Bio Data Form Officer HR RFCL 062018

RAMAGUNDAM FERTILIZERS AND CHEMICALS LIMITED NATIONAL FERTILIZERS LIMITED
4TH FLOOR, MOHTA BUILDING, A-11, SECTOR -24, NOIDA - 201301

4, BHIKAJI CAMA PALACE, DISTT. GAUTAM BUDH NAGAR, U.P.
NEW DELHI - 110066, PHONE: 0120-2412294, 2412445,
PHONE: 011-26701400, FAX: 011-26180729 FAX: 0120-2412397
RAMAGUNDAM FERTILIZERS AND CHEMICALS LIMITED

APPLICATION FOR RECRUITMENT OF ___________________
ADVT. NO. 02(RFCL)/2018 DATED 11.04.2018
Are you employed in Govt. / Semi Govt. / Public

Sector Undertaking / Govt. Department?
Affix one
passport size
Has your application come through proper channel? photograph
here
If not, have you produced No Objection Certificate?
ALL ENTRIES TO BE MADE IN CAPITAL BLOCK LETTERS

SURNAME FIRST NAME MIDDLE NAME
1. Name in full (in block letters) with aliases,
if any, (Please indicate if you have added
or dropped at any stage any part of your
name or surname)
2. Date of Birth/Age as on 30.04.2018 Day Month Year Age
3. Present Correspondence Address

(to which communications are to be
addressed)
Mobile No.
Email ID
4. Permanent home address
5. State to which you belong:
6. (a) Identification marks
(b) Height & weight

Height Weight
7. Whether you belong to SC/ST/OBC
community or an Ex-
serviceman/dependent of a jawan killed/
severely disabled in action or are person
with disability. If the answer is 'Yes', state
the name of the caste/particulars.
8. Marital status (bachelor / spinster /
married / widow / widower / divorcee).
9. State your nationality and religion.
10. Do you have any dependent? If so, state
number of dependents, their relationship
with you.
11. Father’s / Husband's name
12. Are you related to any of the present

Director of the Company? If yes, state the
name and relationship.
13. Are you related to any of our present
employees? If yes, please furnish the
details
14. Languages Known: READ WRITE SPEAK
15. If ever engaged in Defence Services, give

details of rank, emoluments, functions
performed etc.
16. Are you a Govt. Pensioner? If yes, state

the amount of your monthly pension and
last pay drawn.
17. Have you ever been arrested /
prosecuted / bound down / kept under
detention or convicted, fined by a court of
law or debarred from any examination or
rusticated by any University or FIR filed
by police against you? If yes, give full
particulars of the case.
18. Have you ever been discharged /
removed from service? If yes, give
details.
19. Are you in debt? If yes, state the sources
from which you can repay.
20. State the hereditary/chronic diseases /
physical handicap, if any.
21. How do you consider yourself suitable for
the position (Attach separate sheet of not
more than one page, if necessary).
22. Any other details you wish to furnish

(attach separate sheet, if necessary).
23. Educational qualification & professional

training, if any, please give details of your
educational qualification & professional
training in Annexure I.
24. Achievements / Distinction in sports /
extracurricular and other activities.
25. Technical/ Professional Publications/

Thesis.
26. Work Experience: (Please give details of
your experience in the proforma attached
as Annexure II)
27. Particulars of awards/ outstanding
contributions made/ appreciation letters/
punishments, etc. during service may be
given.
28. If selected, what notice do you need to

join?
29. Are you presently employed in

Govt./Public Sector Undertaking/Joint
Sector/ Private Sector?
30. Have you worked in the company before,
if 'yes' when and how long.
31. Have you ever applied before to this

company? If 'yes' when and for which
post?
32. Have you been interviewed before by this

company? If 'yes' when and for which
post? Result of interview may be
indicated. In case offer of appointment
received that may also be specifically
indicated.
33. Permanent Account Number (PAN):
34. AADHAAR No.:
35. Universal Account Number (UAN):
36. List three personal references:
Name Address & Contact No. Occupation Years Known
(a)
(b)
(c)
With reference to Advt. No. 02(RFCL)/2018 dated 11.04.2018 and my online application, I hereby
declare that the above particulars furnished by me are true to the best of my knowledge and belief.
If appointed, I agree to be governed by the rules and regulations of the Ramagundam Fertilizers
and Chemicals Limited (RFCL) framed/ modified from time to time. I know that if any information
given here is found to be wrong or incomplete or any facts, etc. are found to have been suppressed
or concealed by me, my service is liable to be summarily terminated at any point of time.
Date Signature of the applicant

Annexure-I
STATEMENT INDICATING THE DETAILS OF EDUCATIONAL QUALIFICATION AND

PROFESSIONAL TRAINING OF THE APPLICANT
A-EDUCATIONAL QUALIFICATION
Period Name & address of the Examination University/ Subjects Division %age of Remarks
From To School/College attended Passed Board taken marks
B- PROFESSIONAL TRAINING
Period Name & Address of the Course Examination Sponsored by Division % age of Remarks
From To Institution contents Passed marks
(Signature of the Candidate)

Annexure-II
STATEMENT INDICATING THE DETAILS OF EXPERIENCE IN RESPECT OF
THE APPLICANT
Name & Post Held Period Salary Details Duties Reasons for leaving
Address of From To Total Scale Basic Pay DA Other performed (specifically
the Perks indicating the
employer circumstances
under which you
have resigned from
the previous post or
whether your
services were
terminated).
I hereby certify that the contents/ information supplied above are true.
(Signature of the Candidate)

Bio Data Form Officer HR RFCL 062018

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RAMAGUNDAM FERTILIZERS AND CHEMICALS LIMITED NATIONAL FERTILIZERS LIMITED

4TH FLOOR, MOHTA BUILDING, A-11, SECTOR -24, NOIDA - 201301

RAMAGUNDAM FERTILIZERS AND CHEMICALS LIMITED

ADVT. NO. 02(RFCL)/2018 DATED 11.04.2018

Are you employed in Govt. / Semi Govt. / Public

ALL ENTRIES TO BE MADE IN CAPITAL BLOCK LETTERS

3. Present Correspondence Address

5. State to which you belong:

6. (a) Identification marks

(b) Height & weight

11. Father’s / Husband's name

12. Are you related to any of the present

14. Languages Known: READ WRITE SPEAK

15. If ever engaged in Defence Services, give

16. Are you a Govt. Pensioner? If yes, state

22. Any other details you wish to furnish

23. Educational qualification & professional

25. Technical/ Professional Publications/

28. If selected, what notice do you need to

29. Are you presently employed in

31. Have you ever applied before to this

32. Have you been interviewed before by this

Name Address & Contact No. Occupation Years Known

Date Signature of the applicant

STATEMENT INDICATING THE DETAILS OF EDUCATIONAL QUALIFICATION AND

(Signature of the Candidate)

(Signature of the Candidate)

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