CANDIDATE INFORMATION SHEET

All Cummins Entities in India

Full Name: Mr First Name Om Middle Name Prakash Last Name Khuntia

Total Yrs of Prior Relevant Work

Work Experience Experience

Personal Details

Father/Husband's Name Rabindra Khuntia Blood Group A+ Marital Status Single

Maiden Name (if applicable) Date of Birth 8-Nov-03 PAN No. KVXPK0617R

Place of Origin (State Name) Odisha Gender Male Caste General

Aadhaar Card No. 4425 6080 0809 Name as per Aadhar Card Om Prakash Khuntia

Did you have a PF

Did you have a PF contribution If Yes Please mention UAN
No Pension (FPS) with your No
with the previous organisation (Universal Account Number)
previous Organisation
Do you have any Physical If Yes, Please mention % of
No
Handicap? disablement

Address Line 1: Plot No-768,Saheed Nagar,Bhubaneswar,Odisha

Address Line 2: Plot No-4343/11324,Pandra,Bhubaneswar,Odisha

Permanent City/ Town: Bhubaneswar

Address Pin Code: 751007

State Odisha

Personal Email ID

Address Line 1: Plot No-768,Saheed Nagar,Bhubaneswar,Odisha

Address Line 2:
Mailing / City/ Town: Bhubaneswar
Current
Address Pin Code: 751007

State Odisha

Personal Email ID soamprakash22@gmail.com

Contact Numbers, with STD codes (e.g 020-26611990)

Additonal Contact
Home 9861102598 8895555826
Number
Personal Mobile 8260708242

Work Experience Details (Start with latest employer)

Duration Salary Last Drawn

Employer Name & Address Last Designation Reason For Leaving
From To (PA)

Career Gap Duration Reason

Do you have any bond with existing company? Current Notice period
Are you a case of Re- Hire? If Yes, please mention you WWID at the time of employment with Cummins

Educational Details (Start with highest degree)

Qualification (Degree/Exam) Duration
Type of Course Institute Board / University Year of Passing % Marks Class
(mention specialization) (years)
10th Board Full Time 1 Year Prabhujee English Medium School CBSE 2019 70 2nd
Diploma Full Time 3 Years Nilachal Polytechnic SCTEVT 2022 75 2nd

Education Gap Duration Reason

Languages Known: *(Levels - 1-Basic, 2-Intermediate, 3-Fluent) (Start with native language)
Language Comprehension Spoken Reading Written
Odia 3 - Fluent 3 - Fluent 3 - Fluent 3 - Fluent
English 3 - Fluent 3 - Fluent 3 - Fluent 3 - Fluent
Hindi 3 - Fluent 3 - Fluent 3 - Fluent 3 - Fluent

Emergency Contact Person Details

First Name Middle Name Last Name Relation Date of Birth Address Phone No.
Sarthak Mohanty Friend 30/07/2002 Plot No-1195,Nayapalli,Bhubaneswar,Odisha 8249186268

Professional References (Please do not give references of Relatives or Cummins employees)

Name Organization Designation Mobile No. Landline No. Email ID

Previous Salary Details (Attach a copy of your latest salary slip)

Per Month (INR) Per Annum (INR)
Monthly Cash Component
Basic
House Rent Allowance
Special Allowance
Conveyance Allowance
A Education Allowance
Medical Reimbursement
Leave Travel Allowance
Any other allowances (please mention below)

Total A
Retirement Benefits
PF
B
Gratuity
Superannuation
Total B
Variable Pay
C
Performance Pay
Total C
Total A+B+C (Total Compensation)

Please mention your expected salary

I hereby certify that the particulars given above are true and correct to the best of my knowledge and belief, I agree that, at any time in future, if any of this information
is found to be false / incorrect, the company would be free to cancel my selection / appointment or terminate my services.

My personal data may be stored on secured servers and or computer networks in or out of India protected as per Cummins IT policies in force regarding access and
data security. I hereby agree to permit access to your personal data to authorized Cummins Officials in India and abroad for official purposes from time to time.

Signature Om Prakash Khuntia

Place Bhubaneswar
Date 18/06/2022