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Fssai Id Card Form

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dfccilhqdelhi
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198 views1 page

Fssai Id Card Form

Uploaded by

dfccilhqdelhi
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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Serial No……

Food Safety and Standards Authority of India

Application for Fssai Employee Identity Card (Training)


Recent stamp size
colourphoto

(Please write in BLOCK LETTERS)

1. Name of the applicant (Employee)

2. Name of Father/Husband/Guardian

3. a. Date of Birth b. Date of Joining c. Blood Group


D D M M Y Y Y Y D D M M Y Y Y Y

4. (a) Designation (b)


5. Mark of Identification (i)……………………………………………………………………………………………………………….
(ii)……………………………………………………………………………………………………………….
6. Current Postal Address with Pin Code:

7. Permanent Postal Address with Pin Code:

8. Email Id of the Empolyer:


9. Telephone Number with area code : Mobile Number:

Place :

Date:
(Signature of the Applicant)

…………………………………………………………………………………………………………………………………………………………………....
(FOR OFFICEL USE ONLY)
Verified Proof of address card may be issued.

(Signature of the PRI (P)

………………………………………………………………………………………………………………………………………………………………………………………

Acquittance for receipt.


Employee Name : DOB

Serial No
Date:
(Signature of the PRI (P)

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