INDUCTION KIT

Forms - Booklet
Dear Employee,

This booklet consists of various statutory and necessary forms that you are kindly requested to document on the
day you join, and hand over to the concerned Human Resource officer.

Mentioned below are the list of forms and the concerned departments and person you may contact in case of
any queries.

Sl. No. Form Fill by Concerned Contact Number

Employee

1. Joining Report
2. Four Page Application
3. Age Declaration
4. Instruction for filling up Provident Fund Form
4(A) Transfer of EPF Account (Form 13) (Revised)

5. Form 2 (Revised) consisting of: Part A (EPF)

Provident Fund Part B (EPS) Pension Scheme

6. Provident Fund Nomination Form A(Revised)

7. Gratuity Nomination Form (Form‘F’)

8. Superannuation Nomination Form
9. Instructions for filling up Superannuation Form
9(A) Transfer of Superannuation Fund (Annexure I)
9(B) Form(A)
10. Medical Insurance Form
11. Business Declaration Form
12. Employee Declaration form
13. Flexi Allowance Sheet
14. Bank Account Details
15. Laptop Requisition Form
16. Employee Identification
17. Information Security Declaration
18. Document Checklist
19. Memo Approval
20. Induction Sheet
21. Posting Letter

For creating E-mail ID :

On getting your Employment No., log a call on ITSM.

 TP CENTRAL ODISHA DISTRIBUTION LIMITED

JOINING REPORT

Date :

Head (Human Resources),

This is to inform you, that I, , have joined the

TP Central Odisha Distribution Limited effective in

Department/Division.

(Employee Signature)

(Signature of Div./Dept. Head/HR Representative/Induction In charge)

`

The TP Central Odisha Distribution Limited

Corporate Centre
IDCO Towers
Janapath, Bhubaneswar – 751022
Odisha

Tel. No:

APPLICATION FORM

NAME :

POST APPLIED FOR :

ADVERTISEMENT REF :

This application must be filled in by the candidate in his/her own handwriting. Extra sheets may be
attached if space is not sufficient for any item.
PERSONAL DATA

Name:
(FirstName) (Middle Name)
Sex: Male/Female

Date of Birth: Age:

Year
Place of Birth:
State PHOTO

State you originally belong to: Mother Tongue:

_Nationality :_

Whether belonging to SC/ST/OBC/SBC/NT :

(Furnish documentary evidence)

Blood Group :
Status : Single/ Married/ Widow (er)/ Divorcee/ Separated
If Married, please state the date of marriage:

ADDRESSES:

Present Address:

C/o : House No: Building No.:

Address Line 1: ____________________________________________________________________

Address Line 2:

City : ______________________ District: _____________________ State: _______________________

Postal Code: __________________________________________ Telephone No.:_____________________

Emergency Address: (Same as Present Address )

C/o : House No: Building No.:

Address Line 1: ____________________________________________________________________

Address Line 2:

City : ______________________ District: _____________________ State: _______________________

Postal Code: __________________________________________ Telephone No.:_____________________

Permanent Address:

C/o : House No: Building No.:

Address Line 1: ____________________________________________________________________

Address Line 2:

City : ______________________ District: _____________________ State: _______________________

Postal Code: __________________________________________ Telephone No.:_____________________

FAMILY DATA

Name of Father: Date of Birth :

Name of Mother: Date of Birth :

Name of Spouse: Date of Birth :

applicable)
Employed: Yes / No
If yes, Profession and Official Address:

of Dependents: Wife/Husband Children : Others:

Details of Dependents:
Sex
Sr. No Dependent’s Name Date of Birth Age
M/F
1
2
3
4
5

Details of relatives, if any, in Tata Group

Sr No Name Relationship Designation Department/Division

1
2
LANGUAGES KNOWN, PLEASE STATE /READ/WRITE/SPEAK

Sr No Language Read Write Speak

1

ADDITIONALINFORMATION

a) Give a brief record of your extra-curricular activities including sports and games in which participated:
a(i) School:

a(ii) College/ University:

a(iii) Elsewhere:

b) Are you a member of any professional body/ organization? If so, please give particulars.

I declare that the particulars given above are true and complete to the best of my knowledge
And belief and if found otherwise my appointment shall be liable for termination.

Date : Signature:
EDUCATIONAL DATA (YEARWISE DETAILS FROM SCHOOL LEVEL)

Proficiency
(I, II, Pass Start Date End
Education Class/ % of dd/mm/year Date Duration of Name of School/ College/Institute
Level of (Incl. Branch Distinction/ marks dd/mm/ Course and University Location of
Education of study and Gold year (No. of School/
specialization) months) College
Medalist)

SSC

HSC

Graduation

Post-
Graduation

Others
(Including
Professional
Research)

Give Particulars of Thesis / Project Work / Publication, if any

EMPLOYMENT DATA (STARTING FROM MOST /RECENT JOB)

Periods of Employment
Brief Basic per month and
Name of Employer Type of Designation Description of CTC per annum at the Reasons
From To
with Location Industry Responsibilities time of leaving for
dd/mm/yy dd/mm/yy
Leaving

Total Employment Details of Contractual Obligations, if any with the Present Employer
Duration (Years/Months)
 AGE DECLARATION FORM
I,
(Full name including surname)

S/o D/o
(Full name including surname)

Hereby declare that my age as on is years

Months, based upon my date of birth - viz.

(Figures)

(Date of Birth in Words)

as entered in the certificate issued by the Municipality/Army/Village Patil/Gram

Panchayat/School/SSC Board/College/University/Church (extract from Baptism Certificate), a copy
of which is attached herewith for companies records. I hereby Undertake to abide by the name
throughout the course of my employment with the companies or thereafter

With the Companies or thereafter.

Date : Signature :

The Date of Birth of Name :

Mr. /Mrs. /Miss Designation:

Division :

Certificate and found to be correct, Original Certificate Received Back

verified from the original

Signature : ______________________________ Signature : ______________

Date : _ Date : ______________________________
Instructions for filling up Provident Fund Forms Provident Fund

Forms

Form A (PF Nomination form), Form 13 (revised) – PF transfer form and Form 2(revised)-Pension nomination
form are statutorily required to be filed up by every new joinee of the company. Given below are the guidelines
which should be strictly followed by the employees for filling the statutory forms :

Form A – PF Nomination form

1. All the items in column 1 to 5 should be filled.

2. In column 4, the date of birth of the nomiee should be filled.
3. If the nominee is a minor, column 6 should be filled.
4. The form should be signed by the employer and the Divisional / Dept. Head.

Form 13 – PF Transfer form

1. All the items int the form 13 should be filled correctly & completely except item no. 11 & 12 which will
be filled by the payroll & Trust Management Dept.

2. PF A/c Number with previous employer should be filled in the item No. 4

3. Pension A/c Number with previous employer should be filled in item No. 5

4. The employee should contact his previous employer and check whether the previous
establishment was exempted or unexempted.
If unexempted, then the complete address of the Regional Provident Fund Commissioner should be
given in Item No. 6(a)
If exempted, then the name & complete address of the exempted Trust Fund should be given in Item
No. 6(b)

5. The rest of the items which are self explanatory, should also be complete in all respects.

6. The form should be signed by the employee.

Form 2 (Revised) – Pension Nomination Form

1. Items 1 to 7 should be filled completely except no. 6 which will be filled by Payroll & Trust Mgmt. Dept.
2. Part A pertains to PF nomination which may not be filled as ours is an exempted PF Trust & we have a
separate nomination form.
3. Part B pertains to pension nomination. The top portion of Part B is to be filled by married pension
members with the name of the spouse & maximum two children only.
The lower portion of Part B is to be filled by unmarried pension members with the name of the nominee
other than spouse & two children.
4. The form should be signed by the employee and the Divisional/Dept. Head. Unsigned forms will not be
accepted.
TRANSFER CLAIM FORM CLAIM ID
FORM 13 (REVISED) (For EPFO Use only)

(PARA 57)

To, To,
The Regional P F Commissioner, Trust Name:
Office Name: Trust Address:
Office Address:

(Please see instruction 3) (in case the PF A/C is with Exempted Establishment)

Sir,
I request that my provident fund balance along with my pension service details may please be
transferred to my present account under intimation to me. My details are as under:

PART A: PERSONAL INFORMATION

1. *Name:
2. *
3. Mobile number: 4. E-mail id:
5. Bank A/C number: 6. IFS code of Bank branch:

PART B: DETAILS OF PREVIOUS ACCOUNT (WHICH IS TO BE TRANSFERRED)

1. *PF Account No. :

In case the previous establishment is exempted Provident Fund Scheme,1952
Pension Fund Account No. :
2. *Name and Address of the previous establishment:

3. *PF Account is held by: (Name of EPF Office/ PF Trust)

4. *Date of Birth: (dd/mm/yyyy) 5. *Date of joining : _(dd/mm/yyyy)
6. *Date of leaving: (dd/mm/yyyy)

PART C: DETAILS OF PRESENT ACCOUNT

1. *PF Account No. :
In case the present establishment is exempted Provident Fund Scheme,1952
Pension Fund Account No. :
2. *Name and Address of the present establishment:
3. *Account is held by: (Name of EPF Office / PF Trust)
4. *Date of joining : (dd/mm/yyyy)
5. #Name of Trust (to whom funds are to be paid in case of present establishment being
exempted
under EPF Scheme, 1952) :
6. #Employee code under the Trust: _

(* indicates mandatory fields) (# Strike off if not applicable)

I, Certify that all the information given above is true to the best of my knowledge and I have
ensured the correctness of my present and previous account numbers.

Signature of the
Member Date:

IMPORTANT: Member has the option to get the claim form attested by present or previous
employer. In case of attestation by the previous employer, time taken in settlement will be
relatively less.

Certified that I have verified the data in Part B in respect of the member mentioned in Part A
of this form and the signature of the member.

Signature of Previous Employer

Seal of the Establishment Date:
OR
Certified that I have verified the data in Part C in respect of the member mentioned in Part A
of this form.

Signature of Present Employer

Seal of the Establishment Date:

INSTRUCTIONS AND GUIDELINES

1. The Bank A/C details are for verification purpose even if the Fund i s transferred t o the
EPFO Office/Trust maintaining the present account number.
2. In case the Previous Account was maintained by PF Trust of the exempted establishment,
the member should submit a Transfer Claim Form {Form-13(Revised)} to the Trust while
sending another Transfer Claim Form {Form-13(Revised)} to the PF Office for transferring
the service details under the Pension Fund to the new account.
3. The Form should be submitted to that PF Office under which previous or the present
account is maintained, depending upon as to which employer has attested the c l a i m .
(In case the claim is attested by the present employer, claim should be submitted with
the PF Office under which the present account is maintained, and so on).
4. The mobile number (wherever provided) of the member would be used for sending an
SMS alert informing him/her the processing of his/her claim and is non-mandatory for
Physical form.
 Composite Declaration Form No.-11
(To be retained by the employer for future reference)
EMPLOYEES'PROVIDENT FUND ORGANISATION
Employees' Provident Funds Scheme, 1952 (Paragraph 34 & 57) &
Employees' Pension Scheme, 1995 (Paragraph 24)
(Declaration by a person taking up employment in any establishment on which EPF Scheme, 1952 and /or EPS, 1995 is
applicable)

Name of the member

1

Father's Name
2 Spouse's Name
Date of Birth: (DD / MM / YYYY)
3

Gender: (Male/Female/Transgender)
4

Marital Status:
5 (Married/Unmarried/Widow/Widower/Divorcee)

(a) Email ID:

6
(b) Mobile No.:
Present employment details:
7 Date of joining in the current establishment (DD/MM/YYYY)

KYC Details: (attach self-attested copies of following KYCs)

a) Bank Account No. :
b) IFS Code of the branch:

8 c) AADHAAR Number
d) Permanent Account Numberr(PAN), if available
Whether earlier a member of Employees' Provident Fund Yes / No
9 Scheme, 1952
Whether earlier a member of Employees' Pension Yes / No
10 Scheme, 1995
Previous employment details: [if Yes to 9 AND/OR 10 above] – Un-exempted
Establishm Universal PF Date of Date of Scheme PPO Non-
ent Name Account Account Joining Exit Certificate Number (if Contribut
& Address Number Number (DD/MM/ (DD/MM/ No. (if issued) o r y Period
YYYY) YYYY) issued) (NCP) Days
11

Previous employment details: [if Yes to 9 AND/OR 10 above] – Exempted Trusts

Name & UAN Member Date of Date of Exit Scheme Non-

Address of EPS A/c Joining (DD/MM/Y Certificate Contributory
the Trust Number (DD/MM/Y YYY) No. (if Period (NCP)
12 YYY) issued) Days
 a) International Worker: Yes / No
b) If Yes, state country of origin (India/Name of the other
13 country)
c) Passport No.
d) Validity of passport [(DD/MM/YYYY)
to (DD/MM/YYYY)]

UNDERTAKING:

1. Certified that the particulars are true to the best of my knowledge.

2. I authorize EPFO to use my AADHAR for verification/authentication/eKYC purpose for service delivery.
3. Kindly transfer the funds and service details, if applicable, from the previous PF account as declared above to the
present P.F. Account as I am an Aadhar verified employee in my previous PF Account. *
4. In case of changes in above details, the same will be intimated to employer at the earliest.

Date:
Place: Signature of Member

DECLARATION BY PRESENT EMPLOYER

A. The member Mr./Ms./Mrs. ………………………………………………. has joined on ……………………… and

has been allotted PF Number………………….. and UAN ……………………..

B. In case the person was earlier not a member of EPF Scheme, 1952 and EPS, 1995:
* Please Tick the Appropriate Option:

The KYC details of the above member in the UAN database

o Have not been uploaded
o Have been uploaded but not approved
o Have been uploaded and approved with DSC/e-sign

C. In case the person was earlier a member of EPF Scheme, 1952 and EPS, 1995:
* Please Tick the Appropriate Option:

o The KYC details of the above member in the UAN database have been approved with E-Sign/Digital
Signature Certificate and transfer request has been generated on portal.
o The previous account of the member is not Aadhar verified and hence physical transfer form shall be
initiated.

Date: Signature of Employer with Seal of Establishment

* Auto transfer of previous PF account would be possible in respect of Aadhar verified employees only. Other employees are
requested to file physical claim (Form-13) for transfer of account from the previousestablishment.
 FORM A (Revised)

THE TP CENTRAL ODISHA DISTRIBUTION LIMITED

CONSOLIDATED PROVIDENT FUND

Form of Declaration

Pursuant to Rule 6 of the above Fund

1) Name of the member………………………………………………………………………………………………….

(In block letters)
2) Date of Birth……………………………………………………………………………………………………………

3) Employee No.………………………………………………………………………………………………………….

4) MaritalStatus (whether married / unmarried) ……………………………………………………………………

Nomination for Provident Fund

I hereby nominate the person(s) / cancel the nomination made by me previously and nominate the person(s), mentioned
below to receive the amount standing to my credit in the Fund, in the event of my death:

Name of the Address Nominee’s Age of Total amt. or If the nominee is

Nominee/Nominees relationship nominee(s) share of a minor, name,
with the accumulations address &
member to be paid to Relationship of
each nominee the guardian who
may receive the
amount during the
minority
of the nominee

(1) (2) (3) (4) (5) (6)

P.T.O.
* 1. Certified that I have no family as defined in Rule 3 of the Rules of the Tata Power Consolidated Provident Fund and
should I acquire a family hereafter the above nomination should be deemed as cancelled.
* 2. Certified that my father / mother is / are dependent upon me.

* Strike out whichever is not applicable.

Place : ……………………
Signature / or thumb impression
Date : …………………… of the subscriber

CERTIFICATEBY E M P L O Y E R

Certified that the above declaration and nomination has been signed / thumb impressed before me by

Shri/Smt./Kum. …………………………………………………………………………………………………………
employed in my establishment after he / she has read the entries / the entries have been read over to him / her by me and
got confirmed by him / her.

…………………………………………………….
Signature of the employer or other authorized
officer of the establishment

Place:………………………………………. Designation: …………………………………………….

Date : ……………………………………… Name & Address of the Factory / Establishment

and rubber stamp thereof

NOTE : Whom you can Nominate :

(1) A member of the Fund who is married and /or his father / mother is /are dependent upon him / her can
nominate only one or more persons belonging to his family as defined below:

(a) In the case of a male member, his wife, his children, his dependent parents and his deceased son’s
widow and children.
(b) In the case of a female member, her husband, her children, her dependent parents, her husband’s
dependent parents, her deceased son’s widow and children.

(2) If the member has got no family, or is a bachelor, nomination may be in favour of any person or persons,
whether related to him or not or even to an institution. If the member subsequently acquires a family, such
nomination shall forthwith become invalid and the member should make afresh nomination in favour of one
or more persons belonging to his family.
 Form ‘F’
[See Sub-rule (1) of Rule G]
Payment of Gratuity Act 1972
Nomination

To
The TP Central Odisha Distribution Limited
Odisha.
I, Shri/Shrimati/Kumari
Name in Full here

Whose particulars are given in the statement below, hereby nominate the person(s) mentioned
below to receive the gratuity payable after my death as also the gratuity standing to my credit in the
event of my death before the amount has become payable, or having become payable has not been
paid and direct that the said amount of gratuity shall be paid in proportion indicated against the
name(s) of the nominee(s).

2. I hereby certify that the person(s) mentioned is are a member(s) of my family

within the meaning of clause (h) of Section 2 of the payment of Gratuity Act,
1972.
3. I hereby declare that I have no family within the meaning of clause (h) of Section 2 of
the said Act.

4. (a) My father/mother/parents are dependent on me.

(b) My husband’s father/mother/parents is are not dependent on my husband.
5. I have excluded my husband from my family by a notice dated the_ to
the controlling authority in terms of the proviso to clause (h) of Section 2 of the
said Act.
6. Nominations made herein invalidates my previous nomination.

Nomination(s)
Name in full with Relationship with Age of Nominee (3) Proportion by which
address of the employee the gratuity will be
nominee(s) (2) shared (4)

(1)
 Statement
1. Name of the employee in full :

2. Sex :

3. Religion :

4. Whether unmarried/married/widow/widower

5. Department/ Branch/Section where employed

6. Post held with Ticket, or serial No. if any :

7. Employee No.

8. Date of Appointment:

9. Permanent Address:

Village: Thane Sub-division:

Place Post Office : Division:
District State :
Date :

Signature/Thumb impression of the

Employee No.
Declaration By Witness

Nomination signed/thumb impression before me

Name in full and full address of Signature of witnesses

1. 1.
2. 2.
Certificate by the Employer

Certified that the particulars of the above nomination have been verified and recorded in
this establishment

Employer’s Reference No. Signature of the employer/

Divisional File Code : Officer authorized
Date :

Name & address of the

Establishment or rubber stamp thereof

Acknowledgement by the employee

Received the duplicate copy of nomination in the form ‘F’ filled by me and duly certified by
the employer

Date : Signature of the Employee

Note : Strike out what is not applicable.

 HEALTH INSURANCE SCHEME
FAMILY HEALTH STATEMENT
(For coverage/Deletion of Employee/Dependent)
UNION/NON-UNION

1. Name of Employee:

2. Employee No: Div./Dept. : Grade :

3. Date of Joining: Date of Confirmation:

4. Residential Address: _______________________________________________________________

Tel No. :

5. Details of Persons to be COVERED/DELETED:

Mr/Mrs Name of the Relationship Date of Date of
Mst/Miss Employee/Dependent* Birth Coverage/Deletion

6. Have you or any family members listed above suffered from any major illness during the last
five years? Please give the particulars in brief.

7. At present are you or any family members suffering from any disease?

(Employee Signature & Date)

Place: Date :

*Dependent – (1) Legally married spouse, (2) legitimate or legally adopted son/daughter,
(3) parents – father, mother who is not gainfully employed for wage or profit or in service, business
or profession and to be truly a ‘dependent’ of the employee and normally reside with him.
 Application for Mediclaim ID Cards (for groups)

Policy No.:
Name of the Corporate: TP Central Odisha Distribution Limited
Name of the Employee:
(Div.)/ (Dept.): (Emp. No.):

HIS No. Name

Relation
Relati

Code*

(Stamp
(Emp.

Photo
(M/F)
No.

size)
SL.

No.)
on

Age

Sex

(SL No.1)
(SL No.2)
(SL No.3)
(SL No.4)
(SL No.5)
(SL No.6)

(Employee Signature & Date)

 BUSINESS DECLARATION
Date :
Chief HR Officer

PART I (FOR EMPLOYEES WHOSE RELATIVES HAVE NO BUSINESS DEALINGS WITH THE TP CENTRAL
ODISHA DISTRIBUTION LIMITED)
I, do hereby declare that neither I am, nor my relatives * are directly or indirectly interested or
concerned in any business dealings of any supplier / Contractor / Dealer of The TP Central Odisha Distribution Limited,
either as a partner if the supplier / Contractor / Dealer is a firm, or as a director of a member, if the supplier /
Contractor / Dealer is a private Limited Company, or as director or a member holding 2% of more subscribed share
capital if the supplier / Contractor / Dealer is a Public Limited Company, either for sale or purchase of goods or for
rendering of any services to The TP Central Odisha Distribution Limited.
If in the future, I or any of my relatives become concerned or interested in any business dealing of any supplier /
Contractor / Dealer either existing or to the engaged in the future in any of the capacities mentioned above, I shall
promptly keep The TP Central Odisha Distribution Limited informed of the same.
PART II (FOR EMPLOYEES WHOSE RELATIVES HAVE BUSINESS DEALINGS WITH THE TP CENTRAL
ODISHA DISTRIBUTION LIMITED)
I, do hereby declare that I and / or my relatives * am/are concerned or interested in business
dealing with The TP Central Odisha Distribution Limited in the manner set out below:

Name Relative’s Name& Nature of Nature of Interest of Nature of Interest of

of the relationship Address of the Business with The relative Employee (Director/
Relative with the supplier / TP Central Odisha (Director / Partner/ Member in
employee Contractor / Distribution Proprietor/ the relative’s
Dealer Limited& Dept. Partner/Member) Business)
dealing with

I undertake not to involve myself in any way with the said business of the relative and to avoid influencing in any manner
the decision-making process of The TP Central Odisha Distribution Limited pertaining to the said business.

It is understood that this declaration is truthfully made and if it sis found that it is falsely or incorrectly made by me
knowingly, it would be constituting a misconduct on my part giving right to The TP Central Odisha Distribution Limited
to take such disciplinary action against me as it may consider fit and proper.

Name Grade

Employee No. Divn./Dept Tel. No.(O):

(Signature of the Employee)

Note :

(i) PART I to be filled in if there are no relatives having direct or in direct business dealings with The TP Central
Odisha Distribution Limited
(ii) PART II to be filled in if there are relatives having direct or indirect business dealings with The TP Central
Odisha Distribution Limited
(iii) *Relatives as mentioned above include spouse of the employee and :
1. Employee’s/Spouse’s parents (including step-father/mother), grandparents, parent’s
brothers/sisters and their children.
2. Employee’s /Spouse’sbrothers/sisters(includingstep-brothers/sisters), their spouses and
 their children.
3. Employee’s/Spouse’s children (including step-children), their spouses and their children.
 Division

Name Grade Employee

No.

Providing the following information is voluntary.

Please tick whatever is applicable

1 Caste SC ST OBC GENERAL Do not Wish to declare

2 Ex-Serviceman Yes No Do not Wish to declare

3 Differently abled Yes No Do not Wish to declare

If “Yes” please provide brief details

4 Religion Hindu Muslim Christian Others Do not Wish to declare

If “Others” please provide details

Employee Signature
 Flexi Allowances Compensation Sheet

Emp. No. :

Name :

Grade :

Designation :

Division / Dept. :

Sl. Component Range Input – Nos. Amount

No. Allocated
Rs P.a.
a) Flexi Allowance (After
adjusting, for those
occupying Company
Accommodation)
b) HRA Up to maximum 50% of Basic Salary,
may be opted if staying in rented
accommodation
c) NPS As per the Income tax laws and
Company policy which are subject to
change from time to time
d) Education Aid For children in School & College – No of
Rs. 100/- p.m. for a maximum of 2 Children
children
e) Hostel Subsidy For children studying in Hostel – Rs. No of
300/- p.m. for a maximum of 2 Children
children
f) LTA Not eligible for tax rebate before
completion of one year of service
g) Telephone Up to a maximum of
Rs. 2,000/- p.m. (for MB1 to MD1)
Rs. 825/- p.m. (for MD2 to ME01)
Rs. 350/- p.m. (for ME02)
Rs. 325/- p.m. (for ME03)
Balance Cash (a) - (b + c + d + e + f + g)

(Employee Signature & Date)

 DECLARATION OF BANK ACCOUNT

Employee Name :

Employee Number :

Name of Bank :

Complete Address of the Bank :

Account Number :

(Employee Signature & Date)

 TP CENTRAL ODISHA DISTRIBUTION LIMITED CORPORATE IT

RESOURCE REQUEST FORM TYPE - HARDWARE

Requisition Form NEW REPLACEMENT++

A Date / /
Other
Request for PC Laptop Printer Device*
If other, specify*

Employee Name:

Employee Number: Phone:

Designation:

Division: Department:
Cost Center /
WBS:

Signature of Requisitioner / /

B
Approver NAME SIGNATURE DATE
GM & MB2
Grade above)
&
Above
/ /
AGM (FMS), Corporate IT
Head ICT / /
InfChie
rastruc
f ICture
T Head
Chief
CorporatCeIO
IT ICT Infra & Non-SAP / /

Remarks

C
Issued By: / /

Make:

Serial Number:

IT Asset Code:

Receiver’s Signature: / /
Name of representative: Phone:

D++
++ ++
Details of existing device Code
++
For helpReason
just call IT call center
for replacement on intercom 1957 or mail to itcallcenter@tpc.co.in

*Device permitted as per IT Policy of company DOC. VER. R.1

 EMPLOYEEIDENTIFICATIONCARDFORM

Employee Name:
1 Passport Size
Photo to be
stapled

Employee Number:

Division/Department:

Location:

Date of Joining:

Date of Birth:

Blood Group:

Residence
Telephone
Number:

Employee Signature:
 Date:

Induction In charge,
HR

Declaration
I am aware that The TP Central Odisha Distribution Limited follows an Information Security Policy
and Procedures, which are available under Policies & Guidelines a Info Security Policies.

I agree to abide by these regulations in total.

I Understand that the email and Domain IDs will be conveyed to me on my contacting IT Helpdesk.

_____________________________
(Employee Signature & Date)