Languages Spoken-1

Hindi_read ? 'checked' : ''}}> Read

Hindi_write ? 'checked' : ''}}> Write

Hindi_spoke ? 'checked' : ''}}> Speak

Languages Spoken-2

English_read ? 'checked' : ''}}> Read

English_write ? 'checked' : ''}}> Write

English_spoke ? 'checked' : ''}}> Speak

Languages Spoken-3

Marathi_read ? 'checked' : ''}}> Read

Marathi_write ? 'checked' : ''}}> Write

Marathi_spoke ? 'checked' : ''}}> Speak

Nominee Name *

Age *

Relation *

Permanent Address

Village & PO *

Tehsil *

Pincode *

City

State

Present Address

Same as Permanent Address

Village & PO *

Tehsil *

Pincode *

City

State

Mobile.(Whatsapp No)*

Police Station

Aadhar Card Receipt No.

Aadhar Card No*

Name as per Aadhar*

DOB as per Aadhar.

Pan Card Receipt No

Pan No*

Name as per Pan*

Bank*

IFSC Code*

Branch

Account No*

Name as per Bank

Family Details for PF

Sr.No	Name	Date of Birth	Age	Relation	Gratuity Proportion(%)	Minor Name
1
2
3
4

Educational Qualification

Sr.No	Class/Degree	Year	College/University	Percentage
1
2
3
4

employment_type == '0' ? 'checked' : '' }}> Civil Experience

employment_type == '1' ? 'checked' : '' }}> Ex Army

employment_type == '2' ? 'checked' : '' }}> Fresher

Sr.No	Address of Organisation	From	To	Post Held	Reason for Leaving	Remark
1
2
3

Document submitted-ID Proof*

id_voter_card === 'voter_card' ? 'checked' : ''}}> Voter Card

id_pan_card === 'pan_card' ? 'checked' : ''}}> Pan Card

id_aadhar_card === 'aadhar_card' ? 'checked' : ''}}> Aadhar Card

id_passport === 'passport' ? 'checked' : ''}}> Passport

id_bank_passbook === 'Bank_Passbook' ? 'checked' : ''}}> Bank Passbook

id_driving_licence === 'driving_licence' ? 'checked' : ''}}> Driving Licence

id_citizenship_card === 'citizenship_card' ? 'checked' : ''}}> Citizenship Card

Document submitted-AGE Proof*

board_certificate === 'board_certificate' ? 'checked' : ''}}> Board Certificate

leaving_certificate === 'leaving_certificate' ? 'checked' : ''}}> Leaving Certificate

transfer_certificate === 'transfer_certificate' ? 'checked' : ''}}> Transfer Certificate

marksheet === 'marksheet' ? 'checked' : ''}}> Mark Sheet

ageproof_voter_card === 'voter_card' ? 'checked' : ''}}> Voter Card

ageproof_pan_card === 'pan_card' ? 'checked' : ''}}> Pan Card

ageproof_passport === 'passport' ? 'checked' : ''}}> Passport

Document submitted-Address Proof*

addressproof_bank_passbook === 'bank_passbook' ? 'checked' : ''}}> Bank Passbook

addressproof_aadhar_card === 'aadhar_card' ? 'checked' : ''}}> Aadhar Card

addressproof_mseb_bill === 'mseb_bill' ? 'checked' : ''}}> MSEB Bill

addressproof_passport === 'passport' ? 'checked' : ''}}> Passport

addressproof_ration_card === 'ration_card' ? 'checked' : ''}}> Ration Card

addressproof_voter_card === 'voter_card' ? 'checked' : ''}}> Voter Card

addressproof_residential === 'residential_card' ? 'checked' : ''}}> Residential Card

addressproof_domicile_card === 'domicile_card' ? 'checked' : ''}}> Domicile Card

addressproof_citizenship_card === 'citizenship_card' ? 'checked' : ''}}> Citizenship Card

Certificate/Training *

certificate_first_aid === 'first_aid_certificate' ? 'checked' : ''}}> First Aid Certificate

certificate_security_experience === 'security_experience' ? 'checked' : ''}}> Security Experience

certificate_training === 'certificate_training' ? 'checked' : ''}}> Training Certificate

certificate_fire === 'certificate_fire' ? 'checked' : ''}}> Fire Fighting Training

certificate_medical === 'certificate_medical' ? 'checked' : ''}}> Medical Certificate

certificate_driver === 'certificate_driver' ? 'checked' : ''}}> Driver

certificate_computer_literate === 'certificate_computer_literate' ? 'checked' : ''}}> Computer Literate

certificate_other === 'certificate_other' ? 'checked' : ''}}> Other

Death/Accident Contact No.1

Name

Address

Mobile

ESIC Card Issue Status

accident_esic === '1' ? 'checked' : ''}}> Yes accident_esic === '0' ? 'checked' : ''}}> No

ESIC No

UAN

Posted To*

Death/Accident Contact No.2

Name

Address

Mobile

ESIC Card Issue Date

PF No.

Location

Remark

First Name *

Middle Name *

Last Name*

Gender *

gender == 'm' ? 'checked' : '' }}> Male

gender == 'f' ? 'checked' : '' }} > Female

Date Of Birth *

Place Of Birth (Village/Town) *

Father's Full Name/Legal Guardians Full Name(including surname,if any)*

Mother's Full Name of Spouse(including surname,if any) *

Permanent Address including street No./Police Station/Villege and District(with PIN Code) *

Education Qualification *

Height *

Name *

Address*

Mobile No. *

Upload Documents

Remarks

Status *