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Confidential

Ill
INDIAJAPAN LIGHTING PRIVATE LTD.
No.1, TIRUVALLUR HIGH ROAD, P UDHUCHAT HIRAM (PO),THIRUMAZHISAI(V I A),
CHENNAI,TAMILNADU,PI NCODE-600124

APPLICATION FOR EMPLOYMENT


*Tobe filledby candidate in his own handwriting.
*Use additional paper wherever required

POSITION A PPLIED FOR

PERSONAL DATA
Name in full
(inblock letters)

Date ofbirth
I 1 _1 _I_I _I _I _I __
I __ I _1_1 RECENT
PHOTO
Age
I I I '

(Age in Completed years)

Father's Name

Occupation

Address For Communication Pennanent

PIN:....................................................... PIN: .....................................................


Tel No. .................................................... Tel No. .................................................
Place of birth ................................................................. Religion : ..........................................................
State:

□ □ □ □
MARITAL STATUS:

SINGLE MARRIED WIDOWER DIVORCEE

Spouse Name: _________________ Date of Birth: ________

Children: Male D Female D


SI.No. Name of Children Sex Date of Birth Education

Details and location of Property Owned / Business Connections if any


languages Known

1 SPEAK 0 READ 0 WRITE 0 2 SPEAK 0 READ 0 WRITE D

3 SPEAK DREAD D WRITE D 4 SPEAK 0 READ D WRITE D

FAMILY BACKGROUND: (Full details of your family members including those who may not be staying with you)

Name Relationship Age Education Occupation Organisation

PHYSICAL DATA

Height Cms Weight: Kgs

Identification Marks: 1 Wear


Glasses DYes o No

Do you have any physical disability DYes D No Describe briefly

Serious iIInessor operation DYes D No

EDUCATION & TRAINING (Start with highest qualification)


Year
Exam. Passed Class / Marks University College / School Principal Subjects Taken
From To

Professional/Apprenticeship / Special training


Month & Year
Details Organisation
From To
EXTRA - CURRICULAR ACTIVITIES

Sports / Games / Hobbies Professional/Service / Club Membership

PRESENT EMPLOYMENT

Name of the Organisation


Address
Nature of Business
Date of Joining
Designation when joined
I
Present Designation

PLEASE OUTLINE YOUR JOB RESPONSIBILITIES

PLEASE DRAW AN ORGANISATION CHART INDICATING YOUR REPORTING RELATIONSHIP


ON A SEPARATE SHEET ONLY.

Note: Please attach a separate sheet if required to highlight career growth


-,

PRESENT REMUNERATION DETAILS

A. Monthly Salary Rs. B. Annual Benefits Rs.

Salary L.T.A.

DAFixed Bonus

Variable Ex-gratia

Additional DA Others

Total P.A.
HRA

Conveyance
C. Medical

Reimbursement
Education Allowance
I Insurance
Special Allowance
D. Statutory Benefits
Others
E.S.I. Ves 0 No 0
P.F. Ves 0 No 0
Total Per Month
Superannuation Yes 0 No 0

SUMMARY OF PAST EXPERIENCE:

Month & Vear


Total Monthly
Organisation with Address No. of Designation Salary
From To (Rs.)
Years
I

Minimum Salary Expected Monthly Rs. \ Indicate joining time if selected


-
GENERAL DATA
Have you been previously employed I interviewed by this company? If SO
Position Date of interview Result

Whom do you know in our Company ?


Who referred you to us ?

Any of your any relatives working with us presently or worked previously? If so, give details
CC No. Name Relationship Organisation Dept Designation

'

Were you involved in any criminal offence ? If so, give details

REFERENCES (Non Relatives)


1. Name: 2. Name:
Address: Address:

Pin: Pin:
Tel. No.: Tel. No.:

ANY OTHER INFORMATION YOU WISH TO FURNISH FOR CONSIDERING YOUR APPLICATION

DECLARATION
I hereby decalre that the above particulars furnished by me are true to the best of my knowledge and belief.
These will form the basis of contract of employment if I am employed by Indian Japan Lighting Ltd. If at a
later date any of the particulars furnished herein are found untrue or incorrect, the Company will have the right

.
to terminate my services without notice or compensation. I understand that my appointment in the company's
service will be subject to my fitness in the medical examination by the company's doctor or a medical practitioner
.
appointed by the company.

Place: Date: Signature:

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