CANDIDATE INFORMATION FORM-CONFIDENTIAL

A. PERSONAL DETAILS

1. NAME: ___PASUPULETI SRINIVASA RAO

2. DATE OF BIRTH (dd/mm/yy): _ 21/07/78

3. GENDER: MALE/FEMALE

4. MARITAL STATUS: MARRIED

5. DETAILS OF FAMILY MEMBERS:

Family Members Name Occupation/Profession
1. Father Lt. P Subba Rao Real Estate
2. Mother Lt. P Ramanamma House wife
3. Wife P Sai Priya Software
4. Brother(s) P Sudhakar Rao HSE
5. Sister(s) P Suseela House Wife
6.Daughter P Hruthika Student

6. ADDRESS:

Permanent 10/418-4B, Venkateswara Nagar

Landmark Lakshmi Paradise Theatre

Mobile No. 9066050607

BHEL Guest House, Jothi Nagar, Peddapalli, Ramagundam, Karim

Present
nagar, Telanagana-505215

Landmark NTPC Power Plant

Mobile No. 9066050607

8. Pan Card No. : _BHDPP7054M

9. Passport No. : _Z5062336

 CANDIDATE INFORMATION FORM-CONFIDENTIAL

B. EDUCATIONAL DETAILS

Degree (starting Year of % Of Roll/Registration

Institute Name with Board/University
from class-X) passing Marks Number
location
New Model High School, Board of Secondary
SSC 1994 57
Kadapa Education
PVRR & MNR Jr. Board of Intermediate
Intermediate 1996 60
Collage, Kadapa Education
B. Tech SV University, Tirupati SV University
2002 62.5
(Mechanical)
P G Diploma in NIFS, Vijayawada
Health & Safety NIFS 2003 81
Engineering
Diploma in Invotech Precision Engineers, State Board of Technical
2019 73
Industrial Safety Guntur Education & Training

Any Gaps in Education: No If yes, specify period: ___________________________

Reason for Gap: _____________________________________________________________

Any degree/Diploma in progress: Yes/No if yes, then please specify: ________________

C. PROFESSIONAL DETAILS

Details of Employer#1(List recent first)

Company Name: Cholamandalam Risk Services Designation:
Safety Manager
Employee Code:322989 Division/Department/Project: HSE

Employer Address:
Cholamandalam M S Risk Services Ltd.
6th Floor, Gee Gee Universal No.02
Mc Nicholas Road, Chetpet
Emp Contact No: 9066050607
Chennai-600031

Head office location: Chennai

Was the position: Contractual
Employment Period
From Apr 2020
Reporting Manager Name:
Mr. Jothi Basu
Reason for Leaving:
Last CTC drawn: 119709/Month
To Till Date
Reporting Manager Contact No:

Reporting Manager Email ID:

 CANDIDATE INFORMATION FORM-CONFIDENTIAL

HR Name: HR Contact No:

G Manivel
HR Email ID:

Details of Employer#2
Company Name: Capacite Infra Projects Ltd. Designation: Manager-HSE

Employee Code: Division/Department/Project:

3274 HSE
Employer Address:

Anchorage Building, 4th Floor, Behind

Amarnath Patil Compound, Govandi
Emp Contact No: 9066050607
Station rd, Govandi East Mumbai 400 088.
Maharashtra, India

Head office location:

Reason for Leaving
Was the position: Permanent
Last CTC drawn
Employment Period
From Apr 2017 To Mar 2020
Reporting Manager Name: Reporting Manager Contact No:
Sanjay Kumar Singh

Reporting Manager Email ID:

HR Name: HR Contact No:

HR Email ID:

Details of Employer#3
Company Name: Designation: Dy Manager-EHS
Tata Housing Development Company Ltd.
Employee Code: Division/Department/Project:

Employer Address:

Emp Contact No:

Head office location:

Reason for Leaving
Was the position: permanent/contractual
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Employment Period Last CTC drawn

From To
Reporting Manager Name: Reporting Manager Contact No:

Reporting Manager Email ID:

HR Name: HR Contact No:

HR Email ID:

Details of Employer#4
Company Name: Designation:

Employee Code: Division/Department/Project:

Employer Address:

Emp Contact No:

Head office location:

Reason for Leaving
Was the position: permanent/contractual
Employment Period Last CTC drawn
From May 2010 To Mar 2011
Reporting Manager Name: Reporting Manager Contact No:
Mr. Govinda Rajulu

Reporting Manager Email ID:

HR Name: HR Contact No:

HR Email ID:

Declaration & Authorization

I hereby undertake that all informations provided by me in this form are true and accurate. I am
giving my consent to take any verification (based on the details given above) as may be required
by Tata Projects Limited and /or its Associate/its vendor/its employee. I also release Tata
Projects Limited and /or its Associate/its vendor/its employee from any liability that may arise
from such verification.
 CANDIDATE INFORMATION FORM-CONFIDENTIAL

I authorize an inquiry to be made on the information contained on this form. Former employers
and officials of education institutes are authorized to give information about me and I release
them from all liability for issuing such information.

Signature:
Name :