JOINING REPORT

&
EMPLOYEE INFORMATION SHEET

Name : ___________________________________________

Father’s Name : ___________________________________________

Designation : ___________________________________________

Address : ___________________________________________

___________________________________________

___________________________________________

___________________________________________

Date of Joining : ___________________________________________

Aadhar card No : ___________________________________________

PAN Card No : ___________________________________________

Mail ID : ___________________________________________

Contact No : ___________________________________________

Signature of Employee : ___________________________________________

 PERSONAL DATA FORM

RECENT
PHOTO

NAME : ____________________________________________

POST APPLIED FOR : ____________________________________________

FOR OFFICE USE ONLY

PRELIMINARY INTERVIEW BY DATE ______________

Name ___________________________Designation ___________________Signature ___________

Name ___________________________Designation ___________________Signature ___________

Name ___________________________Designation ___________________Signature ___________

Remarks _____________________________________________________________________________

____________________________________________________________________________________

FINAL INTERVIEW BY DECISION

Name Designation Signature Approved/Not Approved for appointment

Designation ______________ Grade _________

Recommended/Not Recommended for Appointment
Salary _____________ Location _____________
As __________ on Salary of Rs.________PM
Appointing Authority
Date ____________ Signature ____________
Name__________________________________

Designation ______________________________
FULL NAME _________________________________________________________________________

DATE OF BIRTH ___________________ WEIGHT __________________ HEIGHT _____________

POSTAL ADDRESS __________________________________________________________________

____________________________________________________________________________________

PERMANENT ADDRESS _____________________________________________________________

____________________________________________________________________________________

CONTACT # ___________________________

EMERGENCY CONTACT # __________________________________

FAMILY DETAILS
NAME DOB / SEX RELATION OCCUPATION

EDUCATION QUALIFICATION (Start with School Leaving Certificate or Equivalent)

YEAR OF % MAJOR
QUALIFICATION UNIVERSITY / INSTITUTE PASSING MARKS SUBJECT
 .m hiiii8EXPERIENCE (CHRONOLOGICAL ORDER EXCLUDING LAST POSITION)
Attach separate sheet(s), if required

PERIOD DESIGNATION JOB DESIGNATION GROSS REASON FOR

RESPONSIBILITY OF SALARY LEAVING
ORGANISATION IMMEDIATE DRAWN
SUPERIOR
AT THE
FROM TO LAST POSITION TIME OF
HELD JOINING
LAST POSITION HELD

DESIGNATION: __________________ORGANISATION_______________________DOJ________

DESIGNATION AT THE TIME OF JOINING: ___________________ No. Of Employees______

ADDRESS: _________________________________________________________________________

BUSINESS: ___________________________________ANNUAL TURNOVER__________________

JOB RESPONSIBILITY: ______________________________________________________________

REPORTING TO: NAME _________________________DESIGNATION_______________________

TOTAL GROSS SALARY PER MONTH _________________________________________________

CASH BENEFITS
BASIC___________

OTHERS ____________________TOTAL_______________

REFERENCE: NAME & ADDRESS OF ATLEAST TWO REFERENCES NOT RELATED TO YOU

1. _______________________________________________________________________________

2. _______________________________________________________________________________

ADDITIONAL INFORMATION
 Have You:

(I) Physical Disabilities __________________________________________________

(II) Marital Indebtness ___________________________________________________

(III) Been involved in Court Proceeding _______________________________________

(Give detail on a separate sheet of paper if answer is yes)
 HAVE YOU EVER BEEN INTERVIEWED BEFORE IN TFPL. IF yes, Give Details

Date: _______________ Position: ______________________

Location: ____________ Outcome: _____________________

 Languages Known: ______________________________________________________________

 Are you willing to travel:

In India: ____________________

In Abroad: ____________________

State Restrictions/Problems if any: ___________________________________________

 Places/Countries of your choice where you’d like to travel: ________________________

________________________________________________________________________

 Passport No. _________________ Valid Up to: __________________________

 Are you related to any of our employees? If Yes his/her Name: _____________________

 Membership of any Professional Institution/Association: __________________________

_______________________________________________________________________________

 Publication if any (list with specimen copy): ___________________________________________

 Any Specialized Training/Training Program attended: ___________________________________

 Would like to attend any specific training: ____________________________________________

_______________________________________________________________________________

 Any Other information/Suggestion: __________________________________________________

_______________________________________________________________________________
EMERGENCY DETAILS
 Blood Group: ________________

 Allergic To: _________________________

 Blood Pressure: ______________

 Sugar: ______________________________

 Eye Sight: Left: ________ Right: ______________

 Any Major Illness:

_______________________________________________________________________________

 Contact Person in case of Emergency: _______________________________________________

 Address: _______________________________________________________________________________

_______________________________________________________________________________

______________________________________________________________________________

 Phone #: ________________________
ATTACHMENTS

Please attach:

1. Passport size Photographs 3 Copies

2. Photocopies of all relevant certificates / degree mark sheets etc.
3. Proof of Birth
4. Experience Certificate from Previous employer.
5. Relieving letter from Previous employer.
6. Photocopy of Passport
7. PAN No.

No Documents Submitted Will submit on

1
2
3
4
5
6

DECLARATION

I DECLARE THAT THE INFORMATION GIVEN, HEREIN ABOVE, IS TRUE & CORRECT TO THE BEST OF
MY KNOWLEDGE & BELIEF & NOTHING MATERIAL HAS BEEN CONCEALED. I UNDERSTAND THAT THE
ABOVE INFORMATION IN FOUND FALSE OR INCORRECT, AT ANY TIME DURING THE COURSE OF MY
EMPLOYMENT, MY SERVICES WILL BE TERMINATED FORTHWITH WITHOUT ANY NOTICE OR
COMPENSATION.

DATE: _______________________ _________________________________

PLACE: _______________________ SIGNATURE OF APPLICANT

 BACKGROUND VERIFICATION

CERTIFICATION BY APPLICANT (read carefully):

I hereby authorize all my employers and schools (unless otherwise noted) to release any and all information concerning me,

including information of a confidential or privileged nature. I hereby release any and all employers from any liability or damage

that may result from furnishing the information requested.

Applicant’s Signature _____________________________ Date ___________________

(TO BE COMPLETED BY HIRING MANAGER)

APPLICANT’S NAME (please print) __________________________________________

POSITION CONSIDERED FOR: ___________________________________ F/T or P/T

NAME OF REFERENCE 1: _______________________________ PHONE # ______________

COMPANY NAME: ______________________________ FAX #_____________

DATES OF EMPLOYMENT: __________________________

WAS APPLICANT’S RELEASE FAXED TO REFERENCE? YES ____

NAME OF REFERENCE 2: _______________________________ PHONE # ______________

COMPANY NAME: ______________________________ FAX #_____________

DATES OF EMPLOYMENT: __________________________

WAS APPLICANT’S RELEASE FAXED TO REFERENCE? YES ____

1. Reference refused to give any information: ______

2. What was ________ (applicant’s name) overall performance when he worked for you?
_____________________________________________________________________

3. Were there any problems, on the job, that we should know about?
________________________________________________________________________

4. Are you aware of any allegations involving patient abuse or abusive behavior?
________________________________________________________________________

5. Would you rehire? Y N

6. Other Comments: ______________________________________________________

 _____________________________________________________________________

Manager’s Signature _______________________________ Date: _______________

Printed Name __________________________________________

BACKGROUND AND REFERENCE INQUIRIES:

Guidelines to Reviewing An Applicant’s Current and Past Work History
A Sample Telephone Script

After reading numerous applications and interviewing the top applicants for 30-60 minutes, how do you know which of the finalists
is the perfect candidate for your work unit? How can you find out more about the applicants you interview? An avenue to assist
you with furthering your hiring decision is calling and checking an applicant’s previous employers.

When to Check: At a minimum, a background check of the candidate of choice is required. A hiring
manager may do a background check on other finalists if he/she believes it will assist with making the final
decision.

Whom to Call: The hiring manager must contact at least the candidate’s current* or last employer. The hiring manager is
free to contact other previous employers.
(complete another form)

Introduction**: Be sure to introduce yourself and the purpose of your call.

Sample introduction: “Hello, my name is ________. I am (title/ organization). _________ (Candidate’s

name) is applying for (title/position) job with my Department. I am conducting a background check on
________(candidate’s name) and would like to ask you a few questions about him/her. Is this a good time for
us to speak? Or, is there another time that is more convenient?

Closing: Sample closing: “Thank you very much for your time and the information you have provided about
__________(candidate’s name). Should you have any information that you forgot to tell me or have
questions later about our conversation, please call me at ________________.

* Please respect the candidate’s request not to call a current employer or supervisor

** Do not be discouraged that the individual you call may not wish to respond to your inquiries about the candidate’s
current or past work performance. Get as much information as you can and document responses (even it is “no
information given by reference”) to your inquiries.
 FORM 2 (Revised)

NOMINATION AND DECLARATION FORM

FOR UNEXEMPTED/EXEMPTED ESTABLISHMENTS

Declaration and Nomination Form under the Employees’ Provident Funds and Employees’ Pension Scheme

(Paragraphs 33 & 61 (1) of the Employees Provident Fund Scheme, 1952 and Paragraph 18 of the Employees’ Pension scheme, 1995)

1. Name (in Block letters) :

2. Father’s/Husband’s Name :

3. Date of Birth :

4. Sex :

5. Marital Status :

6. Account No. :

7. Address : Permanent :

Temporary :

8. Date of Joining : EPF :

EPS :

PART – A (EPF)
I hereby nominate the person(s) /cancel the nomination made by me previously and nominate the person(s) mentioned below
to receive the amount standing to my credit in the Employees’ Provident Fund in the event of my death :

Name & Address of the Nominee’s relationship with Date of Birth Total amount of share of If the nominee is a minor, name &
nominee/nominees the member Accumulations in Provident relationship & address of the guardian who
Fund to be paid to each may receive the amount during the
Nominee minority of nominee
1 2 3 4 5

1 * Certified that I have no family as defined in para 2(g) of the Employees’ Provident Fund Scheme, 1952 and should
I acquire a Family hereafter, the above nomination should be deemed as cancelled.

2 * Certified that my father/mother is/are dependent upon me.

Signature or thumb impression of the subscriber

*Strike out whichever is not applicable.

 Part B (EPS) (Para 18)
I hereby furnish below particulars of the members of my family who would be eligible to receive widow/children pension
in the event of my death.

S.No. Name of the family members Address Date of Birth Relationship with the member
1 2 3 4 5

** Certified that I have no family, as defined in para 2(vii) of Employees’ Pension Scheme, 1995 and should I acquire a family
hereafter I shall furnish particulars thereon in the above form.

I hereby nominate the following person for receiving the monthly widow pension (admissible under para 16 2(a)(i) and (ii)
in the event of my death without leaving any eligible family member for receiving Pension.

Name and Address of the Nominee Date of Birth Relationship with the member

Date :
Signature or thumb impression
of the subscriber
Place :

**Strike out whichever is not applicable.

CERTIFICATE BY EMPLOYER

Certified that the above declaration and nomination has been signed/thumb impressed before me by Shri/Smt./Kum.

employed in my establishment after he/she has read the entries/entries have been read over to him/her

by me and got confirmed by him/her.

Place :
Signature of the employer or other
Authoried Officers of the Establishment.

Designation
Dated the :
Name & Address of the Factory/
Establishment or Rubber Stamp