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QF-HRM-109

Tlo R PROXI MITY I CAR ll u in


LTD'
POWER GRID COMPANY OF BANGLADESH

Expired/Others'
Category of application: New/Lost/Promotion/Time
Category of Post : Permanent/Temporary/Outsourcing/Others'

1 Full Name(Block Letter)


muAgALtN HCA/A
,

2 Father's Name: fnD. t^/azED trLl


*1,,
lcehh, e n*
3 Designation: ^/
4 hrnD - Is hutaali
lrr

5 Office: -*,tu t3y'99 4*r( ,..iq

6 Date of Joining:
09-o+- Lo2L
7 Service Conttact ExPire Date: 0)-'0q'
8 Group: ba+
9 National lD No: 237 vq+ 0q q I
10 Mobile No: 07qIt" 6t7{ (B r *:-
lt EmergencY Contract No
o!7L9" 056' 7o
h a h +o h 7 a o ] @ ffo eD M
L2 E-mail address:

13 PMIS/Unique No: 0v9+{


t4 Previous lD No(if anY)
!1C 74
15 Permanent address: Ue, 'f Dit+: Al..e*a-i J"}'

Certlfied bY
Verified bY Manager Approved bY lssued by Manager
Application's offi ce/Section
GM(P&A) SecuritY
Head(sign with office HR-L/2
signature

q
sea

t4k

D ca rd should h ave to be
a. Incase of romotion/time
Note b. lncase of the of GD ;hould have to be attac hed.
with the a on
c. The attested co of NI D ca rd ca rd should have to be submitted

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