Employee Details Sr Field
1 Emp Code
2 Department
3 Designation
4 First Name
5 Middle Name
6 Last Name
7 Fathers Name
8 DOB
9 Gender
10 DOJ
11 Last Day prev Job
12 Blood Group
13 Marital Status
14 Handicap(YES/NO)
15 Address1
16 Mobile No
Basic Details
17 Emergency Contact
18 Email
19 Aadhar Card
20 PAN
21 Passport
22 Passport validity
23 Account No
24 IFSC
25 Highest Education
26 PF(YES/NO)
27 NPS (YES/NO)
28 PF ACC No
29 International Worker (YES/NO)
30 Name of prev Company
31 Address of Prev Company
32 Court Case(YES/NO)
33 Name of the Nominee/Nominees
34 Address
35 Nominee’s relation with the member
36 Date of Birth
NOMINEE DETAILS FOR PF
37 Total amount of share of Accumulation in PF to be
paid to each Nominee
If the nominee is minor name and address of the
38 guardian who may receive the amount during the
minority of the nominee
39 Employer’s Name:
40 Complete Address (Location worked):
41 Contact number:
42 Employee ID:
43 Designation:
44 Period of Employment:
PREVIOUS COMPANY DETAILS
45 Last Salary withdrawn:
46 Name of the Reporting Manager
47 Contact No of Reporting Manager
48 Email of Reporting Manager
49 Reason(s) for Leaving
50 Can a reference be taken now? Yes / No
51 Institution or College Address
52 Name and Address of University
53 Period (dd/mm/yy)
EDUCATIONAL DETAILS
54 Certificate/ Degree/ College
55 Area of Specialization/ Major Subjects
56 Enrollment No. & Roll No.
57 Reference Name
58 Reference Designation
PROFESSIONAL REFERENCES 59 Reference Organization
60 Reference Relationship
61 Reference Address, Telephone & email
62 Name of the Immediate Relative
LIST OF IMMEDIATE RELATIVES 63 Relation to the Employee/Director
64 Name of the Employee or Immediate Relatives
UNDERTAKING REGARDING 65 Name of the Company
TRADING IN SECURITIES 66 Nature of Security
67 Quantity
WIDOW CHILDREN PENSION 68 Name and Address of the Family member(s)
FOR MARRIED MEMBERS – SPOUSE 69 Date of Birth
& CHILDREN DETAILS 70 Relationship with member
FAMILY MEMBER RECEIVING 71 Name and Address of the Family member(s)
PENSION.(FOR UN-MARRIED
72 Date of Birth
MEMBERS – PARENTS /SIBLINGS
DETAILS) 73 Relationship with member
74 UAN
75 DOJ
PREVIOUS COMPANY PF DETAILS
76 DOL
77 STATUS
78 Have you ever worked for us /
or our Group companies? If Yes please fill 79-81
79 Company Name
Declaration on Self / Relative
Working / Worked with Group
80 Department
81 Duration
Declaration on Self / Relative Are you related to any of our present employees /
Working / Worked with Group directors of our / group Companies? If Yes Please
Companies 82
fill point 83-87
83 Name of Relative
84 Relationship with Relative
85 Name of Group Company
86 Department
87 Designation
Data 1 Data 2
Data 3 Data 4
Pension Fund Account Number -
