BUILDINGS & FACTORIES INDEPENDENT COMPANY QUALITY MANAGEMENT SYSTEM

GEN 08 F 20 ISSUE NO.2

EMPLOYMENT APPLICATION FORM
Page 1 of 4 Rev - 0

NOTE : POST APPLIED FOR PLEASE TICK THE APPROPRIATE DEPARTMENT

TO BE FILLED BY THE CIVIL MECHANICAL ELECTRICAL
APPLICANT IN HIS/HER OWN
HANDWRITING CLEARLY AND
ADVT. REFERENCE P&M
COMPLETELY ONLY BLOCK COMMON SERVICES
LETTERS TO BE USED.

PERSONAL INFORMATION
FULL NAME IN BLOCK LETTERS (AS IN SSC/10TH RECOREDS) C NAGAVIJAYABABU
22/10/1988 AGE:35
DATE OF BIRTH

NATIONALITY:INDIAN RELIGION :HINDU BIRTH PLACE :GUNTAKAL SEX*:MALE

MARITAL STATUS **:MARRIED CASTE***:SC MOTHER TONGUE :TELUGU

IDENTIFICATION MARK: A MLACK MOLE N LEFT SIDE OF THE CHEST

LANGUAGES KNOWN READ WRITE SPEAK HEIGHT (CM) WEIGHT (KG) BLOOD GROUP & RH TYPE
POWER OF GLASSES PHYSICAL DISABILITY, IF ANY
ENGLISH YES YES YES 179 80 A+ LEFT EYE NO
HINDI YES YES YES RIGHT EYE
TELGU YES YES YES MAJOR OPERATION DATE OF OPERATION
UNDERGONE

DETAILS OF FAMILY MEMBERS

NAME SEX* DATE OF BIRTH RELATIONSHIP OCCUPATION / IF STUDYING WHAT CLASS WHETHER STAYING WITH YOU
PLEASE GIVE FULL DETAILS OF FAMILY
MEMBERS INCLUDING PARENTS (EVEN IF NAGA SUDHAKAR MALE FATHER RETIRED YES
DECEASED), SPOUSE, CHILDREN, NAGA SUSEELA FEMALE MOTHER HOUSE WIFE YES

BROTHERS & SISTERS. IN OCCUPATION NAG PREETI FEMALE WIFE HOUSE WIFE YES
NAGA AADHYA FEMALE DAUGHTER UKG YES
COLUMN, MENTION EXACT JOB OR
DESIGNATION IF STUDYING, MENTION
CLASS.

PLEASE TICK THE ADDRESS WHERE CORRESPONDENCE IS TO BE SENT (PRESENT / PERMANENT / EMERGENCY ADDRESS)

PRESENT ADDRESS PERMANENT ADDRESS IN CASE OF EMERGENCY / ACCIDENT WHOM TO CONTACT

PLOT NO 12 YELLA REDDY COLONY SAME AS PRESENT
HAYATH NAGR ROAD NO 2 NAGA SUSEELA

STATE :TELENGANA PIN :501505 STATE : PIN :501505 STATE :TELENGANA PIN :
TELEPHONE : MOBILE NO :9701211250 TELEPHONE : MOBILE NO :9000538381 TELEPHONE : MOBILE NO :

EMAIL ID :nagavijayababu@gmail.com ALTERNATE EMAIL ID :nagavijayababu108@gmail.com

CODES : *M-MALE F-FEMALE **M-MARRIED U-UNMARRIED W-WINDOWED S-SEPARATED

***SCHEDULED CASTE SCHEDULED TRIBE DE-NOTIFIED TRIBE NOMADIC TRIBE SPECIAL BACKWARD CATEGORY OTHER BACKWARD CLASS GENERAL / OPEN CATEGORY
 BUILDINGS & FACTORIES INDEPENDENT COMPANY QUALITY MANAGEMENT SYSTEM
GEN 08 F 20 ISSUE NO.2
EMPLOYMENT APPLICATION FORM Page 2 of 4 Rev - 0
EDUCATIONAL QUALIFICATION
EXAMINATION PASSED MAJOR SUBJECTS * DURATION YEAR OF PASSING UNIVERSITY / INSTITUTE GRADE /
F/P/C YRS MTHS ( DD / MM / YYYY) CLASS /
SSC/10TH/EQUIVALENT 2004 Physics and maths 63 1 0 25/03/2004 ssc A
HSC/12TH/INTERMEDIATE

DIPLOMA (S) 2008 MECHANICAL ENGINEERING 59.30 3 0 25/05/2008 SBTET B

DEGREE (S) 2011 MECHANICAL ENGINEERING 63 3 O 20/04/2011 JNTUA A

POST GRADUATE (S)

2012 Occupational Safety Health & 76 1 0 06/06/2012 Bhagat Sava Semaj A
Environment
CERTIFICATE (S)
2012 NEBOSH
GAP IN EDUCATION, IF ANY, SHOULD BE INDICATED WITH REASONS :

TRAINING UNDERGONE DURATION YEAR INSTITUTE / ORGANIZATION PLACE CERTIFICATES AWARDED

PROFESSION AS IN DATE OF VALID PLACE OF COUNTRIES

PASSPORT NUMBER NAME AS IN PASSPORT PASSPORT ISSUE UPTO ISSUE COUNTRIES VALID FOR TRAVELLED VISA APPLIED FOR

CRIMINAL RECORD
HAVE YOU EVER BEEN INVOLVED IN ANY CRIMINAL PROCEEDINGS / CONVICTED OF ANY OFFENCE ? IF YES, PLEASE GIVE DETAILS :
NO

WORK EXPERIENCE
DRAW IN BRIEF THE ORGANIZATION STRUCTURE OF THE COMPANY WHERE YOU ARE PRESENTLY EMPLOYED, INDICATING TWO LEVELS ABOVE AND ONE LEVEL BELOW YOUR POSITION

* INDICATE F-FULLTIME, P-PARTTIME, C-CORRESPONDENCE

 BUILDINGS & FACTORIES INDEPENDENT COMPANY
QUALITY MANAGEMENT SYSTEM
GEN 08 F 20 ISSUE NO.2
EMPLOYMENT APPLICATION FORM
Page 3 of 4 Rev - 0
PLEASE GIVE DETAILS OF YOUR WORK EXPERIENCE IN UNBROKEN CHRONOLOGICAL ORDER STARTING WITH YOUR FIRST EMPLOYMENT TO THE PRESENT ONE
(PLEASE ACCOUNT FOR ALL THE PERIOD OF TIME COVERED BY EDUCATION / TRAINING - IF SPACE IS INADEQUATE, KINDLY USE ADDITIONAL PAPER)

DURATION NAME & DESIGNATION OF GROSS EMOLUMENTS

EMPLOYER'S NAME & ADDRESS POSITION HELD NATURE OF WORK DONE REASON FOR LEAVING
(DD / MM / YYYY) IMMEDIATE SUPERIOR (PER MONTH)

TOTAL SAFETY ARABIA ,AL FROM : / /2014 SAFETY OFFICER/SAFETY FRANK RIVAS-PROJECT HEAD OIL REFINERY 3000 USD WANT TO SETTLE IN INDIA
JUBAIL,SAUDI ARABAI ENGINEER/HSE TRAINER/HSE
TO : / /2024 COORDINATOR.

YEARS MONTH
ASK EHS,GU8JARAT. FROM : / /2013 SAFETY ENGINEER HIMANSHU-PROJECT MANAGER POWER GRID PROJECT 45000 INR FOR CAREER GROWTH AND BETTER LIFE.

TO : / /2014
YEARS MONTH
FROM : / /
TO :/ /
YEARS MONTH
FROM : / /
TO :/ /
YEARS MONTH
FROM : / /
TO :/ /
YEARS MONTH
TOTAL EXPERIENCE YEARS ;10 MONTH BREAK IN EMPLOYMENT, IF ANY, SHOULD BE INDICATED WITH REASONS

HAVE YOU EVER BEEN EMPLOYED BY US OR BY ANY OF OUR SUBSIDIARY / ASSOCIATE COMPANIES ? IF, YES, PLEASE GIVE DETAILS
(IF SO PLEASE MENTION THE NAME OF OUR COMPANY AND / OR ANY OF OUR SUBSIDIARY / ASSOCIATE COMPANIES AND YOUR PAYSLIP IC :
NO
NUMBER) PAYSLIP NUMBER :
YES or NO
HAVE YOU EVER BEEN INTERVIEWED BY US ? NO IF YES FOR WHAT POST : WHEN :

HAVE YOU ANY RELATIVES EMPLOYED BY US OR ANY OF OUR SUBSIDIARY / ASSOCIATE COMPANIES ? NO NAME & POSITION : TYPE OF RELATION :

NAME OF THE PERSONNEL WITH WHOM YOU ARE ACQUANITED IN OUR COMPANY AND / OR ANY OF OUR SUBSIDIARY / ASSOCIATE
NAME & POSITION :
COMPANIES

WHO REFERRED YOU TO US ? NAME & POSITION :

EXPECTED SALARY;10-12 LPA EXPECTED SALARY MINIMUM TIME REQUIRED

PLEASE GIVE DETAILS OF ANY CONTRACT / BOND THAT YOU MAY HAVE WITH YOUR PRESENT EMPLOYER: Frank rivas -0556755475
(Rs. /Month) (Rs. /Annum) 10-12 LPA TO JOIN; 7 days

IF YOUR ARE COVERED BY PF SCHEME UNDER EPF ACT OF 1952. PLEASE FURNISH YOUR ACCOUNT NUMBER
 BUILDINGS & FACTORIES INDEPENDENT COMPANY QUALITY MANAGEMENT SYSTEM
GEN 08 F 20 ISSUE NO.2
EMPLOYMENT APPLICATION FORM
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NAME OF THE PRESENT EMPLOYER / LAST EMPLOYER, IF PRESENTLY UNEMPLOYED DESIGNATION

DETAILS OF CURRENT / LAST DRAWN EMOLUMENTS

MONTHLY EMOLUMENTS ANNUAL BENEFITS OTHER BENEFITS
BASIC SALARY 2170 usd BONUS CHILDREN'S EDUCATION SCHEME
DEARNESS ALLOWANCE EX-GRATIA
SPECIAL ALLOWANCE OT COMPENSATION
CITY COMPENSATORY LEAVE TRAVEL CONCESSION (Please give details) LEAVE BENEFITS (in DAYS)
SITE ALLOWANCE 40 usd per day CASUAL LEAVE
PROJECT ALLOWANCE SICK LEAVE
RISK ALLOWANCE ANY OTHER PRIVILEGE LEVEL
FOOD ALLOWANCE ANY OTHER
HEALTH ALLOWANCE MEDICAL BENEFITS LEAVE ENCASHMENT
MEDICAL ALLOWANCE yes FREE TREATMENT YES
FACTORY ALLOWANCE 100% REIMBURSEMENT YES/NO INSURANCE SCHEME
OT PAYMENT DOMICILIARY TREATMENT REIMBURSEMENT PATTERN
CONVEYANCE HEALTH INSURANCE
ACCOMODATION HOSPITALISED TREATMENT REIMBURSEMENT PATTERN
CANTEEN SUBSIDY PERCENTAGE

FREE YES or NO
SUBSIDISED RENT ANY OTHER VEHICLE ADVANCE
HRA TWO WHEELER
AD HOC ALLOWANCE RETIREMENT BENEFTIS FOUR WHEELER
CHILDREN EDUCATION SUPERANNUATION SCHEME HOUSING LOAN SCHEME DETAILS
ALLOWANCE
SALES COMMISSION /
INCENTIVES
ENTERTAINMENT GRATUITY SCHEME
ALLOWANCE
GAS ALLOWANCE
ELECTRICITY ANY OTHER ANY OTHER
MEMBERSHIP
PF CONTRIBUTION
TOTAL MONTHLY SALARY
3000usd
TOTAL COST TO THE
COMPANY (CTC) PER ANNUM
NAME AND BUSINESS ADDRESS OF TWO REFERENCES (not relatives)
Frank rivas ,Dammam Saudi arabai -0556755475 Himanshu,Gujarat -9770999175,

Declaration under section 314 of companies Act as amended in 1974

I hereby declare that I am not connected with any of the Directors of the Company as his partner or his relatives as defined under Section 6 of the

Companies Act 1956

or
I hereby declare that I am a Partner/relative of Mr./Ms. A Director of the Company as

(Strike out whichever is not applicable)

I declare that the information given above is true to the best of my knowledge. Any false or incorrect information furnished above will result in

disciplinary action being taken against me including removal from service.

PLACE HYDERABAD DATE :13/06 SIGNATURE OF APPLICANT :

/2024 C NAGA VIJAYA BABU.
PLEASE DO NOT ATTACH ANY ORIGINAL CERTIFICATES OR TESTIMONALS