Gender Blood Group Nationality INDIAN Date of Birth DD - MM - YY Marital Status Father's Name Father's Occupation Passport Number, If any Driving License number, If Any
Mobile Number Landline Number E mail ID - 1 E mail ID - 2
** WORK EXPERIENCE Please list your employment history starting with most recent position. Include any periods in which you were not employed and explain what you were doing during that time. Please complete all appropriate items, even if you have provided us with a resume. All information provided is liable for verification.
EMPLOYER (COMPANY NAME) COMPANY WEBSITE EMPLOYEE ID EMPLOYMENT PERIOD FROM TO DESIGNATION HELD REPORTING/HR MANAGER NAME & CONTACT DETAILS EXPLAIN THE REASON(S) FOR LEAVING THE JOB
EMPLOYER (COMPANY NAME) COMPANY WEBSITE EMPLOYEE ID EMPLOYMENT PERIOD FROM TO DESIGNATION HELD REPORTING/HR MANAGER NAME & CONTACT DETAILS EXPLAIN THE REASON(S) FOR LEAVING THE JOB
EMPLOYER (COMPANY NAME) COMPANY WEBSITE EMPLOYEE ID EMPLOYMENT PERIOD FROM TO DESIGNATION HELD REPORTING/HR MANAGER NAME & CONTACT DETAILS EXPLAIN THE REASON(S) FOR LEAVING THE JOB
Please provide details if you have been into contractual employment earlier.
** REFERRENCES Name three persons, not related to you, who are in a position to evaluate your Employment and Conduct preferably former reporting managers or people with whom you have worked.
1. NAME TELEPHONE NO E MAIL ID
ADDRESS OCCUPATION RELATIONSHIP WITH YOU
1. NAME TELEPHONE NO E MAIL ID
ADDRESS OCCUPATION RELATIONSHIP WITH YOU
1. NAME TELEPHONE NO E MAIL ID
ADDRESS OCCUPATION RELATIONSHIP WITH YOU
APPLICANTS STATEMENT
I certify that the information provided by me in this application and resume is complete, true and correct. I hereby authorize Magna Infotech or its agents / clients to investigate and verify the information contained in this application and / or resume. I understand that any falsification, misstatements or omission of vital information by me in connection with this application may disqualify me from employment consideration.
I understand that employment with Magna Infotech is at the mutual consent of the employee and the Company and is for specified terms and conditions.
I have read and understood the foregoing statements and accept them as conditions of employment.
NAME
LOCATION HYDERABAD
DATE SIGNATURE
Page 6 Form - 2 Revised A/C. Group No NOMINATION & DECLARATION FORM FOR UNEXEMPTED/EXEMPTED ESTABLISHMENTS
Declaration and Nomination form under the Employees Provident funds & Employees pension scheme *Paragraph 33 & 61(1) of the Employees Provident Fund Scheme, 1952 & Paragraph 18 of the Employees Pension Scheme, 1995]
1. Name (IN BLOCK LETTERS) :
2. Name of the Parent/Spouse : 3. Date Of Birth : 7. Address
Permanent
4. Sex :
Temporary
5. Marital Status
6. PF Account Number
:
:AP/
Date of joining the fund
PART A (EPF) I hereby nominate the person(s) cancel the nomination made by me previously & nominate 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 Total amount of minor, Name & share of address of the Nominee's accumulations in guardian who may Name of the relationship provident fund to receive the amount Nominee/ with the Date of be paid to each during the minority Nominees Address member Birth nominee of nominee 1 2 3 4 5 6
1.* Certified that I have no family as defined in Para. 2(g) of the employees Provident Fund Scheme, 1952 and should I acquire a family hereafter, the above nomination should be deemed as cancelled. 2. * Certified that my father / mother is / are dependent upon me.
Signature or thumb Impression *Strike out whichever is not applicable of the subscriber Page 7 PART-B (EPS) (Para 18) I hereby furnish below particulars of the members of my family who would be eligible to receive widow /children Pension in the event of my death.
Name & Address of the Family Member Relationship with
SL NO Name Address Date Of Birth Menber
1 2 3 4 5
1. ** Certified that I have no family as defined in Para 2(vii) of the Employees Pension Scheme, 1995 and should I acquire a family hereafter I shall furnish particulars thereon in the above form.
I hereby nominate the following person for receiving the monthly widow pension admissible under Para 16-2(a) (i) & (ii) in the event of my death without leaving any eligible family member for receiving pension.
Name & Address of the Nominee Date Of Birth Relationship with Member
Date Signature or Thumb impression of the subscriber
** Strike out whichever is not applicable
CERTIFICATE BY EMPLOYER
Certified that the above declaration has been signed / thumb impressed before me by Shri / Smt. / Kum.______________________________________________________________________ employed in my establishment after he/she has read the entries / entries have been read over to him/her by me and got confirmed by him/her.
Place Signature of the employer or other authorized
Officers of the establishment
Dated: Designation Name & Address of Factroy/Establishment & Rubber stamp thereof.
Page 8
FORM 11 (REVISED) Employee Code:_____ Mandatory THE EMPLOYEES PROVIDENT FUNDS SCHEME, 1952 (Paragraph 34) AND THE EMPLOYEES' PENSION SCHEME, 1995 (Paragraph 24) Declaration by a person taking up employment in an establishment in which the Employees Provident Funds & Employees Pension Scheme enforce I _______________________________________ Son/ wife/ daughter of*Sh.__________________________ (Name of Employee) do hereby solemnly declare that :- (A) I was employed in M/s ___________________________________________________________________
(Name and Full Address of the immediate previous employer) and left service on __________________________________________ prior to that, I was employed in (Date of leaving with immediate previous employer) __________________________________________ from ____________________ to_________________ (Name and Full Address of the second last employer, if any (Date of joining & leaving with second last employer, if any) (B) I was member of ______________________________________________________________________
(Name of PF Trust / Address of PF Office of immediate previous employer ) Provident Fund and also/but not* of the Pension Fund from_________________to________________ (Date of joining & leaving with immediate previous employer). and my account number (s) was/were______________________________________________________ (PF No. with Establishment Code of immediate previous employer)
(C) I have / have not* withdrawn the amount of my Provident Fund/Pension Fund. (D) I have / have not*drawn any superannuation benefits in respect of my past service from any
employer. (E) I have / have never* been a member of any Provident Fund and/or Pension Fund. (F) (G)
(H) Scheme certificate surrendered / not surrendered*. *Strike out whichever is not applicable.
Date (Date of joining of employee) Signature or left hand thumb impression of the employee
Shri/Smt. ________________________________________is appointed as ___________________________ (Name of Employee) (Designation with Co.)in M/s ___________________________________________ with effect from ___________________________ (Name of the present employer ) (Date of appointment)
P.F. Account Number_________________________________________ (PF No. with Estt. Code of present employer)
Date ___________________________ _______________________________________ (Date of joining of employee) Signature of the Employer/Manager or Other Authorised Officer with Office Seal
Page 9
I am a holder / not holder* of scheme Certificate.
I am drawing / not drawing* Pension under EPS 95. FORM 1 NOMINATION AND DECLARATION FORM [See Rule 3] Payment of Wages Act
1. Name of the person making nominations (in block letters)
3. Date of Birth ........................................................................................................................................................
4. Sex ...........................................................................................................................................................................
I hereby nominate the person (S)/Cancel the nomination made by me previously and nominate the person(S) mentioned below to receive any amount due to me from the employer, in the event of my death.
If the nominee is Total amount of minor, Name & share of address of the Nominee's accumulations in guardian who may Name of the relationship provident fund to receive the amount Nominee/ with the Date of be paid to each during the minority Nominees Address member Birth nominee of nominee 1 2 3 4 5 6
1. Certified that I have no Family and should acquire a family hereafter, the above nomination shall be deemed as cancelled. 2. * Certified that my father/mother is/are dependent upon me. 3. *Strike out whichever is not applicable.
Signature or thumb impression of the Employed person
Page 10
CERTIFICATE BY EMPLOYER
Certified that the declaration and nomination has been signed/thumb impressed before me by sri/smt /kum Employed in my establishment after he/she has read the entry/entries have been read over to him/her by me and got confirmed by him/her.
Signature of the employer or other authorized Officer of the establishment and Designation
Place: Hyderabad Date:
Name and Address of the Factory/ Establishment and rubber stamp thereof Magna Infotech Ltd 10-2-289, Plot No. 79 Shanti Nagar Hyderabad
Page 11 EMPLOYEES STATE INSURANCE CORPORATION FORM - 1 To be filled in by the employee after reading instructions overleaf. Two Postcard Size photographs are to be attached with this form. This form is free of cost. (A) INSURED PERSONS PARTICULARS (B) EMPLOYERS PARTICULARS
1. Insurance No:- Employer's Code No
2. Name Date of
(In Block Letters) Appointment
3. Father's/Husband 11. Name & Address of the Employer
Name Magna Infotech Pvt Ltd, #5/4-2,
Date Of Birth
DD - MM - YY Marital Status
#10-2-289, PLOT NO - 79, SHANTI NAGAR, HYDERABAD 500028
Sex
Present Address
Permanent Address
12. In case of any previous employment
please fill up the details as under:-
a) Previous Insurance No
b) Employer's Code No
c) Name & Address of the employer
Branch Office Dispensary
(C) Details of Nominee u/s 71 of ESI Act 1948/Rule 56(2) of ESI (Central) Rules, 1950 for payment of cash benefit in the event of death. NAME RELATIONSHIP ADDRESS
I hereby declare that the particulars given by me are correct to the best of my knowledge and belief. I undertake to intimate the Corporation any changes in the membership of my family within 15 days of such change.
Counter Signature by the Employer
Signature With Seal Signature /TI, IP (D) FAMILY PARTICULARS OF INSURED PERSON Date Of Birth/Age Whether residing If No, State SL as on dateof filling Relationship with the with him/her? place of resi NO Name form employee YES NO TOWN STATE 1 2 3 4 ................................................................................................................................................................ ESI Corporation
Temporary Identity Card Valid for 3 months from the date of appointment Name
Insurance Number Date of Appointment
Branch Office Dispensary Space for Photograph
Employer's code no &
Address
Validity
Dated: Signature/TI of IP Signature of BM with seal
Page 12
1. Submission of Form-1 is governed by regulations 11 & 12 of ESI (General) Regulations, 1950. 2. Family means all or any of the following relatives of an Insured Person namely:-
(i) A spouse (ii) a minor legitimate or adopted child dependant upon the I.P;(iii) a child who is wholly dependant on the earnings of the I.P. and who is (a)receiving education, till he or she attains the age of 21 years (b)an un married daughter; (iv) a child who is infirm by reason of any physical or mental abnormity or injury and is wholly dependant on the earnings of the I.P. so long as the infirmity continues; (v) dependant parents (Please see Section 2 clause 11 of the ESI Act 1948 for details). 3. Identity Card is Non-transferable.
4. Loss of Identity Card be reported to Employer/Branch Manager immediately.
5. Submission of false information attracts penal action under Section 84 of ESI Act, 1948.
6. This form duly filled in must reach the concerned Branch office within 10 days of appointment of an Employee. Delay attracts penal action under Section 85 of the Act, against employer.
7. As an Insured person you and your dependent family members are entitled to full medical care. The other benefits in cash include (1) sickness Benefit (2) Temporary Disablement benefit (3) Permanent disablement Benefit
(4) Dependents benefit and (5) Maternity Benefit (incase of women employees subject to fulfillment of contributory conditions.
8. For more details Please Visit website of ESIC at WWW.esic.nic.in or www.esickar.gov.in contact
1. Date of Allotment of Ins. No. _______________________________________________________
2. Date of issue of TIC : _____________________________________________________________
3. Name/ No. of Disp : ______________________________________________________________
4. Whether reciprocal Medical arrangements involved? If yes, please indicate : __________________
Date Of Birth/Age Whether residing If No, State
with him/her? place of resi
SL as on dateof filling Relationship with the
NO Name form employee YES NO TOWN STATE
1
2
3
4
Page 13 THE ORIENTAL INSURANCE COMPANY LIMTED DIVISIONAL OFFICE :: IV, HYDERABAD. PROPOSAL FORM FOR INDIVIDUAL PERSONAL ACCIDENT INSURANCE
1.a)Name of the Insured :
2.Correspondence Address :
3)Occupation :
4)Average Monthly Income :
5)Date of Brith : Age :
6)Capital Sum Insured :
I declare that the above answers are true to the best of my knowledge and belief, that I have disclosed all particulars effecting the assessment of the risk. I agree that this proposal and declaration shall be the basis of the contract between me and the company.
ASSIGNMENT
I ____________________________________________do hereby assign the amount payable by The Oriental Insurance Co. Ltd, in the event of my death, to ___________________________________ Relation to the Insured. I further declare that his/her receipt shall be sufficient discharge to the company.
Dated This______________________ Day of_________________ at
Date: Proposer's Signature
Page 14
FORM XIV (See Rule 76) Name and address of Contractor: Magna Infotech Ltd 10-2-289, Plot No. 79 Shanti Nagar Hyderabad
Employment Card (Under Contract Labour Act, 1971) Name and address of establishment to/under which contract is carried on
Nature of Work and location of work
1. Name of the workman
2. Sl. No. in the register of workman employed
3. Nature of employment/Designation 4. Wage rate (With particular of unit in case of piecework)
5. Wage period
6. Tenure of employment
7. Remarks
Name & address of principle employer
___________________________ Authorized Signatory
Page 15 MAGNA INFOTECH LTD INDUCTION CHECK LIST
Employee Name : Magna HR Name :
Client Name : Offer ID:
Date of Induction :
The below mentioned points were been discussed and briefed to you during the induction programme at Magna Infotech Pvt ltd. Request you to duly fill in your comments on your understanding for each points discussed.
YOUR
OPTED UNDERSTANDING
SL NO POINTS DISCUSSED YES/NO YES NO
1 Information about Magna Infotech Pvt Ltd
2 Information on SBI Account (PAN card is mandate)
3 Understanding about Holidays and Leave policy. Policy is Client specific
4 Information about Radar -Magnas internal tool.
5 Information on Timesheet Process
6 Information on Payroll Process
Understanding on Allowance & Expense Reimbursements and the time
7 frame
Information on Provident Fund (Employee and Employer contribution
8 towards PF will be part of Employee CTC )
Information on ESIC (Employee and Employer contribution towards ESIC
9 will be part of CTC . Applicability on gross salary (<Rs.15000/-)
Information on Group Mediclaim policy (Premium on prorated basis for
the billing cycle 01 December to 30 November will be deducted from
10 employees first month salary . Applicability on gross salary (>Rs.15000/-)
11 Understanding on Income Tax & Exemption
12 Information on Separation and Notice period
13 I have understood the leave encashment in the salary break up.
Does the induction programme meet with your queries and expected
14 information
1. Do you have any recommendations that would you like to offer for the further development of the induction
programme is, if yes mention below?
3. Do you know that if you want to opt out of Magna Mediclaim policy then you should upload your personal mediclaim policy document in Radar under mediclaim tab checking the radio button NO option within 2 days upon the receipt of welcome mail from your respective HR from Magna.
1. Name of the resource in block letters : as mentioned in the offer letter. 2. Offer ID : 3. EMP ID : 4. Blood Group 5. Date of Joining : 6. Client : 7. Location :
Page 17
Passport Size Photo *FORM Q+ [See Rule 24(9-A)] Appointment Order
Magna Infotech Ltd,
#10-2-289, PLOT NO - 79, SHANTI NAGAR, HYDERABAD 500028 1. Name and address of the Establishment 2. Name and address of the Employer 3.Nature of work of the Establishment IT & ITES 4.Nature of work of the Employer IT & ITES 5. Name of the Employee 6. His / Her Postal Address 7. His / Her Permanent Address 8. Fathers / Husbands name 9. Date of Birth 10. Date of His / Her entry into employment 11. Designation 12. His / her serial number in the Register of employment
13. Rates of wages payable to him/her
i) Basic.. ii) VDA.. iii) Other allowances if any.. Total. Place: Signature of the employer Date: Seal of the Establishment