Form 1: Employee Personal Information Name of Department: ________________ Employee Personal Information Photo First Name: _______________________________ Middle Name: _____________________________ Last Name: _______________________________ Date of Birth: _____________________________ Father/Mother/husband Name: __________________________ Gender: male/ female 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: ______________________ Present Address Detail Present Address________________________________________________________________ State_________________________ District _____________________________ Block________________________ Panchayat___________________________ Pin Code _____________________ Phone Number_______________________ E-mail (if any) ________________ Mobile Number ______________________ Permanent Address Detail Permanent Address_____________________________________________________________ State_________________________ District _____________________________ Block________________________ Panchayat___________________________ Pin Code _____________________ Phone Number_______________________ 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 Training Details Basic Education Name of Board/ University Marks Obtained (In %) Passing Year Stream Grade Technical Education Name of Board/ University Marks Obtained (In %) Passing Year Stream Grade Professional Education Name of Board/ University Marks Obtained (In %) Passing Year Stream Grade 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 Family Member Name Relation Date of Birth Dependent (Yes/No) Whether Employed (State/centre /unemployed) Whether in Same Deptt. (Yes/No) Employee Code (If in the same deptt.) Name of department (If other then Same Deptt.) Member E-salary Code 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 Type To office To Which Post Class Order Number Order Date Date of Increment Pay Scale Name of the other Department in case of Deputation Area Type (Hard/Tribal/ SubCader/None) Remarks (if any) Form 8: Employee Leave Detail Name of Department: _______________ Employee Leave Detail Type of Action Leave Type From Date To Date Reason Station Leave Availing LTC Desig. of the Sanctioning Authority Remark Balance Till Date 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: __________________________ Date of Appointing Inquiry Officer ___________ Date of Appointment of Presenting Officer_____Designation of Appointing officer____________ Case Status Case Status: ____________________________ Penalty/ Exonerated: _____________________ Appeal by officer: YES/NO Date of Implementation: __________________ Charge Sheet No.: ___________________ Name of the Inquiry Officer: ___________ Name of the Presenting Officer: ________ Designation of the Presenting Officer_____ Date of Decision: ____________________ Date of Penalty: ____________________ Appellate Authority: _________________ Brief detail of the case decision: _________________________________________________ Form 10: Employee Old History Name of Department: _______________ Old Service History Name of the office Designation Date of Joining Order Number Total Service (In months) Total Service in Balance of Remark Hard Area Tribal Area Sub-Cader Earned Leave Half pay 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 (Name of the Officer) Assessment Year Assest & Liabilities Assessment Period Remarks (if any) Filed Not Filed From Date To Date
