ESI No UAN Employee Employee Name Gender Date of

S. No
(if exists) *** (if exists) *** ID *** (As per Aadhar) *** *** Birth ***

1 26 P. AJITH RAJA ISRAVEL Male 25.05.1980

2
3
4
5
 Relationshi
Father Name / p
Date of
Husband Name (Father / Designation Location
Joining ***
*** Husband)
***

R. PAULMANICKAMFather 1.2.2021 Factory Manager Gerugambakkam

 Work Contact No
Site Name Aadhar No *** Pan No Email ID
Location ***

BOLPA3624J

rugambakkam Factory 349971315820 8754197754 Paul.ajith4@gmail.com

Bank Account No Fixed Fixed DA Fixed
IFSC Code *** Bank Name ***
*** Basic *** *** HRA ***

158754197754 INDB0000230
 Fixed
Fixed Special Other Arrear
Medical Leave OT Wages
Conveyanc Bonus *** LTA *** Allowance Allowance Amount
Allowance Wages *** *** *** ***
e *** ***
***
 Other
Advance
Gross *** PF *** ESI *** PT *** LWF *** TDS *** Fine *** Deduction
***
***
 Total
Net Salary Present Address
Deduction
*** ***
***

13/4A, R C
PREETHAM
FLAT,
 Present Address 1 ***

PALAYAKARA STREET,
AYANAVARAM.
 Pincode 1 Permenant
State 1 *** District 1 ***
*** Address

33/36,
NORTH
STREET,
MANJUVI
Tamil Nadu Chennai 600023 LAI,
 Nominee Nominee
Permenant
State 2 District 2 Pincode 2 Nominee Details *** Relation Relation
Address 2
*** DOB ***

PATHAI
POST,
KALAKA
D VIA, Tamil NaduThirunelveli 627501 A.DALIAH JOSE Daughter 3.12.2010
 Dependent Dependen Dependent
Dependent 1 - Dependent Dependent 2 - Dependent Dependent
1- t2- 3-
Name 1 - DOB Name 2 - DOB 3 - Name
Relation Relation Relation

J. JEBA SARON Wife 22.07.1985A. DALIAH JOSEDaughter 3.12.2010

A. DALIN PAUL Son
 Dependent Dependent Dependent
Dependent Dependent Dependent Dependent Dependent Dependent
4- 5- 6-
3 - DOB 4 - Name 4 - DOB 5 - Name 5 - DOB 6 - Name
Relation Relation Relation

31.05.2016
R. PAULMANICKAM
Father 24.08.1940 P. MANGA Mother 6.11.1946
 ESI PF
Dependent PF Gross EPF
Location Location
6 - DOB Wages *** Wages ***
*** ***