SERVANT INFORMATION FORM (DOMESTIC /COMMERCIAL/INDUSTRIAL) (TO BE FILLED BY THE EMPLOYER IN CAPITAL LETTERS FOR EACH SERVANT) 1. Address of Employer Name __________________________________S/o ,W/o_______________________________ H. No.______________________Sector/Village_____________________PhoneNo. _________ Occupation ____________________________________________________________________ Servant Employed Domestic Commercial Industrial Address where servant is working H. N. /Shop No./Factory No_______________________________________________________ Sector________________________________________________________________________ Designation _______________________________________Date of Joining________________ 2. Particular of Servant I Name of Servant ____________________________ (Alias, if any) II Father's Name ______________________________ III Religion______________Caste__________Sex____ IV Age__________________Height________________ V Identification Mark___________________________ VI Married/Unmarried __________________________Fulltime/Part time______________ VII Qualification __________________________Languages Speaking_________________ VIII Permanent Address _______________________________________________________ ____________________________District_____________________________________ Police Station ________________________State_______________________________ IX Staying in Chandigarh since______________________ Staying at place of work Yes/No_______________ X Local Address (if not staying at Place of work) H.No./Jhugi No. _______________________Village/Sector_______________________ Ration Card No. (If any)_________________Vehicle No. if any ___________________ Voter Identity Card No. , (if any) Number of family Members residing locally:- SNo. Name Age Sex Relation Occupation. 1 2 3 4 5 6 7 3. Previous place of Employment at Chandigarh Address ______________________________________________________________________ ______________________________________________________________________________ Sector/Village ________________________________________Phone____________________ 4. Address and phone number of two relatives known persons of Servant (If provided by any security or other employment Agency or person Name and Addres of the Agency/Person with Phone Number) a) ___________________________________________________________________ ___________________________________________________________________ b) ____________________________________________________________________ ____________________________________________________________________ Signature of Servant (if Literate) _______________________________ Right Thumb impression of Servant Employer Signatures WE CARE FOR YOU FOR OFFICE USE ONLY Data entry has been made vide number _____________________________
