Paste a softcopy of your

Recent passport size photograph here

WELCOME TO DOUBLE NEGATIVE INDIA PRIVATE LIMITED
Personal Information Form
Paste a softcopy of
PLEASE COMPLETE THE FORM THOROUGHLY AND ACCURATELY your Recent passport
size photograph here.
Should be a JPEG
format only
POSITION APPLIED FOR:

Title
First Name Middle Name Last Name
Passport Name

Current Address Permanent Address

House / Flat No: House / Flat No: Same As current

City City

State State

Country Country

Pin Code Pin Code

Contact Details

Mobile:

Home:

Personal Mail Id:

Personal Details
Gender: Marital Status
Date Of Birth Blood Group
PAN Card no: PF NO:
UAN No: Aadhar Card No:
Passport No: Valid till:
Nationality Voter's ID No:
Driving Licence Valid till:

Next of Kin
Name
Phone (Work)

Phone (Home)
Email:
Relationship

Local Emergency Contact

Name
Phone (Work)
Phone (Home)
Email:
Relationship

Medical Information
Differently Abled Disability Type
Medical Condidtion

Any Know Allergies

Family Details
Father Date Of Birth DD/MM/YYYY
Mother Date Of Birth DD/MM/YYYY
Spouse Date Of Birth DD/MM/YYYY
Child 1 Date Of Birth DD/MM/YYYY
Child 2 Date Of Birth DD/MM/YYYY

Bank Details
Bank Name Bank Account No.:
IFSC Code Bank Branch

Education
Highest Academic Education: Date Of Passing DD/MM/YYYY
Highest Professional Education: Date Of Passing DD/MM/YYYY

Experience

Reporting Last Drawn

Name of the Organization Position Start Date End Date Reporting to Reason of Leaving
Position Salary

Prime Focus Transferred

Declaration

I hereby declare that I am not under any service obligation / agreement . If appointed, I would join duty only after getting properly relieved by my current
employer. I also declare that, I have no criminal / legal proceedings pending against me. I certify that the information furnished above is true to the best of my
knowledge and any Misrepresentation made by me in this form will render me liable to be terminated from service.

Date:
Place:

Signature:
Time: