Employee Joining Form No.

3091683

Mobile No.: 9692512773

Employee Code: Date of Joining: Job Location: State:

14 Aug 2023 Orrisa
3091683 Jajpur

Instructions

1. Form should be filled in CAPITAL Letters / BLOCK letters only

2. Please fill in the application form completely and correctly (furnish correct information)
3. Avoid overwriting
4. Please fill up your personal details (Name, Address etc.) exactly as it appears on your
government approved valid Photo ID / Address Proof document
5. For effective communication with you (through calls, SMS or E-mail), we request you to
provide us with your current E-Mail ID, Mobile and landline number
6. Please Tick ( ) in the boxes provided in application form (wherever applicable)
7. In case of any questions or queries while filling up the application form or regarding the
joining documentations, please feel free to CALL US @ 60000655
Employee's Information

Full Name (as per valid ID Proof) : Santosh Kumar Sahoo

Marital Status: Gender:

Date of Birth:
Married Unmarried Male Female
1 Jul 1994
Others

Blood Group: O+ Physical Disability: Yes No Nationality:

(In Case Yes, please submit certificate copy)

E-Mail Id: richsantosh163@gmail.com Mobile: 9692512773

Phone: 9692512773

Residential Address (Permanent Address) : Kaimatia Siha Chandikhol

City: Jajapur State: Odisha ZIP Code: 755044

Communication / Mailing Address: Kaimatia Siha Chandikhol

City: Jajapur State: Odisha ZIP Code: 755044

Bank Account & PAN Account Details

Name as per Bank records : Santosh Kumar Sahoo Name of the Bank: State Bank of India
Bank Branch: BAIRI
Bank Account Number : 20226827515
Bank Branch's IFSC Code: (please check with your Bank)
(Cancelled cheque copy with Name, Employee Code & Contact Number
SBIN0005778
written on the face of the cheque to be submitted)

Aadhar Card Number / Enrollment Number: PAN Number: (Please submit PAN Card copy):
470294740944 JYAPS0483Q

Emergency Contact
Name of person: Trilochana Sahoo

Address:
City: State: Zip Code: Phone:

Relationship:
 No. 3091683

Family Information
Date of birth:
Father's Full Name: Trilochana Sahoo
1/1/1967 12:00:00
AM

Date of birth:
Mother's Full Name:

Husband/Wife's Full Name (if Married): Date of birth:

Sradhanjali Sahoo 6/24/1997
12:00:00 AM

Date of birth:
Child 1 Full Name:

Date of birth:
Child 2 Full Name:

Educational Qualification
(Please enclose photocopies of the certificates/documents)
Education Level Degree Board/University School/College Year of % Marks
(B.com/B.Sc.etc.,) Name Passing
10 10 BSE, Odisha Netaji High School, 2009 73
Kaimatia
12 12 CHSE,Odisha P.P College 2011 57
Nischintakoil
B.Tech In B.Tech In Electrical BPUT,Odisha Einstein Academy Of 2015 70
Electrical Engineering Engineering,BBSR
Engineering

Work Experience
(Please detail your entire work history beginnig with the current employer to your oldest employer)
Organization Designation when leaving From To Reason for Leaving

Language
Language 1: Language 2: Language 3:
Read: Read: Read:
Write: Write: Write:
Speak: Speak: Speak:

PLEASE READ CAREFULLY AND ACKNOWLEDGE THAT YOU UNDERSTAND AND ACCEPT THIS INFORMATION:
Santosh Kumar Sahoo
I certify that the above statements made by me are true, complete and correct. In case of the company
finds at any time that the information given me in this form is not correct, true or complete, the company will have the right to withdraw my letter of
appointment or to terminate my appointment at any time without notice or compensation. I hereby acknowledge that I have gone through the Model Service
Rules inclusive of Policy on Prevention, Prohibition of Sexual Harassment at workplace detailed from Page 2 to Page 5 understood & accepted the same.

Signature of the employee: Date: Place:

 No. 3091683

Document Check List to be submitted along with your Employee Joining form
** Photocopies of all the documents that are be attached as enclosures along with "Employee Joining Form"
DOCUMENTS REQUIRED (Mandatory) Boxes to be Verified by
checked by the TeamLease on
employee at the collection of
time of submission documents

1. Updated resume / Curriculam Vitae (C.V.) Y N Y N

2. 3 additional Passport size photographs (Self) with Employee Code & Full name written on the Y N Y N
reverse
3. 1 Postcard size photograph (Family) with Employee Code & Full name written on the reverse N N
Y Y
4. 1 cancelled cheque leaf (Original) with Full Name, Employee Code, Phone/Mobile number,
Y Y N
Bank IFSC code written on the face of the cheque N

5. PAN Card Copy (Self Attested) with Full Name, Employee Code, Phone/Mobile number. Y N Y N

6. Proof of Address & Photo Identification Proof - Voter's ID Card or Driving License or Passport Copy or Y N Y N
Aadhar Card

7. Provident Fund Nomination & Declaration Form (Form 2) duly filled N

**pre-filled Sample copy enclosed Y Y N

8. Gratuity Nomination Form (Form F) duly filled *pre-filled sample copy enclosed Y N Y N
9. Signed Acknowledged copy of the Offer Letter / Appointment letter N Y
Y N

10. Previous Employer Relieving & Experience Letter Y N Y N

11. Photocopy of all Educational Certificates as mentioned in the section "Educational Qualification " in the
Employee Joining form
Y N Y N

12. In case the applicant is Physically challenged, submit the certificate issued by the appropriate
authority
Y N Y N

13.(a) If ESI applicable, submit ESI Declaration Form (Form 1) duly filled with
1 Post Card size Family Photographs pasted on the form Y N Y N
** pre -filled Sample copy enclosed

(b) Or else if falling under income tax bracket kindly submit the income tax/investment N
declaration form duly filled in (if applicable) Y Y N

For TeamLease Office use only

Client ID:
Client Name:

Date of Receipt of the documents at the Local Office

Document Received by (Full Name):

Date of Receipt of the documents at Bangalore Office

Document Received by (Full Name):

Date sent to Docushare at Bangalore Office

Document Scanned by (Full Name):

Document Details updated on ALCS

Updated by Full Name: