New Employee On Boarding Form - NOS - NHOD

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Personal Details
Prefix Ms.
First Name Pallavi
Middle Name
Last Name R
Date of Birth 08-October-1999
Marital Status Un-married
Religion Hinduism
Gender Female
Specially Abled No
Personal Email ID [email protected]
Mobile NO 7349728355
Nationality Indian
Citizenship Status Indian Citizen
Aadhaar Number 8292 8874 5469 Please attach a photo copy in the email.
Pan Number EVLPP6927B Please attach a photo copy in the email.
Passport Available Please attach a photo copy in the email.
Passport Number U6621497
Issue date 14-January-2020
Expiry Date 13-January-2030
OCI Card No Not Applicable
Visa Number Not Applicable
Issuing Authority Not Applicable
Issue Date Not Applicable
Expiry Date Not Applicable
Highest Education BBA
Street Address #39, 6th cross rajiv gandhi nagar
Address Line 2: Laggere
Current Address
City: Bangalore
State & Postal: Karnataka 560058
Permanent Address Status Same as Current
Street Address #39, 6th cross rajiv gandhi nagar
Address Line 2: Laggere
Permanent Address
City: Bangalore
State & Postal: Karnataka 560058

Banking Information
Name as Per Bank
Records Pallavi R
Bank Account No 3849101011347
Bank Name and
Branch Details Canara Bank, Laggere Bangalore- 560058
IFSC Code CNRB0003849

Joining Information
Date of Joining 21-February-2022
Department 7671:GS IND SS RECONCILIATION
Employee ID 8341
Title Analyst l
Joining Location Bangalore

Relationship Prefix First Name Middle Name Last Name Date of Birth
E.g. Father Late RAJESH M RAO 14-Nov-1989
Father Mr. Raju M R 05-March-1970

Enrollment For Health Insurance Scheme


Relationship Prefix First Name Middle Name Last Name Date of Birth
You can either choose Parents / Parent -in-Laws (not a combination)
E.g. Father-in-Law Mr. SHARATH S RAO 29-Aug-1960
Father Mr. Raju R 05-March-1970
Mother Mrs. Sumathi R 01-January-1975
Spouse
Child 1
Child 2

Example for all the below


If Minor (Guardian
Relation Name of the nominee Address Date of Birth %
Name)
Father SHARATH S RAO Permanent 29-Aug-1960 10%
Spouse KAVITHA RAO Current 2-Dec-1988 80%
Son MANISH S RAO Jr Current 6-Nov-2005 10% KAVITHA RAO
Daughter

Nomination And Declaration For Insurance ( FORM-I)


If Minor (Guardian
Relation Name of the nominee Address Date of Birth %
Name)
Father Raju R Current 05-March-1970 40%
Mother Sumathi R Current 01-January-1975 50%
Brother Arun R Current 12-April-1991 10%

Nomination And Declaration For PF & Pension (FORM 2 )


If Minor (Guardian
Relation Name of the nominee Address Date of Birth %
Name)
Father Raju R Current 05-March-1970 20%
Mother Sumathi R Current 01-January-1975 60%
Brother Arun R Current 12-April-1991 20%

Nomination And Declaration For Gratuity (FORM F )


If Minor (Guardian
Relation Name of the nominee Address Date of Birth %
Name)
Father Raju R Current 05-March-1970 50%
Mother Sumathi R Current 01-January-1975 50%

Declarations
I hereby declare that I am not related to any Director of Northern Trust
(If you are not related then select - Yes, if you have any relation with any of the Directors select - No) Yes
Are you previously employed in India before Northern ? No
* (11) Are you A Member Of The Employees’ Provident Fund Scheme, 1952
Did you contribute to PF / Provident Fund earlier, Verify the same before you make the selection. No
*(12) Are You A Member Of The Employees’ Pension Scheme, 1995?
Did you have pension contribute earlier, Verify the same before you make the selection. No
PF Number
PF - UAN
Are You Aware That Northern Provides Transport ? Yes

Are you familiar about the business of the company and understand that your job might involve working in different shifts Yes
which includes night shifts?

NTAC:3NS-20_x000D_
Are you familiar about the business of the company and understand that your job might involve working in different shifts Yes
which includes night shifts?

Previous employement details For - Form 11 (Fill the information only if 11 or 12 points above is Yes)

Establishment Name PF Account Number Date of joining Date of exit


Unexempted

NTAC:3NS-20_x000D_
For Exempted Trusts

Note: You will only be able to upload image format of your Aadhaar Card. Also, please attach a photo copy of the PAN card in the email.

NTAC:3NS-20_x000D_

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