THE FOOD CORPORATION OF INDIA
CARDEX FORM
(To be submitted by all employees at the time of joining service)
01. Name of the Employee :
02. Father’s Name :
03. Designation of the post to
which appointed :
04. Martial Status
(Married/Unmarried) :
05. Whether member of
Scheduled :
a) Caste :
b) Tribe :
(Specify the particular
Caste / Tribe) :
06. Identification Marks : 1.
2.
07. a) Permanent Address :
b) Present Address :
contd…2
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08. Home Town ( for the
purpose of LTC) :
09. a) Date of Birth :
b) Particulars of Birth :
i. Place :
ii. District :
iii. State :
10. Languages the employee can :
a) Read :
b) Speak :
c) Write :
11. Mother Tongue :
12. Educational Qualifications :
13. Technical Qualifications :
14. Particulars of previous
experience(Service) :
a) From :
b) To :
c) Post(s) held a brief description :
work / responsibilities
in each assignment
d) Officiating / substantive
capacity :
e) Name of Employer :
f) Scale of pay of the post(s) :
contd…3
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15. Whether a Food Transferee/
Direct recruite/Absorbed
Deputationist. :
16. If Transferee(i) date of
joining in Food Department
and Designation held there :
ii) Gazette Notification No.
& Date under which services
finally transferred to FCI :
17. Particulars of wholly
dependent members of family :
(for the purpose of claiming
LTC and reimbursement of
Medical expenses etc.)
Sl.No. Name of Family Member Relationship Age
Contd…4
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DECLARATION
I hereby declare that the above particulars furnished by me are true to
the best of my knowledge. I also undertake that any change in the above
particulars shall be intimated by me at the appropriate time. I also understand
that any incorrect information submitted by me in this respect shall make me
liable for severe disciplinary action which may include a major penalty.
Signature :
Name :
Date :
Station: Designation
and office :
CERTIFICATE
(To be recorded in the case of Existing Employees only)
This is to certify that I have verified the above particulars submitted by
the employee with the available documents and personal file of the employee
and found them in order and accepted the same.
Signature :
Name :
Designation :
Office :
NOTE : Certificate to be signed by the officers authorized to verify
accept & preserve the Cardex Form.
