
Date of Birth*
Sl No* E-code * ESI Number* Name*
( DD/MM/YYYY )
SHAILESHBHAI ISHVARBHAI
1 01.04.1972
PATEL
ANANDIBEN SHAILESHBHAI
2 01.01.1973
PATEL
3

1
2

1
2

1
2
y Particulars
Relationship with
Adhaar Card No. Aadhar details
the Employee*

746308747129 FATHER

905356141116 MOTHER

FATHER
MOTHER
SON

FATHER
MOTHER

FATHER
MOTHER