ÿþ2 0 1 5 - 0 9

alt2Tcr4,2T :
31-Ta721"
ci &ave., 20 1 5
3
211-e1•g-17T
-e&rcl k3IIdJ r0)
211-eiGi211-e-105).1e-1 .e.)00)-1 Z1re1c6)e-iicII,d Gi 1C11d-Id
c6-102d lcc e.4csi.e&ti ciJuilLID.a.,10-ii
ce406
WErr •• -r .e.e, -t I Tercicflci 1ii
-tv) *.e.i
( I FM IS) ut-eil
uI W4T k)-i I al ITi•a--Ta 6)01i I
1i 3116
c4)•Z c./ ct5Tci ci 311
9iTER-1.g 2 II
c6) e-4ci CDI c.l A To kyli ci cf.) Ii
3crd 1i-&c413LICIGU Wcc.1) 21 I 1
LTil al I 3i-T -QL.TI) 10) 3-11 a 2T Z5"aTat .21 Cl dal W-1->1
cl
I ef
411
1TT,
3-i1cr)C1 cZ) 01 t
w-1,11q-e11.e. ullcicDI1 3i1oun4 403
I 1ci 0))
A-UfT 21 I sl I.e-qd ct) , CI I cr) cl I tb e-1 ul I G1 0)121
-a-ICI 001
31
c!
c?)
'C
1'
127T) Ir'49
(4 W.0
eR)-i•evj1G1W1
lcG1 ICt)
Cl cksi2 0 1
5
lIcjIc'1Iq:-
T-:1tY-42.1V Ucl
(P-211.e1Gi/ Ge1ire-10)-1 1-20 2/ 0t0/ cg0uri0/G
uctui
I
di
1 ciA"-a
Pei
SZA 2M-/za01:110 u.e.i301,7N.10g)0
6140-))J 12i e)cii .e1d411?-0 3"cri Gene-noel -a=1"0;10,
ui ciI
G-10D
ci cId-I I ci TI-EzP;a2T .e kye-i.cr iiAI1 tI I Cicr),IG- -11P-1 (4-1 310)1, 1i
2.
ci ciI
cicf di IciTrEZigaQTiue-1II 1l0)
3 .Riftcocfce-i -e-eT 3i1 M-Tg,1i
-./c)c-1 I fel
3a1M
-71:11-
0 ;I- 0'1ciciL I
3vr-1
1I1C1,
1i
,
lI
1
4.
t3-4. Riroicl-e-1)/
ei
ci (Ge-nreicr,)/giPi
5. RiP.i
lI
1 -a LI el
-eici.eRTI.ev(3i 0 uci 03iTTOci /R.
1.
c'e-lk-11C1el TrOVO, iciciI
(u0k)11d1
3T1E/A-R3:11- 3TllCDI& 3rz1 Ge-ie-i T1 0 -rf 0 , LTIOC1I
6.
f
S
- -Cer t/G-euRico— 1 Lci 2, .31:74 c1I.1IcirOVO, LTIGICI.e. 1
7.
01-a u (Te
8. fgATZT 4(111- 3TrETW-traTuT/TA7T -4trft 0)4.
•-icioci) I 3•- • G-e-11-11c1e-1 TrOVO, LTistsici.e. I
-1-g, 3-cci
II—llCDici
31R-1Th
.
ci
9.1d1d tl 2f sAvit co A-41 GY-11e-11c1-1 T10;1- 0, uialci.e I
q Cy1S
0) 2i i i1:17 al
en
•zr)d-i di) 3i ?,q I
1 1 . dICD(101 t-1 ODLTICl) I1ICD 2dci LI
Genenclei TrOVO k.Tioci. I
•rr'
d)13t1ciI afc 31IdI1d 3fra.2e-i cr) col 4c.i
"I cr, 311Z-11Z4d
3ifl qci I
(e oa-rzoo
aRTIT 3ifETWitt
2,51
eld Name
Data to be fill here
Filling Instruction
EMPLOYEE CODE
AADHAR NUMBER
(Optional)
FIRST NAME(ENGLISH)
FIRST NAME(HINDI)
MIDDLE NAME(ENGLISH)
MIDDLE NAME(HINDI)
LAST NAME(ENGLISH)
LAST NAME(HINDI)
FATHER/HUSBAND FLAG
FATHER/HUSBAND NAME
DateOfBirth OF FATHER/HUSBAND
FATHER/HUSBAND DEAD/ALIVE
EMPLOYEE CATEGORY
(GEN/OBC/SC/ST/OTHERS)
EMPI OY E PAYROLL CATEGORY
do not fill
IS PHYSICALLY CHALLENGED?
YES/NO
GENDER
M/F
MARITAL STATUS
Single/married/divorce/widow
EMPLOYEE DATE OF BIRTH
dd/mm/yyyy
CLASS
DEPAR MENT NAME
CADRE NAME
do not fill
do not fill
do not fill
DESIGNATION
POST tD(CSEMS System)
DESIGNATION(CSFMS System)
POST TYPE
GAZET1 ED/NON GAZETTED
DDO CODE
do not fill
do not fill
Permtt./Temp.
do not fill
1802103001
DATE OF SERVICE JOINING
DATE OF POSTING CURRENT
PROBATION (START DATE)
PROBATION(END DATE)
CONFIRMATION DATE
PAY COMMISSION
PAY SCA ., E
GRADE PAY
BASIC PAY
GPF ACCOUNT NO
DPF ACCOUNT NO
NPS ACCOUNT NO
PRAN NO
STATE
DISTRICT
CITY
do not fill
do not fill
do not fill
do not fill
do not fill
do not fill
do not fill
do not fill
Native State
Va-21'
Native District 5t15 ITE9T
current city
PERSONAL MOBILE NUMBER
OFFICE MOBILE NUMBER
PERSONAL EMAIL ID
OFFICE EMAIL ID
EMPLOYEE SERVICE EXPIRY DT (RETD DATE)
BCO CODE
BUDGET ONE
EMPLOYEE BANK ACCOUNT
EMPl OYi E BANK ACCOUNT IFSC
EMPLOYEE STATUS TYPE
DATA STATUS
REMARKS IF ANY
do not fill
do not fill
do not fill
do not fill
do not fill
do not fill
do not fill
Signature