EMPLOYEE PERSONAL INFORMATION

(Please fill up the form with Block letters)

NAME: _________________________________________________________________
(First) (Middle) (Last)

FATHER’S NAME: _________________________________________________________

MOTHER’S NAME: _________________________________________________________

(Maiden Name i.e. before marriage)

GENDER: ________________________ DATE OF BIRTH: ________/________/__________ (As per Aadhar)

(dd) (mm) (yyyy)

MARITAL STATUS: SINGLE / MARRIED DATE OF MARRIAGE: _________/__________/__________

(dd) (mm) (yyyy)

NAME OF SPOUSE: _______________________________________ DO YOU HAVE CHILDREN: Y /N

NO. OF CHILDREN (if Yes): _____________ CATEGORY: SC/ST/OBC/MINORITY/GENERAL/OTHERS

CASTE: __________________RELIGION: ______________________ NATIONALITY: ___________________

NAME OF THE NOMINEE : ________________________

RELATIONSHIP WITH THE NOMINEE: ________________________

PHYSICAL DISABILITY: Y/N GIVE DETAILS (IF ANY): _______________________________________

E-MAIL: ______________________________________________ MOBILE: _______________________________

PRESENT ADDRESS:

________________________________________________________________________________________________

________________________________STATE: ___________________________COUNTRY: ________________

PINCODE: ______________________________ LANDMARK:_________________________________________

(1)
PERMANENT ADDRESS:

_________________________________________________________________________________________________

________________________________________STATE: _____________________COUNTRY: _________________

PINCODE:___________________________________ LANDMARK: ________________________________

EDUCATIONAL DETAILS:

Degree / Diploma / Degree and Institute and From To Percentage /

Certificate Specialization University CGPA / Division

Std. X

Std. XII

Graduation

Post -Graduation

Other

EMPLOYMENT RECORD: (details in Chronological order, starting with last employer)

Employer Name From To Last Gross salary Reasons for leaving

Designation

(2)
PROFESSIONAL CERTIFICATIONS(if any) : _______________________________________________

LANGUAGE PROFICIENCY (Mother tongue first)

Language Speak Read Write

REFERENCE CHECK:
(give reference of two persons who are familiar with your background & not related to you)

Name : Name :

Place of work : Place of work :

Designation : Designation :

Contact Number : Contact Number :

E-mail Id: E-mail Id:

OTHER DETAILS:

PREVIOUS UAN No. (If any): _____________________________

PREVIOUS ESIC No. (If any):_____________________________

PAN No. : ______________________________

AADHAR No: _______________________________

BLOOD GROUP: _______________________________

EMERGENCY CONTACT No.: ______________________________

(3)
 SAVINGS BANK ACCOUNT DETAILS: (Please attach relevant proof)

BRANCH NAME

BANK NAME

BANK A/C No. IFSC

Declaration:
• I , shall, if and when required to take to up duty in this discharge of company assignment anywhere in India or
abroad.
• I certify that foregoing information is correct and complete to the best of knowledge and nothing has been
concealed/distorted.
• In case of any change, I will intimate to you in writing immediately.

----------------------------------------------------- ------------------------------------ ----------------------------------

(Signature of Employee) (Date of Joining) (Place)

For Office Use Only

Employee Code : _____________________ Deputed Client:________________Deputed Location: _____________

HR Signature: ____________________ Date: ___________________

(4)