CHENNAI

LOCATION: ________________________

Request for ID Card Reset Form

Details to be furnished by the Employee in BLOCK LETTER ONLY

VANISHREE SUGUMAR
Name of the Employee :
CONTRACTOR
Employee Type : ---------------------------------------------------------------------------

Employee’s Portal ID Number: ---------------------------------------------------------------------------

Employee’s Synergy ID : ----------------------------------------------------------------------------

O+
Blood Group : ----------------------------------------------------------------------------
9751639299 PARENT
Emergency Contact No : ---------------------------------------------------------------------------

Date of Joining :

Click Blank Space To Upload Image

Glossy Passport Size Photo With
White Background Only Employees Signature

NO POLAROID PHOTOS PLEASE Signature NOT TO TOUCH THE BOXLINE

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 Contract Employee Personal Details

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PHOTO

Personal Information: Click Blank Space To Upload Image

Name Date of Birth Date of Joining

VANISHREE SUGUMAR 01/30/1996

Present Address Permanent Address

No 104,VALMIKI STREET, THIRUVANMIYUR, No 31/9A, KASTURIBAI STREET, GANDHIPET,

CHENNAI-600041 TIRUPATTUR DT., 635601, TAMLNADU.

Residence No. 31/9A Mobile No. 9789670975

Email Id: nivashree30@gmail.com

Marital Status Passport Details

Married Single Self Spouse

If Married Name Date of Birth Passport No Passport No
Spouse
Children
Valid upto Valid upto

Date of Marriage

PAN Card Number BNXPV7565G

Emergency Contact Details

Name : SANTHOSH S Blood Group: Name for mail ID:

Address: hisanthoshtpt@gmail.co
31/9A, KSTURIBAI STREET,
GANDHIPET, TIRUPATTUR DT, m
635601, TAMIL NADU O+

Contact No: 7010574846

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Family Particulars

Relationship Name of Family Member DOB Age Occupation

Father Y.S. SUGUMAR 12/05/1957 63 DAILYWAGES

Mother S. KASTHURI 09/09/1967 53 HOUSEWIFE
Spouse
Sons /
Daughters

Academic and Professional Qualifications

Degree / Marks /
S.No Institution From To
Qualification Position

1 B.Sc(Com.Sci) SACRED HEART COLLE 06/10/2013 04/30/2016 FIRST CLASS

2
3
4
5

Employment Details

F. Previous Employment History (In reverse chronological order-latest employment first)

1.Company Name :
Date of Date of
Period of Employment
Joining: Relieving:
Organization:

Address:

Telephone / Fax No: Last Salary (CTC):

Position Held: Reporting To:

Nature of
Responsibility:

Reasons for Leaving:

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2. Company Name :
Date of Date of
Period of Employment
Joining: Relieving:
Organization:

Address:

Telephone / Fax No: Last Salary (CTC):

Position Held: Reporting To:

Nature of
Responsibility:

Reasons for Leaving:

3. Company Name :
Date of Date of
Period of Employment
Joining: Relieving:
Organization:

Address:

Telephone / Fax No: Last Salary (CTC):

Position Held: Reporting To:

Nature of
Responsibility:

Reasons for Leaving:

4. Company Name :
Date of Date of
Period of Employment
Joining: Relieving:
Organization:

Address:

Telephone / Fax No: Last Salary (CTC):

Position Held: Reporting To:

Nature of
Responsibility:

Reasons for Leaving:

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 UPLOAD ID CARD (PAN/AADHAR /PASSPORT)

NTT DATA Global Delivery Services Private Limited, Confidential

NTT DATA Global Delivery Services Private Limited, Confidential