Family Details form

Employee Name GADDAM NAGARAJU Bhadratha Number 161628

Gender Male Designation PC
Date of Birth 18-Dec-1985 Date of Appointment 01-Feb-2018
Unit Name TSSP 4 Battalion Date of Retirement 31-Dec-2046

Father Mother Spouse

Name Not Provided Name GADDAM BHARATHAMMA Name GADDAM MOUNIKA

Date of Birth Not Provided Date of Birth 01-Mar-1964 Date of Birth 10-Jun-1996
Gender Not Provided Gender FeMale Gender Female

Dependent Not Provided Dependent Yes Dependent Yes

Children-1 Children-2 Children-3

Name GADDAM SAGANRAJ Name GADDAM NIKHIL Name Not Provided

Date of Birth 24-Nov-2015 Date of Birth 02-Oct-2019 Date of Birth Not Provided
Gender Male Gender Male Gender Not Provided

Dependent Yes Dependent Yes Dependent Not Provided

I, hereby declare that my Mother BHARATHAMMA, my Spouse MOUNIKA, my Son / Daughter SAGANRAJ ,
NIKHIL , is wholly dependent upon me, He/ she is not having any other source of income.

Note: Please sign this form and attach the Aadhar card details of self and family members, attest the signature
& seal of Unit officer/ AO and submit to Bhadratha office.

Signature of the Member

Unit Office Use Only

Verified the above Declaration Form with the records and found to be correct. Forward to the
secretary.Bhadratha

Attested Signature of the Unit Officer

(with seal and date)