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Employee Personal Information: (Please Fill Up The Form With Block Letters)

This document contains a form for collecting personal information of employees. It requests for details such as name, father's name, gender, date of birth, marital status, spouse name, number of children, category, caste, religion, nationality, nominee details, physical disability, email, mobile number, present and permanent addresses, educational qualifications, employment record, professional certifications, language proficiency, references, previous UAN number, ESIC number, PAN number, Aadhaar number, blood group, emergency contact and bank account details. The employee is required to declare that the information provided is correct and will intimate any changes in writing.

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Aziz Ahammed A
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71 views4 pages

Employee Personal Information: (Please Fill Up The Form With Block Letters)

This document contains a form for collecting personal information of employees. It requests for details such as name, father's name, gender, date of birth, marital status, spouse name, number of children, category, caste, religion, nationality, nominee details, physical disability, email, mobile number, present and permanent addresses, educational qualifications, employment record, professional certifications, language proficiency, references, previous UAN number, ESIC number, PAN number, Aadhaar number, blood group, emergency contact and bank account details. The employee is required to declare that the information provided is correct and will intimate any changes in writing.

Uploaded by

Aziz Ahammed A
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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EMPLOYEE PERSONAL INFORMATION

(Please fill up the form with Block letters)


NAME: _________________________________________________________________
(First) (Middle) (Last)

FATHER’S NAME: _________________________________________________________

MOTHER’S NAME: _________________________________________________________


(Maiden Name i.e. before marriage)

GENDER: ________________________ DATE OF BIRTH: ________/________/__________ (As per Aadhar)


(dd) (mm) (yyyy)

MARITAL STATUS: SINGLE / MARRIED DATE OF MARRIAGE: _________/__________/__________


(dd) (mm) (yyyy)

NAME OF SPOUSE: _______________________________________ DO YOU HAVE CHILDREN: Y /N

NO. OF CHILDREN (if Yes): _____________ CATEGORY: SC/ST/OBC/MINORITY/GENERAL/OTHERS

CASTE: __________________RELIGION: ______________________ NATIONALITY: ___________________

NAME OF THE NOMINEE : ________________________

RELATIONSHIP WITH THE NOMINEE: ________________________

PHYSICAL DISABILITY: Y/N GIVE DETAILS (IF ANY): _______________________________________

E-MAIL: ______________________________________________ MOBILE: _______________________________

PRESENT ADDRESS:

________________________________________________________________________________________________

________________________________STATE: ___________________________COUNTRY: ________________

PINCODE: ______________________________ LANDMARK:_________________________________________

(1)
PERMANENT ADDRESS:

_________________________________________________________________________________________________

________________________________________STATE: _____________________COUNTRY: _________________

PINCODE:___________________________________ LANDMARK: ________________________________

EDUCATIONAL DETAILS:

Degree / Diploma / Degree and Institute and From To Percentage /


Certificate Specialization University CGPA / Division

Std. X

Std. XII

Graduation

Post -Graduation

Other

EMPLOYMENT RECORD: (details in Chronological order, starting with last employer)

Employer Name From To Last Gross salary Reasons for leaving


Designation

(2)
PROFESSIONAL CERTIFICATIONS(if any) : _______________________________________________

LANGUAGE PROFICIENCY (Mother tongue first)

Language Speak Read Write

REFERENCE CHECK:
(give reference of two persons who are familiar with your background & not related to you)

Name : Name :

Place of work : Place of work :

Designation : Designation :

Contact Number : Contact Number :

E-mail Id: E-mail Id:

OTHER DETAILS:

PREVIOUS UAN No. (If any): _____________________________

PREVIOUS ESIC No. (If any):_____________________________

PAN No. : ______________________________

AADHAR No: _______________________________

BLOOD GROUP: _______________________________

EMERGENCY CONTACT No.: ______________________________

(3)
SAVINGS BANK ACCOUNT DETAILS: (Please attach relevant proof)

BRANCH NAME

BANK NAME

BANK A/C No. IFSC

Declaration:
• I , shall, if and when required to take to up duty in this discharge of company assignment anywhere in India or
abroad.
• I certify that foregoing information is correct and complete to the best of knowledge and nothing has been
concealed/distorted.
• In case of any change, I will intimate to you in writing immediately.

----------------------------------------------------- ------------------------------------ ----------------------------------


(Signature of Employee) (Date of Joining) (Place)

For Office Use Only

Employee Code : _____________________ Deputed Client:________________Deputed Location: _____________

HR Signature: ____________________ Date: ___________________

(4)

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