HR PERSONAL PARTICULARS FORM

FOR OFFICE USE ONLY: (TO BE COMPLETED BY HRBP EMPLOYER)

NEW EMPLOYEE NUMBER STARTING DATE:
POSITION TITLE SAP CONSULTANT
CTC CELLPHONE
05 09 27 28 29 26 34 35
TYPE OF EMPLOYMENT FUEL ALLOWANCE/CARD
X
COST CENTRE 507C100500 IPAD
CONTRACT FROM CONTRACT TO
POSITION NUMBER ORG UNIT 2123
PREVIOUS EMPLOYER NO 10025497 CLIENT ACCOUNT
SUB DEPARTMENT SUB PORTFOLIO
MANAGER JULIA DE VRIES POSTAL POINT
HR BUSINESS PARTNER BUSINESS ADMINISTRATOR GEROLENE UNGERER

TIMESHEET EMPLOYEE YES NO X

IM CATEGORY: CUSTOMER BASED X IM CATEGORY: OFFICE BASED IM CATEGORY: ROAMING
PLEASE NOTE: THIS FORM MUST BE COMPLETED COMPREHENSIVELY BEFORE YOU CAN BE REGISTERED INTO THE GIJIMA HUMAN
RESOURCES DATABASE

SECTION 1: NEW EMPLOYEE PERSONAL CONTACT DETAILS – provide Copy of your ID document (TO BE COMPLETED BY
EMPLOYEE)

1(A): NEW EMPLOYEE PERSONAL DETAILS

Mr/Mrs/Dr/Other: Mr Full Names Luis Manuel
Known As Louis Initials LM
Surname Da Silva Maiden Name NA
Nationality SA Birth Date 1958.03.08
Identity Number: 580085030080
Place of Origin (i.e. where were you born/ grew up and/or did your schooling?) Vereeniging

*NOTE: REQUIRED FOR THE PURPOSE OF REPORTING DEMOGRAPHICS TO GOVERNMENT

*Disability Yes No X *Specify Disability NA
Coloure
*Gender Male X Female *Ethnic Origin Asian African White X Other
d
Marital Status Single X Married Divorced Widowed
No Name & Surname Date of Birth

1. NA / /
Children 2. / /
3. / /
4. / /

1(B): CONTACT DETAILS (TO BE COMPLETED BY EMPLOYEE)

HOME ADDRESS POSTAL ADDRESS (IF SAME AS HOME ADDRESS, INDICATE AS SUCH)
Unit Number & Name 3 ORWELL PLACE 3 ORWELL PLACE
PO Box Number / Suite No
Street Number And Name ORWELL DRIVE ORWELL DRIVE

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Suburb / Area THREE RIVERS Suburb / Area THREE RIVERS
City VEREENIGING City VEREENIGING
Postal Code 1929 Postal Code 1929
Home Telephone Number ( )NA Cellular Number 0833045786

1(C): HEALTH INFORMATION: PLEASE SPECIFY ANY CHRONIC ILLNESS OR ALLERGY (TO BE COMPLETED BY EMPLOYEE)
ASTHMA

PLEASE PROVIDE INFORMATION / OR INSTRUCTION THAT IS ESSENTIAL WHEN AN EMERGENCY OCCURS

1(D): FAMILY / RELATED PERSON CONTACT DETAILS (TO BE COMPLETED BY EMPLOYEE)

Full Names Maria Elena Known As Name Lena
Surname Da Raquel Initials ME
Birth date 1956.12.04 Relationship Sister
Gender Male Female X Employer Pensioner
Contact information
Home Telephone Number NA 3 Rosa Teresa Villas
Physical Home Address
Work Telephone Number NA Gen Hertzog Road, Three Rivers
Cellular Number 0832890206 City Vereeniging
E-mail Address Postal Code 1929

1(E): ADDITIONAL FAMILY DETAILS (TO BE COMPLETED BY EMPLOYEE)

Are any of your immediate family members employed by Gijima? Yes No X

If Yes, State full names of family member NA

State relationship with family member (e.g. spouse / brother etc.) NA

SECTION 2: BANKING AND PERSONAL TAX INFORMATION

2(A): BANKING INFORMATION - provide bank statement or letter, not older than 3 months (TO BE COMPLETED BY EMPLOYEE)
Account Holder Name LUIS MANUEL DAV SILVA Own X 3rd Party* Joint Account*
*Please provide additional information
Bank Name ABSA BANK Branch Name VEREENIGING
Account Number 480261712 Branch Code 632005
Type of Account Cheque X Savings Transmission Bond Subscription Share

2(B): TAX INFORMATION - It is your own responsibility to register as a taxpayer (TO BE COMPLETED BY EMPLOYEE)
Tax Reference Number 0306104688 Tax Office VEREENIGING

SECTION 4: HISTORY AND SKILLS (please attach certified copies of mentioned qualifications)
4(A): LIST HIGHEST FORMAL QUALIFICATIONS – e.g. MBA Degree, Grade 12 (TO BE COMPLETED BY EMPLOYEE)
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Qualification Name Higher Diploma in Cost and Institution Vaal Triangle University of
Management accounting Technology
Start date 1983.01.01 End Date 1984.12.01

Qualification Name Diploma in Cost and Institution Vaal Triangle University of

Management accounting Technology
Start date 1980.01.01 End Date 1982.12.01

4(B): LIST ANY MAIN ACQUIRED SKILLS – e.g. Java programming, Clipper, etc. (TO BE COMPLETED BY EMPLOYEE)
Skill Name Acquired from date Company / Position
1)SAP Academy, Certification of SAP Controlling 2013.05.31 AMSA Snr Analyst Plan and Manage Finance
2)SAP Implementations, upgrades, Migrations and Consolidations 1997.09.01 AMSA Snr Analyst Plan and Manage Finance
3)
4)
5)

4(C): PRIOR EMPLOYMENT HISTORY (TO BE COMPLETED BY EMPLOYEE)

Employer AMSA Industry Steel
Occupation Snr Analyst, SAP Plan and Manage Finance
Start Date 1.12.1980 End Date 31.07.2020

I hereby acknowledge that all the information provided in this HR Personal Particulars form is correct:

LUIS DA SILVA
Employee (Name & Surname) Signature Date

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