EMPLOYMENT FORM

Full Name (As per Aadhar card): _____________________________________________________

Father/Husband’s Name: __________________________________________________________
Post Applied for: ________________________ Department: _____________________________
Interview Date: __________________________ Interview Location: _______________________
Source of hiring: HR Consultant Int. Reference
Date of Birth: ______________________ Birth Place: ______________________ Age: _________
Native Place: ___________________ Nationality: _____________ Religion: ______________
Birth Mark: ______________________________________________________________________
Mob. No: ___________________ E Mail ID: ____________________________________________
Present Address Permanent Address

Blood Group: __________ Marital Status: Married Single Separated

Marriage date: _________________ No.of Child/ren: __________PAN No: _____________________
Aadhar No: ___________________________ Passport No: ___________________________
Driving License No: ________________________ Two wheeler Four Wheeler
Emergency Contact Details: Name of Person: __________________________ Relationship: _______________________
Contact Number:
_____________________________________
Family Details:
Sr. No Name Relationship D.O.B/Age Occupation

Education Details:
Examination Specialization Full/Part Duration School/College/ Grade/ Year Of
passed Time (MM-YYYY) University Percentage Passing
SSC
HSC
Diploma
Graduation
Post
Graduation
Other
Language Known:
Proficiency
Language
Reading Writing Speaking
Is there any gap in your qualification? Yes No
If yes, please give detail & reason for gap:
___________________________________________________________________________________________________
_______________________________________________________________________________________________
Do you have any plan for further study? Yes No
Are you/Have you preparing Government Exams: Yes No
If yes, please give detail:
_________________________________________________________________________________________________
Membership of Professional Institute:
Name of Institute Type of membership & Position Held Duration of Membership
From To

Extra-Curricular Achievements: (Sports/Social & Literary activities etc.)

Activity Institute/Association Society/ Club Year Position Held Prize Won

Criminal Record:
Have you even been involved in any criminal proceeding/ convicted of any offence? If yes, Please give details

Health Record:
Height (cms) Weight (Kg.) Power of Glasses Identification Marks Physical Disabilities, If any

Most Recent From To Nature of Illness

Serious Illness

Do you or your spouse suffer from any of the following conditions/Diseases?

Diabetes High blood Pressure Other Major Illness
Cardiac Asthma
Work Experience Details (Start with current employer)
DURATION
CTC
Employer Name & Address From To Designation Reason for leaving
(ANNUAL)
DD/MM/YYYY DD/MM/YYYY
Is there any gap in your professional career? (If more than 3 months) Yes No
If yes, please give detail & reason for gap:
___________________________________________________________________________________________________
___________________________________________________________________________________________________

Current Reporting Structure (Also mention Number of reportees)

Significant Achievements: Mention some of the major contributions made by you in your present and previous
Jobs:

Detail of Current Emoluments:

EMOLUMENTS
Proposed
PARTICULARS Monthly Yearly
Remarks (to be filled by
(In Rs.) (In Rs.)
M&B Eng.)
MONTHL BASIC
Y DEARNESS ALLOWANCE OR
EMOLUM EQUIVALENT
ENTS HRA
CONVEYANCE
(Do you own a Car / any other vehicle)
CITY COMPENSATORY ALLOWANCE

EDUCATION ALLOWANCE
ANY OTHER (Please Specify)
i.
ii.
SUB TOTAL (A)
ANNUAL BONUS ( %) ON RS.
BENEFITS LEAVE TRAVEL ASSISTANCE (LTA)
ANY OTHER (Please Specify)
i.
ii.
SUB TOTAL (B)
RETIREM PROVIDENT FUND ( %)
ENT CONTRIBUTION
BENEFITS BY EMPLOYER
SUPERANNUATION
GRATUITY
SUB TOTAL (C)
VARIA SALES INCENTIVE SCHEME
BLE PERFORMANCE PAY
PAY BUSINESS PERFORMANCE LINKED
VARIABLE PAY
OTHER
SUB TOTAL (D)
GRAND TOTAL (A+B+C+D)
Expected Salary:

Annual CTC Fixed Variable

Component Component
Monthly
Yearly

Notice Period at your current organization? _______________

If selected, how soon you can join? _______________

Explain why you consider yourself suited for this position

Have you been interviewed by any of the companies under M&B Engineering Ltd? If yes, Please give Details
Month & Year Department/Position Company & Location

Is there any relative working with M&B Engineering Ltd? If yes, Please give details
Name Relationship Department/Position Company

Are you engaged in any personal Business/NGOs/Political parties? If yes, indicate nature.
___________________________________________________________________________________________________
Do you have any contact/Bond with Present Employer? If yes, mention the duration of the contact.
___________________________________________________________________________________________________
References from your previous organizations:

Sr. Name of the Person Relationship Company Designation Contact Number

1

2
 Declaration under Section 314 of companies act, as amended in 1974
(Strike out whichever is not applicable)
I hereby declare that I am not connected with any of the Directors of the company as his partner or his relative as defined
under section 6 of the companies Act 1956

Or

I hereby declare that I am a partner or relative of Mr. _________________________________ A Director of the company
as __________________________________.

I declare that the information given above is true to the best of my knowledge. I am aware that any false or incorrect
information by me may result in termination of my services with the Company. I have no objection to your inquiring
from any of my previous employers on any matters pertaining to me, if I join your Company.

Place: ___________________________

Date: ___________________________ ______________________________

Signature
For Office use only:

Designation Offered Name of Reporting

Manager
Department Offered Grade

Expected D.O.J Location

Remarks:
___________________________________________________________________________________________________
___________________________________________________________________________________________________

Name: _____________________________ Signature: ____________________________