VEHICLE REGISTRTION APPLICATION FORM (CONTRACTOR)

Note1. Use black or blue ball point pen only. Do not fill the application form with ink-pen or pencil.
Note2. Use capital letter
New Renew Yes
PERSIONAL DEATAILS
1 NAME SHAKIL AHAMAD
2 DESIGNAT DRIVER
3 Bio-MetricA000116572
4 COMPANYNANDI ENGINEERING WORKS
5 DEPARTMEWRM
6 MOBILE 9E+09
7 LOCATION TORANAGALLU
8 E MAIL ID nandi.engineeringworks764@gmail.com
VECHILE DEATAILS
1 VECHILE T FOUR WHEELER
2 VECHILE MTATA ACE MAGA XL BS IV
3 VECHILE NKA 33 A 8665
4 RC NO. RSA4635940
INSURANCE DETAILS
1 POLICY NO TAQ1047815
2 ISSUING D ###

Attachment-1.Rc 2. Insurance 3. Driving license 4. Gate pass 5. Vechile pass Requestion oncopany letter head
Persional Bond By Individual
I here by decalare and undertake that
1 I am entering the jsw permisesat my own risk
During the course of my stay in company permises.lshaa l not hold company responsible for any accident
2 /injur un towards incident occurred to me and belongings
3 I shall not claim any damages from jsw on any account.
4 I shall abide by all traffic rules and visit only permited/specific area.

SECURITY DEPARTMENT INDVIDUAL

opany letter head

or any accident
To,
The Security Officer,
JSW Steel Ltd,
Vidyanagar,
Toranagallu, Bellary.

Sub: Requesting to Renewaling of Vehicle Gate Pass.

Dear Sir,

With Respect to above the subject, we requesting to Re-newling the vehicle

gate pass. So kindly please do needfull for me.
VEHICLE TYPE:- FOUR WHEELER
VEHICLE NO:- KA.33 M 4541

Thanking you,

Yours Faithfully

For NANDI Engineering works

To,
The Security Officer,
JSW Steel Ltd,
Vidyanagar,
Toranagallu, Bellary.

Sub: Requesting to Re-Issuing of Bio-Metric Card

Dear Sir,

With respect to above the subject, Mr. MAHAMMAD GOUSE is working in our Orgnization. his Bio-
metric Card is missing. Requesting you to Reissue the bio-metric card.
So kindly please do needfull for me.
Sl NO Name Card No Dept: ESIC NO ACCOUNT NO.
1 MAHAMMAD GOUSE A000061223 BRM#2 :7117973055 :7722500102646101
P.O.No:- 4500063386 Exp Date:- 31/3/2018

Yours Faithfully

For NANDI ENGINEERING WORKS

ing in our Orgnization. his Bio-
d.

UAN No.
:101074738038