CONFIDENTIAL

RECENT PHOTO

PHD Chamber of Commerce and Industry

PHD House
4/2, Siri Institutional Area, REF. NO. _________________
August Kranti Marg, New Delhi 110016

BIO-DATA FORM

POST APPLIED FOR ____________________________________________________

A. PERSONAL PARTICULARS

FULL NAME ____________________________________________________________________

(In Block Letters)

PRESENT ADDRESS _____________________________________________________________

_____________________________PHONE: (Off.)________________(Res.)__________________

FATHERS/HUSBAND’S NAME & OCCUPATION _______________________________________

ADDRESS ______________________________________________________________________

_________________________________________________________________________
(If employed give designation and official address)

DATE OF BIRTH ___________________ AGE ____________ PLACE OF BIRTH _____________

MARITAL STATUS (Single/Married) CHILDREN/WITH AGES

EARNING MEMBERS IN FAMILY

Relationship Address where employed/working Approx. monthly income (Rs.)

Source / Amount of any other Income _______________________________________________________

- Please complete in your own hand-writing. All columns should be filled up completely.
- Please answer all questions completely. If necessary attach a separate sheet and add any
additional information which may be relevant.

DEPENDENTS (excluding spouse and children) : -

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 RELATIONSHIP AGE REASONS FOR DEPENDENCE

IF YOU HAVE BEEN INVOLVED IN ANY COURT PROCEEDINGS, PLEASE GIVE PARTICULARS : -

HEIGHT ____________________ CMS/FT. ______________ IN. WEIGHT ___________________KGS

LIST PROLONGED OR SERIOUS ILLNESSES OR PHYSICAL DISABILITY, IF ANY

B. QUALIFICATIONS

EDUCATIONAL HISTORY (Secondary School Onwards)

Name & Address Board of / Year of Degree / Main Subjects Div. Marks
of School/College University Entering Leaving Exam %

LANGUAGES KNOWN (Indicate proficiency in speaking, reading & writing)

C. EXPERIENCE

Employer’s Name & Address Period Salary on leaving Reasons for leaving
(please indicate place of posting) From To Basic Total

PRESENT (1)

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NEXT LAST (2)

THIRD LAST (3)

FOURTH LAST (4)

DETAILS TO BE GIVEN ON PAGE 5

Sl. DESIGNATION AND SCOPE OF RESPONSIBILITY under each employer Name and Designation of the

No person to whom you report(ed)

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SPECIAL ABILIY/EXPERIENCE/STUDY, if any:

D. GENERAL
Name of any employee of PHD Chamber known to you
Name Department/Unit Relationship or other connection

Two reference (names/addresses of responsible persons known to you/past employer)

NAME ADDRESS

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 OTHER PARTICULARS

Do you or your family members

Own a house, if so where : ____________________________________________

Do you own a vehicle, if yes, : ____________________________________________

Particulars of same

Any preference for posting? : ____________________________________________

Have you been interviewed by us before? : ____________________________________________

(if yes, give particulars)

How much notice would you require to

Join? : _____________________________________________

Any other information you wish to : _____________________________________________

to furnish
DECLARATION

I certify that the foregoing information is correct and complete to the best of my knowledge and belief and nothing has
been concealed. I am not aware of circumstances which might impair my fitness for employment. If at any time, I am
found to have concealed any material information or given any false details, my appointment shall be liable to
summary termination without notice or compensation.

______________ ______________ __________________

Date Place Signature of Applicant

E. DETAILS OF PRESENT REMUNERATION / FACILITIES

PARTICULARS AMOUNT BASIS

REMUNERATION • Basic Salary

• D.A.
• Bonus
• Incentive
• Any other

RESIDENCE • Company Lease

• Rent / Allowance
• Furniture
• House Maintenance
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 • Elec. / Water / Gas
• Telephone
• Magazines / News Papers
• Servant

CONVEYANCE • Company Car

• Conv. Subsidy /
• Allowance / Fuel limit
• Driver

RETIREMENT • Contributory P.F.

BENEFITS
• Gratuity
• Superannuation

OTHERS • ESI
• Medical
• Leave Travel Assistance
• Education subsidy
• Hosp. Insurance
• Per. Acc. Insurance

TOTAL
Remarks
FOR OFFICE USE ONLY

Preliminary Interview Notes Board Members

___________ __________ __________

Date Signatures

Final Interview Board Members

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___________ __________ __________
Date Signatures

DECISION

 File 
 Issue appointment 
 Unit of placement
 Terms – Rank / Desig -
• Salary -
• Facilities -
• Any other -
___________ __________
Date Signature

ACTION TAKEN
 Filed 
 Appointment letter issued ____________ date _____________
 Signed copy received back _____________________________
 Joined ___________ Placed in _______________________
__________ __________ __________
Date Signature