Annexure 9

FORM 9
ASSESSOR PROFILE
(To be filled in capital letters only)

NAME OF THE
ASSESSMENT AGENCY Please
NAME OF THE ASSESSOR Attach
DEEPAKKUAMAR YASHVANTRAY PARMAR
a pass
port
B 301, VIJAYALAXMI RESIDENCY, size Photo
ADDRESS OF ASSESSOR BEHIND TOYOTA SHOWROOOM
ADAJAN PAL ROAD
SURAT -390005 GUJARAT ,INDIA
ASSESSOR MOBILE NO 7575063061
ASSESSOR E-MAIL deeppparmar@yahoo.com
Approved by any textile
related SSC
(Attach Proof)

Scope of Accreditation (tick Garment Knitting Processing Jute Handloom Silk Handicraft Manmade
the relevant sub sector) & Carpet Fibres

  
ASSESSOR EDUCATIONAL QUALIFICATION (Please attach attested copy of proof of qualification)
Year of Board/
Area of Specialization
Diploma/ Degree Passing University Remarks
Textile Processing MAHARAJA
B.Sc Tech (textile SAYAJIRAO
/Garment Manufacturing 1996
UNIVERSITY
chemistry)
/Fabric ,VADODARA

ASSESSOR EXPERIENCE DETAILS (Please attach attested copy of proof of experience)

Department/
Sr.No. Name of Employer Designation Section Period of Service

ASSESSMENT EXPERIENCE (Please attach attested copy of proof of experience)

Area of Period of No. of candidates
Sr.No. Name of Employer
Assessment Assessment Assessed

889
AADHAAR No.

PAN CARD No.

UNDERTAKING BY We undertake that Sh/Smt -----------------------------------

ASSESSMENT AGENCY is not involved in any of the training activities as trainer.

NAME & SIGNATURE OF

AUTHORIZED
SIGNATURY WITH
OFFICE SEAL/STAMP
(Note: All information to be filled in Capital letters only)