Prasadam bhojnalay

Verification of Employee

Please tick to Register in

ESIC

Both

Full Name

Father Name

Date of Birth

Mobile No

Date of Joining

Present Address

Permanent Address

Marital Status

Married

Unmarried

Sex

1) Aadhar Card No

2) PAN Card No

3) Bank Details

a) Name of the Bank

b) Account No

c) Bank Address with IFSC Code and MICR Code

d) Old ESIC No

Old PF UAN No

Family Details (FOR ESIC)

Sr.No	Name of Family Member	Date of Birth	Relation
1

Upload Employee Passport Photo

Upload Aadhar Card (Xerox copy)

Upload PAN Card (Xerox copy)

Upload Bank Passbook (Xerox copy)

Upload Family Passport Photo (FOR ESIC)

Undertaking. I am I understood all above terms and conditions. Also my family is ready to allow me to join Prasadam bhojnalay with the above details. Willingly I made a decision to join Prasadam bhojnalay as per the above joining conditions. I request the respective management please approve my employment with Prasadam bhojnalay.

Date

Place