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Ather / Mother / Brother / Wife Electricity Service Number (For A'bad Resident Only)

This document appears to be a job application that collects personal details such as name, contact information, family details, educational history, previous work experience, and documents submitted. It requests information including address, date of birth, gender, nationality, religion, education levels and schools attended, positions and dates of prior employment. The applicant signs to confirm the information provided and lists any pending documents still needed to submit.

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205 views3 pages

Ather / Mother / Brother / Wife Electricity Service Number (For A'bad Resident Only)

This document appears to be a job application that collects personal details such as name, contact information, family details, educational history, previous work experience, and documents submitted. It requests information including address, date of birth, gender, nationality, religion, education levels and schools attended, positions and dates of prior employment. The applicant signs to confirm the information provided and lists any pending documents still needed to submit.

Uploaded by

Meet Prajapati
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Date: Designation: Per No:

First Name Middle Name Last Name

Personal Details:

Number Name as per Card


PAN No.
AADHAR No.
DATE OF BIRTH (SELF) BIRTH PLACE
MARITIAL STATUS Single / Married / Widow DATE OF MARRIAGE
GENDER Male / Female NATIONALITY
MOTHER TONGUE RELIGION
BLOOD GROUP SHOES SIZE
HEIGHT in cms. WEIGHT in Kg
TROUSER SIZE (For Male) SHIRT SIZE (For Male)
KRUTI SIZE ( For Female) SALWAR SIZE ( For Female)
CONTACT NO. (Self Mobile PERSONAL EMAIL ID.
No.)
CONTACT NO. ELECTRICITY SERVICE
Family member : Father / NUMBER
Mother / Brother / Wife (For A’bad resident only)

Family Details

Name Gender Birth Date Birth Place Aadhar No.


FATHER MALE
MOTHER FEMALE
WIFE/HUSBAN
D
CHILD 1
CHILD 2

Nominee Details

Name Relation Date of Birth Aadhar No. Share


100%

Previous Exp. Details:

Org. Type
Period (From - To) Name of Company City Industry
(Private/Govt)
1
2
3
4
5

Signature of Applicant

Date
Date: Designation: Per No:

Address Details:

PERMENANT CURRENT EMERGENCY


CARE OF NAME
HOUSE NO.- STREET
2ND ADDRESS LINE
3RD ADDRESS LINE
VILLAGE / TOWN / CITY
PIN CODE
STATE
CONTACT NO -
Family Member:
Father/Mother/Brother/Wif
e

Educational Details:

Period Name of Board / Result %


Branch
(From - To) University Class
SSC
HSC
DIPLOMA
DEGREE
MASTER

List of Documents Submitted (Please √ mark if submitted)

EDUCATIONAL DETAILS OTHERS


SCHOOL LEAVING CERTIFICATE PAN CARD – SELF
10TH MARKSHEET & CERTIFICATE AADHAR CARD – SELF
12TH MARKSHEET & CERTIFICATE DRIVING LICENCE
ITI CERTIFICATE AADHAR CARD – FATHER
APPRENTICE CERTIFICATE AADHAR CARD – MOTHER
DIPLOMA MARKSHEET & CERTIFICATE AADHAR CARD – WIFE
DEGREE MARKSHEET & CERTIFICATE AADHAR CARD – CHILD
MASTER MARKSHEET & CERTIFICATE RELIVING LETTER
EXPERIENCE CERTIFICATE
LAST SALARY SLIP

Pending Documents to Submit:

Signature of Applicant
Date

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