OMB Control No.

0412-0520; Expiration Date: 05/31/95

CONTRACTOR EMPLOYEE BIOGRAPHICAL DATA SHEET 1. Name (Last, First, Middle) PANDEY, SANJAY, KUMAR 3. Employees Address (include ZIP code) C-702, PNB APARTMENT, PLOT: 11, SECTOR 4, DWARKA, NEW DELHI - 75 PIN: 110 075
8. Telephone Number
(include area code)

2. Contractors Name Population Foundation of India, New Delhi 4. Contract Number 6. Proposed Salary 5. Position Under Contract 7. Duration of Assignment

9. Place of Birth JAMSHEDPUR (JHARKHAND)

10. Citizenship (if non-U.S. citizen, give visa status) INDIAN

011-45610212/ 098781648844

11. Names, Ages, and Relationship of Dependents to Accompany Individual to Country of Assignment 12. EDUCATION (include all college or university degrees)
MAJOR DEGREE DATE

13.

LANGUAGE PROFICIENCY
(See instructions on reverse)

NAME AND LOCATION OF INSTITUTION

LANGUAGE

Proficiency Speaking

Proficiency Reading

INDIAN INSTITUTE OF TECHNOLOGY, KANPUR UNIVERSITY OF ALLAHABAD UNIVERSITY OF ALLAHABAD

ECONOMI CS ECONOMI CS PHY, CHEM, MATHS 14.

Ph.D. M.A. B.Sc.

1993 1987 1983

HINDI ENGLISH BHOJPURI

5 5 5

5 5 5

EMPLOYMENT HISTORY

1. Give last three (3) years. List salaries separate for each year. Continue on separate sheet of paper if required to list all employment related to duties of proposed assignment. 2. Salary definition - basic periodic payment for services rendered. Exclude bonuses, profit-sharing arrangements, commissions, consultant fees, extra or overtime work payments, overseas differential, or quarters, cost of living or dependent education allowances. POSITION TITLE EMPLOYERS NAME AND ADDRESS POINT OF CONTACT & TELEPHONE NUMBER
Dates of Employment (M/D/Y) From To
Annual Salary Dollars

COUNTRY PROGRAMME REPRESENTATIVE

INSTITUTE OF INTERNATIONA;L EDUCATION, 210, SF, JORBAGH, NEW DELHI,

May , 2008

February 2, 2009

$3,000/mo nth+Tel. at Residence (Rs. 6000/mont h) +Vehicle (Rs.10000/ month) on reimburse ment $2,000/mo nth+Tel. +Mobile+in ternet at Residence (Rs. 5000/mont h) +Vehicle (Rs.8000/ month) on reimburse

COUNTRY PROGRAMME REPRESENTATIVE

INSTITUTE OF INTERNATIONA;L EDUCATION, 210, SF, JORBAGH, NEW DELHI,

JUL. 3, 2006

April, 2008

ment EXECUTIVE DIRECTOR STATE PROGRAMME REPRESENTATIVE PROGRAM OFFICER JHARKHAND HEALTH SOCIETY, RCH DIRECTORATE, NAMKUM, RANCHI CARE, 381 A, ROAD NO. 4, ASHOKNAGAR, RANCHI JUNE 1, 2005 FEB.15, 1999 MARCH, 1996 JULY 2, 2006 MAY 31, 2005 FEBRUA RY, 14, 1999

ACTIONAID, BIHAR OFFICE, PATNA

15.
SERVICES PERFORMED

SPECIFIC CONSULTANT SERVICES (Give last three (3) years)

EMPLOYERS NAME AND ADDRESS POINT OF CONTACT & TELEPHONE NUMBER
Dates of Employment (M/D/Y) From To Days at Rate
Daily Rate in Dollars

16.

CERTIFICATION: To the best of my knowledge, the above facts as stated are true and correct.
Date

Signature of Employee

SANJAY KUMAR PANDEY, Ph.D. 17. CONTRACTORS CERTIFICATION (To be signed by responsible representative of contractor) Contractor certifies in submitting this form that it has taken reasonable steps (in accordance with sound business practices) to verify the information contained in this form. Contractor understands that USAID may rely on the accuracy of such information in negotiating and reimbursing personnel under this contract. The making of certifications that are false, fictitious, or fraudulent, or that are based on inadequately verified information, may result in appropriate remedial action by USAID, taking into consideration all of the pertinent facts and circumstances, ranging from refund claims to criminal prosecution. Signature of Contractors Representative Date
AID 1420-17 (9/94)