Person Details
Mr./Ms Name
Blood Group: Photo
Age Date of Birth Place of Birth and State Nationality
Present Address Permanent Address
City/Town City/Town
District District
State with State with
Pincode Pincode
Contact Details
Mobile No
Residence Phone No/Mobile no
Mail Id
Emergency Contact no
Family Details Marital Status
Education
Name Date of Birth Occupation Aadhar Card No
Qualification
Father
Mother
Spouse
Children
with
Gender
details
Education Qualification
Duration School/College/ Major Examination
S.NO Location Percentage
(year) University Subjects Passed
From SLLC or Class 10th
Any break in Education kindly mention:-
Other Training
S. No Duration Training Programme/Course Organization
Work Experience:-
Designatio Last Drawn Reason for
From To Company Name Location
n Salary leaving
Kindly explain the reason in Career Break:
Current Job Profile :-
Salary Details of Last Employer:
Take Home
CTC/ YR
Salary
Fixed Salary Variable Salary
Aadhar Card No: Place of Issues
PAN Card No: Place of Issues
Family/Ration
Place of Issues
Card No
Voter Id Card No Place of Issues
Driving License No Date of Issues
Place of Issues Validity Date
Passport No Date of Issues
Place of Issues Validity Date
BANK DETAILS:- (for Salary Credit purpose)
Bank Name:-
Account Holder
Name:-
Account Number:-
Address:-
IFCSE Code :-
City:-
Employees Provident Fund Details
Employees Provident Fund Contribution from Previous Employer YES/NO
If Yes UAN
No: Last Working Date:
If No,
Relationship
Nominee Name
Any other details related to EPF:-
Tax Deductions
TDS Deducted in your Salary: Yes/No
If Yes kindly produces the document required.
Remarks:
Remarks
Declaration – The information furnished above are true to the best of my knowledge.
DATE SIGNATURE