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
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: 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 Sanctioning Remark Date
Leave LTC
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 (In Total Service in Balance of Remark
the office Joining Number
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