Aculife Healthcare Pvt. Ltd.

Employment Application Form

Important : Post Applied for : Portfolio Management

1. Please read the contents of this form
Thoroughly before filling it. How did you come to know about this position (Please specify source :)
2. Form needs to be filled completely Linkedin post of HR
Before submitting. If space is insufficient,

I. Personal Data Record

Full Name : RUSHI SURESH MOR

(IN CAPITAL

LETTERS)

Short name used in routine communication : RUSHI

E-mail: Rushi.mor@icloud.com

Present Address: Permanent Address: Same as Present

Gala Haven B1003,
Near Vaishnodevi Circle,
Ahmedabad

Pin Code: 382421 Pin Code:

Mobile No. : 9420072297 Residence Phone No. :

Residence Phone No Incase if Emergency (Mobil No.: 9099035578

Other Particulars :

Date of Birth:06/09/1989 Place of Birth: Pachora Marital Status: Married

Nationality: Indian Religion: Hindi Caste SC/ST/OBC/Other: General
Height (cms): 178 (……..'……………") Weight (Kgs) : 70 kg Blood Group: A+

PAN No. : AZEPM8056D Passport No. UID:

Did you have any physical disability or serious sickness during the last two years interrupting your work for over two weeks? If yes,
give details : No
II. Details of Family
Name Age Occupation
Husband / Wife Ankita Rushi Mor 34 Job
Children 1 Kartika Rushi Mor 0.3
2
3
Father Suresh Mor 71
Mother Prema Mor 68
Brothers 1
2
3
Sisters 1
2
3
If you have any dependents (excluding wife and children), indicate relationship and reason /s for dependence :
………………………………………………………………………………………………………………………………………………………………
………………………….
III. Education and Training

Degree /
Place Diploma Class
School / College Attended Attende Period obtained / Major Subjects
d Grade Studied
Fro To
m
RC Patel COP Shirpur 2012 2014 M.Pharm 1st Class Pharmaceuticd
SSDJ COP Chandwad 2008 2012 B.Pharm 1st Class Pharmacy

IV. Short - term & Part-time Specialized Courses / Training Programs Attended

Institutio Place Year Duratio Course Description Certificate Awarded

n n

Do you possess any specific skill suited to the job you have applied for? Give Details :
………………………………………………………………………………………………………………………………………………………………
…………………………………………………

V. Work Experience

Company’s Tenur Salary on leaving Basic/ Total

e Reason for Leaving
Name : Monthly / Annual Gross
Sr .No (In order of In From T
 current company Year o
to previous s
company)
1. Intas Pharmaceuticals 1 year 2024 Till date 12 lacs Professional Growth

Zydus Cadila 7 Years 2017 2024 9.14 Approx Professional Growth

2.
FDC Ltd 2 Years 2015 2017 Forgot Career growth
3.

Ajanta Pharma 1 Years 2014 2015 2.25 Lac Career Growth

4.

5.

Designation and job description

Sr. No. under Immediate Superior's Name & Email & Contact No.
each employer as above* Designation

If space is insufficient, please attach a separate sheet.

VI. Hobbies and Pastimes, Computer/Web Literacy

Driving, Trekking, watch web series

VII. Languages Known (Underline Mother- Tongue)

Spea Rea Writ

k d e
Englist Englist Englist
Hindi Hindi Hindi
Marathi Marathi Marathi
Gujarati Gujarati

VIII. Have you been previously interviewed in Aculife Healthcare Pvt. Ltd.? No

When (Date) : For (Dept. / Location): Interviewed By:

IX. References

Please share two references (name, current company, designation & contact no.) preferably your reporting head from your previous
organization / current organization (who has left now) in the application form. Do not share names of colleagues, relatives etc.,

1. Name: Tushar Luhade

Company: FDC Ltd Designation / Occupation:Sr Manager Project Management
Address: Mumbai Jogeshwari

Phone: 7057687831 Period for which known: 12 years

2. Name: Prakash Prajpati

Company: Zydus Designation / Occupation: Associate Manager
Address: Maninager
E-mail:
Phone: 9909239609 Period for which known: 7 years
X. Salary/ Remuneration Expected

Rs/- 17,40,000 Per annum When can you join if selected : 90

Days (Negociable)
XI. Is any employee of Aculife Healthcare Pvt. Ltd. known or related to you? If yes, Please give details :

Name:
Designation: Location:
Company: Relationship:

XII. Declarations

1. I agree to undergo a medical check -up from an authorized Medical Practitioner as suggested by the company from time to time
2. I am willing to be placed / transferred anywhere in India or abroad, if necessary, in the interest of the company's
business and or as a part of the employment contract.
3. I would keep the company posted about any change in my present address or change in marital status.
4. I certify that the foregoing information is correct and complete. If at any time, I am found to have concealed any
material information or given any false details, my appointment shall be liable to summary termination without notice or
compensation in lieu thereof.
5. I hereby authorize the Company and its appointed agencies, to verify information provided in my resume, Aculife
Healthcare Pvt. Ltd. Employment Application Form and other relevant documents submitted by me for the purpose of
employment. I agree and consent for verification process and request those - concerned to facilitate and disclose the relevant
data to complete the authentication process.

Date: 24-02-2025 Place: Ahemedabad Signature: Rushi Mor

ANNEXURE TO EMPLOYMENT APPLICATION FORM

INFORMATION TO BE FURNISHED BY CANDIDATES

FOR LAST TWO PREVIOUS JOBS INCLUSIVE OF CURRENT JOB

1. PRESENT JOB

Brief nature of duties & responsibilities including

reporting relationship and no. of subordinates Direct &
Name of the company with Turnover & Total no. Indirect with
of Employees Organogram and achievements.
Industry Designation
 Pharma Assistant Manager Portfolio Management for Global Market
Business case forecasting
Capacity Mapping
Name of the Co. : IMS Data Mining
Intas Pharma Long term & Short term Project Selections
R&D Budged

Turnover: Rs.
20,000 Cr : 2024

Total no. of Employees in the company

10,000 +

ORGANOGRAM OF THE PRESENT COMPANY

(HIGHLIGHT YOUR POSITION SPECIFICALLY)
President Operations

Vice President
(Project & Portfolio Management)

Senior Manager
(Portfolio Management)

Rushi Mor
(Assistant Manager : Portfolio Mnagament)
2. LAST JOB

Brief nature of duties & responsibilities including

reporting relationship and no. of subordinates Direct &
Name of the company with Turnover & Total no.
Indirect with organogram and achievements.
of Employees Industry Designation

Name of the Co. : Pharma Assistant Manager Formulation Development for Global Market
Zydus Cadila

Turnover: Rs.
20,000 cr +

Total no. of Employees in the company

10,000+

ORGANOGRAM OF THE PRESENT COMPANY

(HIGHLIGHT YOUR POSITION SPECIFICALLY)

SALARY DETAILS FORM – CURRENT ORGANIZATION

 I Mr.

As on

Sr. No
TAX APPLICABLE REMARKS

HEADS GROS GROS

S S (P.A.) TAXABL NON PARTLY
(P.M.) E TAXABL TAXABL
E E
MONTHLY HEADS

1 BASIC

2 HRA

3 EDUCATION ALLOWANCE

4 SPECIAL ALLOWANCE

5 CONVEYANCE ALLOWANCE

A 6 MEDICAL ALLOWANCE

7 CAR ALLOWANCE

8 DRIVER'S WAGES ALLOWANCE

9 NEWS PAPER ALLOWANCE

10 TELEPHONE

11

12

TOTAL ANNUAL GORSS (A)

ANNUAL HEADS
i) MEDICAL

ii) L.T.A.

iii) EX-GRATIA / BONUS

B
iv) P.F. ( %)

v) SUPERANNUATION PM ( %)

vi) PRODUCTIVITY INCENTIVE

TOTAL ANNUAL GORSS (B)

TOTAL GROSS (A+B)

To include amount only if it is a part of compensation. If

unlimited please do not mention.
Designation Current Company Allowance Structure

HQ Ex-HQ

OS Internet

Postage/photocopy Others 1

Others 2 Others 3

Travelling fare

*Please provide if any other details are existing in your allowance structure
OTHER PERQUISITES DETAILS
Sr.no. PERQUISITES STATUS REMARKS
1 COMPANY'S CAR
i. Model
ii. Any limit in milages (K.m.)
iii. Petrol Consumption (Average Rs. per month)
2 COMPANY'S LEASED ACCOM.
i. Co.'s leased (Please specify)
ii. Whether Flat stand in wife's name Yes / No
iii. Monthly Rent (Rs.)
iv. Deposit amount(Rs.)
3 HARD FURNISHING
i. Kindly specify limits
ii. Whether limits annualized basis or some other
period (please specify)
iii. What would be the cost to the company on annual
basis
4 INCENTIVE IF ANY
I. Give particulars in whatever form the same is
received

ii. If these details are already covered above, please specify to avoid
duplication.
5 TELEPHONE Company / Personal
i. Whether it is Company's or your personal
ii. Is there any limit of reimbursement. Yes / No
iii. If yes, please specify the amount. Rs.
6 TAX AT SOURSE (MONTHLY AS PER PAY SLIP) Rs.

IMPORTANT

Details furnished are meant for internal use and be kept confidential.
The same, however would not be divulged to any outsider.