Emp ID @Emp_Name Emp_Email ID

406 T VENKATAKRISHNA SHARMA krishnavenkat983@gmail.com

PF Account No @Emp_Sex Emp_Branch @Emp_Department @Emp_Designation
MALE MANAGEMENT TRAINEE
Emp_Type Emp_Bank @Emp_SBAccNo @Emp_PAN @Emp_DateJoin Emp_Marital Status
ICICI 4801631877 05-02-2018 SINGLE
Emp_Date of Birth Emp_Blood Group Emp_Father's Name Emp_Spouse Name Emp_Mobile No
19/11/95 B +VE T SRINIVASA SHARMA - 9705178471
 Employee Present Address
01, GULREZ APARTMENTS,RAJBHAVAN ROAD, NISHAT BAGH COLONY,SOMAJIGUDA,HYDERABAD 500082
 Employee Permanent Address Employee_Qualification ESI NO
EAR SRI RAMA TEMPLE,ALAMKHANIPET(VILL),NEKKONDA(MDL), WARANGAL(DIST),506112
M.B.A
 NEW ESI PERSONS TO ADD

Details of the

Date of
S.No Insured Person Name Date of Birth Sex Marital Status
Appointment

1 T VENKATAKRISHNA SHARMA 19/11/95 05/02/18 MALE SINGLE

 Details of the employee
Telephone No
(Mobile or Land
Name of Parent/Spouse Line)

T SRINIVASA SHARMA 9705178471

 Address (Pin code & district are required) (Please fill in the local address you are
Nomination
residing)

NO.101,GULREZ APARTMENTS,RAJBHAVAN ROAD, NISHAT BAGH COLONY SOMAJIGUDA, HYDERABAD,500082

 Details of the Nominee Details relatin

Date of Birth (Mandatory

Relation Address (Pin Code is required) S.No.
Field)

1
Details relating to Family (Only parents are treated as dependent)

Date of Birth (Mandatory

Name Relation Residing with
Field)
 Details of Bank Account

Bank Account No Name of the Bank Branch

Emp Name Date of Joining UAN Previous Employer PF Date of Birth Father's Name
Education Qualification Marital status Aadhar Card NumberName as per Aadhar Card Date of Birth as per Aadhar
PAN Name as per PAN Bank Account IFS Code Name as per the Bank