FLEXI BENEFITS - DECLARATION FORM

April 2019 to March 2020

Employee ID : 22399

Employee Name : Harish Vijayakumar

I wish to avail following flexi benefits forming part of my fixed base salary for the period Apr'19 to Mar'20

Amount
(Update only
Maximum Per month
Sl.No Benefit amount amount) Remarks
1 Food Card Rs.6600 (PA) 550 Restricted to Rs.550/- per month
2 Gift Card Rs.4000 (PA) 333 Restricted to Rs.333 per month
Academic or Research Allowance granted for encouraging the academic,
3 Allowance research and other professional pursuits.

I declare the above information is correct.

Date: 23-Jan-2020

Please send this file to elumalai.arumugam@adp.com