Application Blank Personal Details (write in CAPITAL letters) First Name: Middle Name: Last Name: Date of Birth (dd/mm/yy): Place of Birth: Sex: Male Female Please affix passport size photograph Hindu / Muslim / Christian / Jain / Budhism / Sikh / Any Other(pls specify) Religion: Nationality: Marital Status: Unmarried Married Please tick(^) the options applicable to you GEN sc ST OBC Physically Ex-Servicemen Have you ever been interviewed by TPDDL in the last one year?' Yes ' No If Yes please provide the details of Deptt/Profile interviewed for: Challenged Creamy Non Creamy * VH* OH * HH*** How Did you come to know about TPDDL *VH - Visually Handicapped, **OH- Orthopaedic Handicapped, ***HH - Hearing Handicapped Friend Present Address: Newspaper Any Employe of TPDDL (Pls Specify Name) Advertise ment Any Other Permanent Address Tel No. Tel No. (Res) E-Mail Id: Fax/Mobile No.: Family Details: Name Relationship Date of Birth (dd/mm/yy) Occupation Academic Details (starting from the most recent): Examination Passed Year of Passing School/College /University attended Main Subjects Details of Previous Employment(starting from the most recent): held in an organisation please provide breakup Organisation CURRENT SALARY Are you a member of any social or cultural association? □ Do you have any relatives / friends working with TPDDL? □ From To Expected CTC (Rs. Lacs) /%jump NOTICE PERIOD(ifany) Yes Yes Division Total Experience (in Yrs.): Post/Designation Present CTC Rs. Lacs % age □ □ No . Regular/ Arrears/B Part Time / ack DL Papers * if more than one position Major Responsibilities If Yes, Please give details. No If yes, please give the following details: Name Division / Department Relative /Friend (Pls Mention the Exact Relationship) Contact No. Designation Please give 2 References (references shd not be be relatives; pvd. references which are sure to respond) Name Division / Department Designation Contact No E.Mail Id I hereby declare that all the information provided herein above is true to my knowledge and that any misrepresentation by me in this application will disqualify my candidature. Date: Page 1 of 3 Signature: Your position in present organisation chart (inlcude two levels of reporting above & below): Time spent in the present role: No of Employees in the Organisation: No. & Level of People reporting: Page 2 of 3 TATA POWER DELHI DISTRIBUTION LIMITED Particulars of Last Drawn Emoluments (This form is to be completed by the candidate in detail) Name Qualification Designation Experience yrs I Salary ` p.m. Basic salary Dearness Allowance Total ` p.m, II Allowances ` p.m. House Rent Allowance (In case of Company leased premises indicate the rent borne by you) Conveyance (If not provided Co.Car) If Car provided by Company, then *Fuel limits *Driver Allowance *Car Maintenance Allowance Food Allowance Total ` p.m. III Annual Benefits (` p.a.) Leave Travel Bonus/Ex-gratia/Performance Pay Medical Total ` p.m. IV Retirement Benefits Provident Fund Superannuation Fund Gratuity Total ` p.m. ( ( ( ) % of ( ) % of ( ) % of ( ) ) ) V Any other benefit not covered above: Total ` p.m. Staying in Recognised Hostel With Relatives No.s No.s Present cost to Company (`per annum) (I to V) Expected cost to Company (` per annum) Date: Page 3 of 3 Signature: Age yrs