GAIL GAS LIMITED
(A wholly owned subsidiary of GAIL (India) Limited-A Maharatna Company)
3 Floor, Infohub Building, GAIL Jubilee Tower, B-35 & 36, Sector-1, Noida 201301 (U.P.)
rd
PHONE: +91-120-2446400;
Email: [email protected]
Corporate Identification Number: U40200DL2008GOI178614
Sl. No. _______
Please affix your
passport size
colour photograph
Advertisement No. _________________________________
Name of the post: __________________________________
Pay Scale: Rs. _____________________________________
PERSONAL DATA
1. (i) a. Category: SC ST OBC (NCL) EWS GENERAL
Category of PwBD Specify the disability (ies)
b. Sub Category: XSM
a b c d e
(Tick in appropriate box if applicable)
(ii) Name: __________________________________________________
(in Capital Letters – Underline Surname)
-1-
GAIL Gas Limited
(iii) Father’s /Husband’s Name: _________________________________________________________________
Father’s/Husband’s Occupation:
If Service, Please Specify: Name of the Organization where employed: _________________________________
Present Designation: _________________________________________________________________________
If Business, Please indicate the nature of Business: _________________________________________________
If Self Employed / Others, Please specify: ________________________________________________________
2. (i) Present Postal Address: ______________________________________________________________
______________ State________ ____________ PIN ___________________
(ii) Telephone No.: Office ________________________/ Residence _______________________
(iii) Mobile No. ________________________ e-mail address: _____________________________
(iv) Permanent Address: _________________________________________________________________
________________ State ________________ PIN _____________
(v) Home Town: ___________________________________________________
3. (i) Date of Birth (DD/MM/YYYY): _____________________________________
(ii) Exact Age (As on the day of interview): _________Years__________Months__________Days
(iii) State to which you belong: ____________________________________
(iv) Nationality: ____________________
(v) Religion: _______________________
4. (i) Height ________________cms. (ii) Weight: _________Kgs.
5. In case of SC/ST/OBC, Provide name/details of Caste/Tribe: __________________
(Also attach attested copy of Certificate from prescribed authority)
6. In case of Persons with Benchmark Disabilities, give details of Nature and Percentage of disability: (Also attach
attested copy of Certificate from competent Medical Authority):
7. In case Ex-Serviceman state:
(i) Rank _______________________________________________
(ii) Corps/ Regiment No.___________________________________
(iii) Date of Commission ___________________________________
(iv) Date of Discharge _____________________________________
(v) Date of Start of pre-commission training, if any ______________
(vi) Education of Military ___________________________________
(Also attach attested copy of Ex-Serviceman Certificate issued by Competent Authority)
-2-
GAIL Gas Limited
8. (i) Sex: Male Female
(ii) Marital Status: Single Married Widowed Divorcee
(iii) Details of Children:
S.N. Name Age Sex Class in which studying
1.
2.
3.
(iv) Details of other Dependents if any:
S.N. Name Age Sex Relationship Remarks
1.
2.
3.
4.
5.
(v) Is Your spouse employed? Yes No
If Yes, give details as under:
• Name of the Organization: ________________________________
• Present Designation: _____________________________________
• Present Place of Posting: _________________________________
-3-
GAIL Gas Limited
ACADEMIC & PROFESSIONAL QUALIFICATION
9. Details of Academic & Professional Qualifications (Matriculation onwards). Also mention details of
statutory qualifications, if any, required for the post.
Examination School/College/ Year of Year of Board/ Class/ % of Main Subject Mode of
/ Degree Institution Joining Leaving University Division marks Studied/ Study (Full
Passed /passing obtained obtained Branch/ Time/Part
Specialization Time/Corresp
ondence)
Note: Copy of all Degrees, Diplomas and Certificates along with semester/year wise marksheets (Matriculation onwards) to be invariably
enclosed.
10. Proficiency in Languages:
Language Can read Can write Can speak
Mother Tongue
Other Languages
1.
2.
3.
4.
-4-
GAIL Gas Limited
Training & Attainments
11. Details of Training/Apprenticeship /Articleship etc.:
S. Name of Nature of Training From To Examination Pay/Stipend if any
No. Institute or Apprenticeship/Articleship/Main passed if any
Employer contents of the course
PARTICULARS OF EXPERIENCE
12. Total Experience ___________________ Years _________ Months.
13. Details of experience starting from present. Please give details of different positions held in each organization
with dates:
Employer's Period of Employment Duration Designation Basic Total Exact Reason
Name & and scale of Pay Emoluments nature of for
Complete pay per month duties/ leaving
Address (start functions
from present
employer)
From Date To Date Year Month
Note: Copy of complete and proper proof of experience in respect of details of experience indicated above to be
invariably enclosed including apprenticeship.
-5-
GAIL Gas Limited
14. (i) Present Employment Status (as on the date of interview): Employed Unemployed
If Unemployed, indicate the date from which unemployed: ___________
If Employed, please indicate details as under:
Name of the Organization: _______________________________________
Sector : (Please tick in appropriate box)
State Govt. Undertaking / Central Govt. Public State Govt. Department/
Company Sector Undertaking Institution
Central Govt. Private Listed Private Unlisted Others, Please
Department/ Institution Company Company Specify:__________
__
In case employed in a State Govt. PSU/Central Govt. PSU/State Govt. Dept./Central Govt. Department/Autonomous
Institute of State/ Central Govt.:
a) Please indicate whether your application has been forwarded through proper channel: YES NO
b) If Yes, please enclose a copy of the forwarding letter issued by your present employer.
c) If No, please indicate whether you have submitted the NOC from your present YES NO
employer along with this application form:
(ii) (a) Details of Salary being drawn in the present post as on the date of interview
(APPLICABLE FOR CANDIDATES PRESENTLY EMPLOYED IN GOVT. SECTOR / PSUS):
Scale of Pay Date of entry Basic Pay Special Pay, DA/ADA/VDA Total Date of next
in the scale Grade Pay if Increment
any
(ii) (b) Details of Salary being drawn in the present post as on the date of Interview
(APPLICABLE FOR CANDIDATES PRESENTLY EMPLOYED IN PRIVATE SECTOR ORGANIZATION)
Scale of Pay Basic Pay Band/Level/Grade Date of Entry in Present Next Total CTC (Per
(If (If any) associated with Grade/Designation/Level/Band Revision of Emoluments Month)
applicable) Designation Pay per month
-6-
GAIL Gas Limited
15. If retired from Govt./Defense Services, give details of pension/equivalent of pensionary Benefits
____________________________________________________________________________________
16. (i) Basic Pay acceptable ______________________________________________
(ii) Minimum time required to join, if selected_____________________________
17. Are you prepared to serve anywhere in India?
YES NO
18. Have you been an applicant for any post in this Company before? YES NO
If ‘yes’ Give the following details:
Year Name of Post If called, date/ month Whether Remarks
of interview selected/offered
appointment
19. Have you ever been arrested in a criminal case or convicted, fined or imprisoned for violation of any law (excluding
minor traffic violation) or is any criminal/ disciplinary/ vigilance case pending/ ever instituted against you or have
you been barred/disqualified by a Public Service Commission/ University or any other educational authority form
appearing in its examinations?
YES NO
If yes, give details:
-7-
GAIL Gas Limited
20. Are you related to any of the Directors of GAIL Gas Limited? Is any of your relatives employed in GAIL
Gas Limited?
YES NO
If ‘Yes’ give the following details:
Name Designation Place of Posting Relationship
21. Have you ever been abroad?
YES NO
If ‘Yes’ give the following details
Country visited Date/ month of Date/ Month of Duration of Stay Purpose of visit Financed By
Departure Arrival
22. Extra-Curricular Activities:
23. Details of Research Works, Books/ Papers published / Major accomplishments, if any
24. References:
(These persons should be residents of India and holder of responsible positions and they should be
intimately acquainted with your character and work but must not be relatives)
Name Address and Phone No. Occupation or Position
-8-
GAIL Gas Limited
25. Any other relevant details/ information not covered above, that you may wish to furnish:
26. List of documents attached (True copies) (in respect of Point no. 5, 6, 7, 9, 13 & 14):
I certify that
(i) The information /declarations given above are true to the best of my knowledge and belief.
(ii) I am ready to join as Fixed Term Employee in GAIL Gas Limited after resigning the post/ retaining
protective lien on my present Post in Government / Public Undertaking.
(iii) If selected, I will not bring any influence for posting me at any particular location/ region.
(Delete whichever is inapplicable.)
Note:-
1. Furnishing of false information or suppression of any factual information in the application form would be a
disqualification and is likely to render the candidates unfit for employment in GAIL Gas Limited.
2. If the fact of any false information having been furnished or that of suppression of any factual information
in the application form comes to notice at any time during the service of a person, his/her services would be
liable to be terminated.
Date ___________________ (Signature of Applicant)
FOR OFFICIAL USE ONLY
The entries and documents regarding age, qualifications, experience etc. made above have been verified by me with
the originals and found correct. The following Degrees/Certificates/Testimonials have not been produced for
verification.
Representative of HR Deptt.
-9-
GAIL Gas Limited
INSTRUCTIONS FOR FILLING THE APPLICATION FORM
Kindly make sure that all the instructions given below are complied with failing which your application is liable to
be rejected.
1. All entries in this form should be typed or written neatly.
2. Submission of this form involves no commitment on either side and no correspondence with regard to the
suitability or otherwise of the applicant will be entertained.
3. Application forms from employees of Government/ Public-Sector Undertaking/ Statutory Organizations
must be sent through proper channel.
4. Incomplete application will not be considered.
5. Self-attested copies and testimonials should be attached with the form, if not already sent. All enclosures to
the application form should preferably be of the size of application form and all the sheets be properly stitched
or tagged. Original Degrees and testimonials should not be sent.
6. All the information given in the application form should be correct. Any mis-statement/ Suppression of facts
would render the candidate liable to rejection and termination after appointment.
7. Any changes in address should be communicated to us. While every care would be taken to record the change
in address, the Company will not accept any responsibility, whatsoever, for delivery of interview letter on
changed address. The candidates should, therefore, arrange for redirection of communications to their
changed address.
8. A recent passport size photograph should be affixed on the application form.
9. Candidates belonging SC/ST/OBC (NCL)/EWS communities should invariably attach attested copy of the
certificate from one of the following authorities.
(i) District Magistrate/ Additional District Magistrate/ Collector/ Deputy Commissioner/ Additional
Deputy Commissioner/ Deputy Collector/1st class Stipendiary Magistrate/ City Magistrate*/ Sub
Divisional Magistrate/ Taluka Magistrate/ Executive Magistrate/ Extra Assistant Commissioner.
• (Not below the rank of 1st class Stipendiary Magistrate)
(ii) Chief Presidency magistrate/Additional Chief Presidency Magistrate/Presidency Magistrate
(iii) Revenue Officers not below the rank of Tehsildar.
(iv) Sub-Divisional Officer of the area where the candidate and /or his family normally resides.
(v) Administrator/Secretary to Administrator/ Development Officer (Lakshadweep Islands)
10. Candidates belonging to OBC communities have to submit the undertaking that He or She does not
belong to persons/ sections (Creamy Layer) in the enclosed format.
11. Canvassing in any form will lead to disqualification.
12. Extra sheet should be added wherever space is insufficient
-10-
Dated: _________________
To,
The Chief Manager (HR)
GAIL Gas Limited
5th Floor, GAIL Jubilee Tower,
B-35 & 36, Sector-1,
Noida 201301 (U.P.)
Subject: Undertaking by OBC (NCL) candidates
Dear Sir,
I appeared for the selection process for the post of ________________________________ in GTI, Noida on
_______________________ against Advt. no. GAIL Gas/OPEN/RECTT.-FTE/1/2023.
I undertake that, I ___________________________ do not belong to Persons/Sections (Creamy Layer).
In case, any discrepancy found at any stage, my candidature is liable to be disqualified for the
selection/appointment for the post of ____________________________.
Thanking You,
Yours faithfully,
Signature____________________________
Name ______________________________
Mobile No. __________________________
Email ______________________________
