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Employee Info Form

The document contains a employee's personal, insurance, PF, and ESI details. It requests information such as the employee's name, date of birth, address, bank details, insurance beneficiary details, UAN, ESI and Aadhaar numbers.

Uploaded by

RajOmkar
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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0% found this document useful (0 votes)
59 views16 pages

Employee Info Form

The document contains a employee's personal, insurance, PF, and ESI details. It requests information such as the employee's name, date of birth, address, bank details, insurance beneficiary details, UAN, ESI and Aadhaar numbers.

Uploaded by

RajOmkar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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Personal Details

1 Employee full Name


2 Date of Joining in Atyati Technologies
3 Date of Birth (DD/MM/YY) format
4 Marital Status (Single/Married/Widowed/Separated/Divorced)
5 Contact Number
6 Emergency contact number
7 Blood Group (Mandatory to Fill)
8 PAN Card Number
9 Aadhar Number
10 Personal Mail ID
11 Highest Education Qualification (Mention the degree name)
12 Permanenet Address with Pin code number
13 Communication address with pin code number
14 Bank Account number
15 IFSC Code
Father's Name
17 UAN Number
18 ESI Number
19 Working Since (First employment date)
Rahul kumar singh
7/1/2023
5-3-1997
Single
6202774604
8102233068
A+
LCGPS7565D
7163-1479-2495
rahulk49914@gmail.com
10+2
vi+po chapar p/s mohiuddin nagar DI Samastipur bihar 848501

A/c 50100315347546
HDFC0000186
ANIL KUMAR SINGH
U 101516121978
E 4216045865
Insurance Details

Note: Please update the DOB as per the KYC document

Employee Name RAHUL KUMAR SINGH

Employee Date of Birth 3/5/1997

Spouse Name ANIL KUMAR SINGH

Spouse Date of Birth 4/10/1971

Child Name 1
Child Date of Birth
Child Gender

Child Name 2
Child Date of Birth
Child Gender

Father Name ANIL KUMAR SINGFH


Date of Birth 4/10/1971

Mother Name SUDHA DEVI


Date of Birth 6/6/1974
Premium for dependent parents
Age Premium per life (SI 3 Lakhs)
46 to 50
4,390
years
51 to 55
5,757
years

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

Date Of Birth Gender Date of Joining @ Atyati


Are your internation worked if yes please furnish Passport No. Date of expiry & origin of the
contry
Are you already a member of EPF in your Prev. Are you already a member of Pension in your
Establishment Prev. Establishment
UAN No (12 Digit) Aadhar (12 Digit) Name as per Adhar Specially Abled If Yes - Specially Abled
Category
ESI Details

Employee Name As Old ESI Number


Sl.No Employee Id Per Aadhar If Available Gender Mobile Number
Date Of Date Of Marital Present
Personal e-mail Id Birth Joining Status Address Permanent Address
Relationship with Bank
Family member details Date Of Birth Member Account Ifsc Code
Number

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