For TeamLease Services Private Limited

04/08/2010 Authorised Signature

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pl
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RAJIV GUPTA 15/3/1953 FATHER YES

PUSPA GUPTA 23/7/1960 MOTHER YES

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Forms from page number 20 are
to be duly filled and returned
within 7 days of receipt of this kit.

19
 No.

Mobile No.: ___________________

Employee Joining Form

Employee Code: Date of Joining: Job Location: State:
D D / M M / Y Y Y Y

Instructions

1. Form should be filled in CAPITAL Letters / BLOCK letters only

2. Please fill in the application form completely and correctly (furnish correct information)
3. Avoid overwriting
4. Please fill up your personal details (Name, Address etc.) exactly as it appears on your Please paste your
5. government approved valid Photo ID / Address proof document unsigned recent colour
For effective communication with you (through calls, SMS or E-mail), we request you to passport size
6. provide us with your current E-Mail ID, Mobile and landline number photograph
Size 3.5 cm x 4.5 cm
Please Tick ( ) in the boxes provided in application form (wherever applicable)
7. In case of any questions or queries while filling up the application form or regarding the
joining documentations, please feel free to CALL US @ 60000655

Employee’s Information

Full Name (as per valid ID Proof) : ____________________ _____________________ ___________________________________

FIRST NAME MIDDLE NAME LAST NAME/SURNAME

Marital Status:
Date of birth: Gender:
D D / M M / Y Y Y Y
Married Unmarried Male Female
Others_________

Physical Disability: Yes No

Blood Group: _______________________ Nationality: ____________________
(Incase Yes, please submit certificate copy)

Phone: Mobile:
E-Mail id: ___________________________

Residential Address (Permanent Address) :___________________________________________________________________________

_____________________________________________________________________________________________________________

City: State: ZIP Code:

Communication / Mailing Address:_________________________________________________________________________________

_____________________________________________________________________________________________________________

City: State: ZIP Code:

Bank Account & PAN Account Details

Bank Account Number: __________________________________ Name of the Bank: ___________________________________

(Cancelled cheque copy with Name, Employee Code & Contact Number Bank Branch: _______________________________________
written on the face of the cheque to be submitted)

Bank Branch’s IFSC Code: (Please check with your Bank) PAN Number: (Please submit PAN Card copy):

Emergency Contact
Name of a person:
Address:
City: State: ZIP Code: Phone:
Relationship:
Family Information
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 No.

Family Information
Date of birth:
Father’s Full Name: ___________________________________________________________
D D / M M / Y Y Y Y
FIRST NAME MIDDLE NAME LAST NAME/SURNAME
Date of birth:
Mother’s Full Name: __________________________________________________________
D D / M M / Y Y Y Y
FIRST NAME MIDDLE NAME LAST NAME/SURNAME
Date of birth:
Husband/Wife’s Full Name (if Married):
__________________________________________________________ D D / M M / Y Y Y Y

FIRST NAME MIDDLE NAME LAST NAME/SURNAME

Date of birth:
Child 1 Full Name: ___________________________________________________________
D D / M M / Y Y Y Y
FIRST NAME MIDDLE NAME LAST NAME/SURNAME
Date of birth:
Child 2 Full Name: ___________________________________________________________
D D / M M / Y Y Y Y
FIRST NAME MIDDLE NAME LAST NAME/SURNAME

Educational Qualification
(Please enclose photocopies of the certificates/documents)
Education Level Degree Board/University School/College Name Year of Passing % Marks
(B.Com/B.Sc. etc.)

10 th

10+2 / PUC

Graduation

Post Graduation

Others

Work Experience
(Please detail your entire work history beginning with the current employer to your oldest employer)
Organization Name Designation when leaving From To Reason for Leaving

Language

Language 1:________________ Language 2:________________ Language 3:______________

Read: Read: Read:
Write: Write: Write:
Speak: Speak: Speak:

PLEASE READ CAREFULLY AND ACKNOWLEDGE THAT YOU UNDERSTAND AND ACCEPT THIS INFORMATION:
I _______________________________________ certify that the above statements made by me are true, complete and correct. In case of the
company finds at any time that the information given by me in this form is not correct, true or complete, the company will have the right to withdraw
my letter of appointment or to terminate my appointment at any time without notice or compensation. I hereby acknowledge that I have gone through
the Service Rules, understood & accepted the same.

Signature of the employee: Date: Place:

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Document Check List to be submitted along with your Employee Joining form
** Photocopies of all the documents that are be attached as enclosures along with “Employee Joining Form”
DOCUMENTS REQUIRED (Mandatory) Boxes to be Verified by
checked by TeamLease on
the employee collection of
at the time of documents
submission
1. Updated resume / Curriculum Vitae (C.V.) Y N Y N
2. 3 additional Passport size photographs (Self) with Employee Code & Full name written on the
reverse Y N Y N

3. 1 Postcard size photograph (Family) with Employee Code & Full name written on the reverse Y N Y N
4. 1 cancelled cheque leaf (Original) with Full Name, Employee Code, Phone/Mobile number,
Y N Y N
Bank IFSC code written on the face of the cheque
5. PAN Card Copy (Self Attested) with Full Name, Employee Code, Phone/Mobile number, Y N Y N
6. Proof of Address & Photo Identification Proof - Voter’s ID Card or Driving License or Passport
Y N Y N
Copy
7. Provident Fund Nomination & Declaration Form (Form 2) duly filled
Y N Y N
**pre -filled Sample copy enclosed
8. Gratuity Nomination Form (Form F) duly filled * pre-filled sample copy enclosed Y N Y N
9. Signed Acknowledged copy of the Offer Letter / Appointment letter Y N Y N
10. Previous Employer Relieving & Experience Letter Y N Y N
11. Photocopy of all Educational Certificates as mentioned in the section “ Educational
Qualification ” in the Employee Joining form Y N Y N

12. In case the applicant is Physically challenged, submit the certificate issued by the appropriate
Y N Y N
authority

13. (a) If ESI applicable, submit ESI Declaration Form (Form 1) duly filled with
1 Post Card size Family Photographs pasted on the form Y N Y N
**pre -Filled Sample copy enclosed
(b) Or else if falling under income tax bracket kindly submit the income tax/investment
declaration form duly filled in (if applicable) Y N Y N

For TeamLease Office use only

Client ID:
Client Name:_______________________________________________________________________________

Date of Receipt of the documents at the Local Office

Document Received by (Full Name):_______________________________
D D / M M / Y Y Y Y

Date of Receipt of the documents at Bangalore Office

Document Received by (Full Name):_______________________________
D D / M M / Y Y Y Y

Date sent to Docushare at Bangalore Office

Document Scanned by (Full Name):_______________________________
D D / M M / Y Y Y Y

Document Details updated on ALCS

D D / M M / Y Y Y Y Updated by (Full Name):_______________________________

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 Date of Joining:_______________ No.
Employee Code: _______________
Mobile No.: ___________________

THE EMPLOYEES PROVIDENT FUND ORGANISATION

NOMINATION AND DECLARATION FORM Form No. 2 (Revised)

FOR UNEXEMPTED / EXEMPTED ESTABLISHMENTS

Declaration Nomination Form under the Employee’ s Provident Fund and Employee’ s Pension Scheme

Employee’s Pension Scheme, 1995)

1. Name (in Block Letters) ............................................. 6. Account No. KN/BN : KN/35224

2. Father’s/Husband’s Name 7. Permanent Address :

(In case of married woman) ......................................

3. Date of Birth ...............................................................

Temporary Address :
4. Sex : .......................Male Female

5. Marital Status. .............................................................

PART-A (EPF)

I hereby nominate the person(s)/cancel the nomination made by me previously and nominated the person(s),
mentioned below to receive the amount standing to my credit in the Employees’ Provident Fund, in the event of my death.

If the nominee is a minor,

Nominee’s Total Amount or share Name, relationship and address
Relationship Date of of accumulation in
Name & Addresss of Nominee/s of the guardian who may
with the Birth Provident Fund to be recieve the amount during the
member Paid to Each Nominee minority of nominee

1 2 3 4 5

1. Employees’

2. *Certified that my father/mother is / are dependent upon me.

x
* Strikeout whichever is not applicable. Signature or thumb impression of the subscriber

FOR OFFICE USE ONLY

Dt. of Joining E.P.F. / /20 ENTRIES VERIFIED

Past Serivce____________Year

Date of Joining EPS / /20 D.A. S.S. A.A.O.

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 PART-B (EPS) PARA 18

Pension in the event of my death.

SI.
Name of the Family Member Address Date of Birth Relationship with member
No.
1 2 3 4 5

**
family hereafter I shall furnish particulars thereon in the above form.

of my death without leaving any eligibel family member for receiving pension.

Name & Address of the Nominee Date of Birth Relationship with member

Date
x
* Strike out whichever is not applicable Signature or thumb impression of the subscriber

CERTIFIED BY EMPLOYER

by him/her.

Signature of the employer or other authorised Officers of the Establishments

TeamLease Services Pvt. Ltd.
No. 27, 3rd ‘A’ C Cross, 18th Main, For TeamLease Services Pvt. Ltd.
Grape Garden, 6th Block,
Koramangala, Bangalore - 560 095.
Designation Authorised Signatory

Date :..............................................

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 Employee Code: _______________ No.
Mobile No.: ___________________

THE PAYMENT OF GRATUITY (CENTRAL RULES, 1972)

STATEMENT
1. Name of employee in full :

2. Sex :

3. Religion :

4. Whether unmarried / married / widow / widower :

5. Department / Branch / Section where employed :

6. Post held with Ticket or Serial No., if any :

7. Date of appointment :

8. Permanent address :

Village ............................................. Thana .................................................. Sub-division...........................................

Post Office ...................................... District.................................................. State......................................................

Place :........................................... x
Signature / Thumb-impression
Date :............................................ of the employee

DECLARATION BY WITNESSES

Nomination signed / thumb impressed before me

Name in full and full address of witness Signature of witness

1. 1. x

2. 2. x
Place :...........................................

Date :............................................

Certificate by the Employer

Certified that the particulars of the above nomination have been verified and recorded in this establishment.
Employer’s Reference No., if any. For TeamLease Services Pvt. Ltd.,
TeamLease Services Pvt. Ltd.,
#27, 3rd “A” Cross, 18th Main, Authorised Signatory
Grape Garden, 6th Block, signature of the employer / officer authorised
Koramangala, Bangalore - 560095.
Designation - HR
Date :........................................ Name and address of the establishment or rubber stamp thereof

Acknowledgment by the Employee

Received the duplicate copy of nomination in Form ‘F’ filed by me and duly certified by the employer.

x
Date :....................................................... Signature of the employee
Note : Strike out the words / paragraphs not applicable.

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 Employee Code: _______________
Mobile No.: ___________________

THE PAYMENT OF GRATUITY (CENTRAL) RULES, 1972

FORM F
(See Sub-rule (1) Of Rule 6)
T
o
NOMINATION

1. Shri/ Shrimati / Kumari (Name in full here) .......................................................................................................................

.....................................................................................................................................................................................whose
particulars are given in the statement below, hereby nominate the person(s) mentioned below to receive the gratuity payable after my
death as also the gratuity standing to my credit in the event of my death before that amount has become payable or having become
payable has not been paid and direct that the said amount of gratuity shall be paid in proportion indicate against the name(s) of the
nominee(s).

2. I hereby certify that the person(s) mentioned is a/are member(s) of my family within the meaning of clause(h) of Section 2 of
the Payment of Gratuity Act, 1972.

3. I hereby declare that I have no family within the meaning of clause(h) of Section 2 of the said Act.

4. (a) My father / mother / parents is / are not dependent on me.

(b) My husband’s father / mother / parents is / are not dependent on my husband.

5. I have excluded my husband from my family by a notice dated the. ................................................................................

to the controlling Authority in terms of the proviso to clause(h) of Section 2 of the said Act.

6. Nomination made herein invalidates my previous nomination.

NOMINEE(S)
Name in full with Proportion by
Relationship with Age of nominee
full address of which the gratuity
the Employee
nominee(s) Will be shared
1 2 3 4

1.

2.

3.

4.

So on

Give here name or description of the establishment with full address.

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 Employee Code: _______________ No.
Mobile No.: ___________________

(FORM - 1)
ESIC DECLARATION FORM

TeamLease Services Private Limited

4.
D D / M M / Y Y Y Y

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 For TeamLease Services Private Limited
x

Authorised Signature

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