Form 1: Employee Personal Information

Name of Department: ________________

___________________________________________________________________
Employee Personal Information
Photo
First Name: Prathmesh

Middle Name: Sanjay

Last Name: Shinde

Date of Birth: 28/01/2007

Father Name: Shinde Sanjay Sonyabapu

Gender: male Martial Status: ____________________

Identity Mark: ___________________________________________________________

**Mark the attached documents

Medical Fitness Character Certificate

Height (in cms): ___________________

Caste: ___________________________ Category: ___________________________

Religion: ________________________ Blood Group: ________________________

Home State: ______________________ Home District: _______________________

Home Office Type: _________________ Home Office Name: ___________________

LTC Home Town: __________________ Nearest Railway St.: ___________________

Remarks (if any) _______________________________________________________________

Employee office Details:

Current Designation: ________________ Current Office: ___________________

Current Cadre: _________________________

 Form 2: Employee Address Information

Name of Department: Mechanical

Present Address Detail

Address: Rahimpur Gavthan
State: Maharashtra
District: A.Nagar
Block: Sangamner
Panchayat: Rahimpur Grampanchayat
Pin Code: 422605
Phone Number: 8237940461
E-mail: shindeprathmeshsanjay@gmail.com
_____________________________________________________________________________
Permanent Address Detail

Permanent Address: Rahimpur Gavthan

State: Maharashtra. District: A.Nagar.

Block: Sangamner. Panchayat: Rahimpur Grampanchyat

Pin Code: 422605. Phone Number: 8237940461

 Form 3: Employee Professional Information

Name of Department: _______________________

_____________________________________________________________________________

Joining Details

Date of Appointment: _____________________ Order Number: __________________

Office name at the time of initial joining in Deptt. :____________________________________

Date of Joining in the Deptt.: _______________ Initial Designation: _______________

Mode of Recruitment:_____________________ Class: _________________________

Employee Type: _________________________ Gazetted/ Non-Gazetted

_____________________________________________________________________________

Salary Details - (At the time of Initial Joining)

Basic Pay: Rs._________________ Date of Retirement: _____________

Deduction Type: GPF / CPS GPF/CPS Number: _____________

GIS Member: YES / NO E-salary Code: _________________

 Form 4: Employee Education Information

Name of Department: ______________________

___________________________________________________________________
™ Education Detail

Basic
Name of Board/ Marks Obtained
Education Passing Year Stream Grade
University (In %)

Technical
Name of Board/ Marks Obtained
Education Passing Year Stream Grade
University (In %)

Professional
Name of Board/ Marks Obtained
Education Passing Year Stream Grade
University (In %)

™ Training Details

In India
Training Type Topic Name Name of the Institute Sponsored by Date From Date To

Abroad
Training Type Topic Name Name of the Institute Sponsored by Date From Date To
 Form 5: Employee Family Information

Name of Department:________________

_______________________________________________________________________________________________________________________

Family Details

Whether
Family Whether in Employee Code Name of department Member
Date of Dependent Employed
Member Relation Same Deptt. (If in the same (If other then Same E-salary
Birth (Yes/No) (State/centre
Name (Yes/No) deptt.) Deptt.) Code
/unemployed)
 Form 6: Employee Loan Details

Name of Department: _______________

Loan Details

Loan Type Loan A/C No. Letter No. Sanction Date Sanction Amount Return Date Remark
 Form 7: Empolyee Service History
Name of Department:____________

____________________________________________________________________________________________________________

Service History

Sr.No. Transaction To office To Which Class Order Order Date of Pay Name of the Area Type
Type Post Number Date Increment Scale other (Hard/Tribal/
Department Sub-
in case of Cader/None)
Deputation

Remarks (if any)

 Form 8: Employee Leave Detail

Name of Department: _______________

Employee Leave Detail

Desig. of
Station Availing the Balance Till
Type of Action Leave Type From Date To Date Reason Remark Date
Leave LTC Sanctioning
Authority
Apply Cancel Yes No Yes No Yes No
 Form 9: Employee Departmental Proceeding
Name of Department: ____________________
___________________________________________________________________

Proceeding Detail
File Number: ____________________ File Date: _________________________

Office where posted at the time of charges: ________________________________________

Designation: ____________________ Proceeding Under Rule________________

Date of Suspension: ______________ Date of Revocation: __________________

Proceeding: _________________________________________________________________

Charges Details

Type of Charge: __________________________ Charge Sheet No.: ___________________

Date of Appointing Inquiry Officer ___________ Name of the Inquiry Officer: ___________

Date of Appointment of Presenting Officer_____ Name of the Presenting Officer: ________

Designation of Appointing officer____________ Designation of the Presenting Officer_____

Case Status

Case Status: ____________________________ Date of Decision: ____________________

Penalty/ Exonerated: _____________________ Date of Penalty: ____________________

Appeal by officer: YES/NO Appellate Authority: _________________

Date of Implementation: __________________

Brief detail of the case decision: _________________________________________________

 Form 10: Employee Old History

Name of Department: _______________

Old Service History

Total
Name of Date of Order Service
Designation Total Service in Balance of Remark
the office Joining Number (In
months)
Hard Tribal Sub- Earned Half pay
Area Area Cader Leave leave
 Form 11: Employee Nomination Details

Name of Department: ________________

__________________________________________________________________________________________

Nomination Details

Name of the Nominee: _________________________

Relation with the employee: _____________________ Type of Nomination: _____________

Nomination %age: _________%

______________________________________________________________________________________________

Nominee Address Detail

Present Address: _______________________________________________________________

State: ______________________ District: ________________________

Block: _____________________ Panchayat: _____________________

Pin Code: ___________________ Phone Number: __________________

 Form 12: Employee ACR Details

Name of Department: _______________

ACR Details

ACR Submitted by
Assessment Year Assest & Liabilities Assessment Period Remarks (if any)
(Name of the Officer)

Filed Not Filed From Date To Date