DOMESTIC HELP REGISTRATION FORM

To,

…………………...

…………………..

…………………..

Applicant/Employer/Owner Details:

1. Name :

2. Father’s Name :

3. Mother’s Name :

4. Address :

5. Mobile No :

6. E-mail :

Domestic Help Registration Details:

1. Name:
Photograph
2. Father’s Name:

3. Mother’s Name

4. Date of Birth:

5. Place of Birth:

6. Language spoken:

7. Permanent Address:

Post Office Name:

Police Station:
Telephone No.
8. Details of identification proof like Ration Card/Driving Licence/ID Card/ Aadhar Card/PAN
No. if any:

9. Identification Mark:

10. Name & Address of the Sarpanch/Talati/ Corporator:

11. Local Address:

12. Name & Address of Previous Employer:

Telephone No.:

13. Date Since when Employed:

14. Name & Local Address of Relatives & Friends:

15. INTRODUCED BY:-

Name:
Address

Telephone No.:

16. Criminal History if any / Any Pending Court Proceeding In any court in India Any Pending
warrant / Notice:

Date: Signature