Employee Info Form
Employee Info Form
A/c 50100315347546
HDFC0000186
ANIL KUMAR SINGH
U 101516121978
E 4216045865
Insurance Details
Child Name 1
Child Date of Birth
Child Gender
Child Name 2
Child Date of Birth
Child Gender
Sm
56 to 60
years
6,056
oke
an
d
mir
ror
s
61 to 65
7,236
years
66 to 70
8,242
years
71 to 75
9,080
years
76 to 80
11,195
years
81 to 85
11,973
years
86 plus
13,136
years
In case if you wish to chosse any one of the Top-Up, the premium amount will be
Top-Up (Yes or No)-Please confirm
the premium amount will be recoevrred from your salary in 4 equal instamnet
PF Details
SL No. Employee Employee name (as Father / Husband name Relationship with
Code per Adhar) member
ails