DETAILS FOR E-SR

1) Full Name:
2) Treasury Id: CFMS ID:
3) Aadhar No:
4) Religion:
5) Caste:
6) Department:
7) Designation/Post: Service Rule:
8) Place of Birth:
State: District:
Mandal: Village/Ward:
Pincode:
9) Local Status:
State: District:
Revenue Division: Mandal:
10) Differently Abled: YES/NO
11) TYPE OF GPF (GPF/ZPPF/CPS/CLASS-IV PF) & No:
12) IDENTIFICATION MARKS (As Per SSC/ Official Records)
i)
ii)
13) Height (in cm):
14) Address:

PERMANENT COMMUNICATION
House No/ D. No:
Street 1:
Street 2:
State:
District:
Mandal:
Village/Ward:
Pin code:

15) Home Town Details:

Nearest railway station: Nearest airport:
Email: Mobile no:
State: District:
Mandal: Village/Ward:
Pincode:
16) Nominations:
i) Graturity:
Name of the family member Relationship % Share for nominee
a)
b)
c)
ii) GPF/CPS:
Name of the family member Relationship % Share for nominee
a)
b)
c)
iii) APGLI:
Name of the family member Relationship % Share for nominee
a)
b)
c)
 17) EDUCATIONAL QUALIFICATIONS

S.N QUALIFICATION STREAM/ YEAR OF SCHOOL/ STATE DISTRICT MANDAL

o BRANCH PASSING COLLEGE/
UNIVERSITY
1 SSC

2 INTERMEDIATE

3 GRADUATION

4 B.Ed

5 POST
GRADUATION

9
 18) FAMILY MEMBER DETAILS
S.N FULL NAME RELATION DOB AADHAR MOBILE DATE OF TYPE OF INCOME
o MARRIAGE EMPLOYENT

DOCUMENTS TO UPLOAD
▪ AADHAR
▪ RECENT PASSPORT PHOTO
▪ SSC/ DOB PROOF
▪ CASTE CERTIICATE (OTHER THAN OC)
▪ MEDICAL CERTIFICATE (FOR DIFFERNETLY ABLED)