Employee Bio Data Form
S.No Employ Design Date of Birth Bank Account details Date Basic Level Cate Father's Male/
ee ation of Pay and go / female
Name Name IFSC code Bank account No. Payee Code arrival Cell ry Husban
of in [A/ d' s
bank prese B/C name
nt pay /D]
scale
1 2 3 4 5(a) 5(b) 5(c) 5(d) 6 7(a) 7(c) 8 9 10
Whether Name of Name of Name of Name of employee’s Date of Previous Assembly Constituency (AC) No.& Name,
spouse in Govt. home home AC* home AC Office with phone No. joining in posting Part No. and Serial No. of polling station in
Service (yes/No Distt. in which the history of which polling personnel is enrolled as a
(if yes, give full presently district entire voter.
particular of residing service
spouse ) Name (on with AC No. Part No. Serial EPIC
of home account of district & No. (voter
Distt. present Name Phone name. Name card No.)
posting)
13
11 17
12 14 15(a) 15(b) 16 18(a) 18 (b) 18(c) 18(d)
Whether already Whether Whether Whether Wheth Date of Mobile E-Mail ID
appointed as BLO/ election duty handicap physically fit er on retirement No.
Supervisor/Sector already ped? If, to perform long
Officer/Magistrate/ peroformed? yes to field duty? If leave
Nodal If, yes in what what not detailed
reasons such Yes/No
Officer/ Member of the capacity extent
as medical .
Election
Expenditure Monitoring (presiding/pol certificate.
ling officer )
Teams;
(yes/No.)
19 20 21 22 23 24 25 26
C/s
Signature of employee DDO/Controlling Officer of Office.