Directorate of Technical Education, Rajasthan

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Government of Rajasthan

Directorate of Technical Education, Rajasthan

W-6, Residency Road, Jodhpur - 342032

POLYTECHNIC STAFF MASTER DATA

Note: Please fill all dates in dd-MM-yyyy (e.g. 25-10-2013) format only

PART-A (Employee personal permanent details)
01 / Employee ID (as per Pay Manager)
( e.g. RJKO199227002303 ) / RJ
02 / Name of present
Institute / Office
03 / Present Post Held
(Against the Post if any) /
Department / Branch Name /
04 / Actual / Original Post
(as per Appointment / DPC) /
Department / Branch Name
05 / Service Category / State Service (Gazetted)Sub-Ordinate ServiceMinistrial ServiceOther Service
06 / Status of Employee / TemporaryProbatationPermanentAd-Hoc / Add Recent Digital
Color Photo
07 / PAN Number (as per Pay Manager)
( e.g. AAZPB9084A ) /
08 / Employee UID (आधार कार्ड नंबर) / (date of Issue)
09 / Title / Salutations / Mr.Mrs.Ms.Dr.
10 / Name of Employee
(as per service record full name)
Use only “DevLys 010” font for hindi / (in English) / Add Right Thumb Digital Impression
(हिंदी में)
11 / Father’s Name / SH.
12 / Mother’s Name / SMT.
13 / Date of Birth (as per service record) / (e.g. dd-MM-yyyy)
14 / Gender (Male/Female) / MaleFemale
15 / Domicile / Resident State Name
16 / Religion / HinduMuslimSikhChristianJainismBuddhist
17 / Category / GeneralSCSTOBCSBC
18 / Cast (इंग्लिश में जाति का नाम लिखे,जैसे धाकड़)
19 / Residence Phone (if any) / (STD code) / (phone number)
20 / Employee Mobile No (in 10 digits) / (1st mobile) / (2nd mobile if any)
21 / Employee Email ID / (1st email ID) / (2nd email ID if any)
22 / Date of First Joining to Govt. Job after RPSC Selection / (e.g. dd-MM-yyyy)
23 / Date of Last Increment / (e.g. dd-MM-yyyy)
24 / Date if Retirement / Superannuation / (e.g. dd-MM-yyyy)
25 / Group Provident Fund (GPF) Number / for Old Pension Scheme
Employee Appointed
before 01/01/2004
26 / State Insurance (SI) Policy Number
27 / PRAN / for new Pension Scheme
Employee Appointed
after 01/01/2004
28 / Voter ID (मतदाता पहचान पत्र) Details / (number same as printed on Voter ID) / (date of issue)
29 / Passport details (if any) / (number) / (date of issue) / (valid up to)
30 / Driving Licences details
(ड्राइविंग लाइसेंस डिटेल्स) / (number) / (date of issue) / (valid up to)
31 / Raashan Card details (राशन कार्ड डिटेल्स) / (number) / (date of issue)
32 / Height (in cm) / cm
33 / Weight (in kg) / kg
34 / Eye Sight / Left: / Right:
35 / Physical Handicapped (yes/no) / NoYes
If yes then Enter Detail of disability
36 / Ex-Serviceman (yes/no) / NoYes
37 / Blood Group
38 / Identification Mark (पहचान चिन्ह)
39 / Color Blindness / NoYes
40 / Chronic disease / NoYes
(if yes then give name of disease)
PART-B (Income and Deduction details)
40 / Present Running Pay Band / 15600-39100 (PB3)37400-67000 (PB4)
41 / Present Academic Grade Pay (AGP) / 54006000660070007600800087008900900010000
42 / Basic Pay (pay in Pay Band + AGP) / रु / Income
Details
43 / Special Pay / रु
44 / Dearness Allowance / रु
45 / City Compensatory Allowance (CCA) / रु
46 / House Rent Allowance (HRA) / रु
47 / Handicapped Allowance / रु
48 / Other Allowance / रु
49 / GPF deduction / रु +
(as per slab) / (Excess) / = /
(total) / Per month Deductions
Details
50 / SI deduction / रु +
(as per slab) / (Excess) / = /
(total)
51 / RPMF deduction / रु +
(as per slab) / (Excess) / = /
(total)
52 / CPF deduction
(for new Employee Only) / रु +
(as per %) / (Excess) / = /
(total)
53 / Income Tax / रु
54 / HRF (if Govt. Residence allotted) / रु
55 / LIC Instalment(s) / रु
56 / GPF Loan Instalment / रु
57 / SI Loan Instalment / रु
58 / Other deduction(s) / रु
PART-C (Qualification details)
59 / Please Give qualification(s) : (Starting with highest degree obtained)
Sr.
No / Qualifi-
cation / Subject /
Topic / University / Board
Name / Pass-ing
Date / Percentage
% / CGPA / Divi-
sion / Achieved
During
Job (Y/N)
1 / % CGPA / FirstSecondPass / NoYes
2 / % CGPA / FirstSecondPass / NoYes
3 / % CGPA / FirstSecondPass / NoYes
4 / % CGPA / FirstSecondPass / NoYes
5 / % CGPA / FirstSecondPass / NoYes
PART-D (Career Advancement Scheme & PB4 Issuing details)
60 / Senior Scale Govt. Order Details
(if any)
e.g. प.स.8(29 )त.शि./2003 पार्ट
Date: 27-01-2011 Serial No: 70 / प.स.8(29 )त.शि./2003 पार्ट
order no / order date / serial no
given date (w.e.f) / 567 years
given after
(5/6/7/ Yr) / Fixed on Basic Pay
61 / Selection Scale Govt. Order Details
(if any)
e.g. प.स.8(29 )त.शि./2003 पार्ट
Date: 27-01-2011 Serial No: 71 / प.स.8(29 )त.शि./2003 पार्ट
order no / order date / serial no
given date (w.e.f) / 567 years
given after
(5/6/7/ Yr) / Fixed on Basic Pay
62 / PB4 Issuing Details
(if any, as on current date position) / order no
given from date (w.e.f) / order date
Basic Pay
(pay in Pay Band +AGP)
PART-E (Short Term Courses & Industrial Training details)
Note: Please Enter STC/Training those are >= one week (Don’t’ enter 1,2,3,4 days STC/Training)
63 / INDUCTION / ORIENTATION Training / week(s)
64 / TTTI/NITTTR Chandigarh Courses (One Week Duration) / nos (except Induction/Ori.)
65 / TTTI/NITTTR Chandigarh Courses (Two Week Duration) / nos (except Induction/Ori.)
66 / TTC/LRDC Courses (One week Duration) / nos (except Induction/Ori.)
67 / TTC/LRDC Courses (Two week Duration) / nos (except Induction/Ori.)
68 / Industrial Training / week(s)
69 / Other AICTE Sponsored STC/Training / week(s)
70 / TEQIP (One Week Duration) / nos
71 / TEQIP (Two Week Duration) / nos
72 / Other Training / week(s)
73 / Total Training Weeks / weeks
PART-F (Joining/posting at various office(s) after Ad-Hoc Selection) if any
74 / Have You Joined as Ad-Hoc in Govt. Job? (yes/no) / NoYes
75 / If YES then fill these Entries: / Joined to Ad-Hoc Job on Dated: and
Left/Relieved from Ad-Hoc Job on Dated:
76 / Please Enter from First Joining to Later on till end of Ad-Hoc Service:
Sr.
No / Institute/Office Name (Joining Place)
Govt. Order no & Date / Date of
Joining / Post of
Joining / By
Appointm-ent/
Transfer/ Deputation
Department / Branch Name
1 / First Joining in Service after Ad-Hoc Selection:
(Place of Joining Inst./Office name)
Order no Order Date / (doj) / (post) / Appointment
Before NoonAfter Noon
(Before/After Noon)
posting Dept. / Branch Name
2 / (Place of Joining Inst./Office name)
Order no Order Date / (doj) / (post) / AppointmentTransferDeputation
Before NoonAfter Noon
(Before/After Noon)
posting Dept. / Branch Name
3 / (Place of Joining Inst./Office name)
Order no Order Date / (doj) / (post) / AppointmentTransferDeputation
Before NoonAfter Noon
(Before/After Noon) / AppointmentTransferDeputation
posting Dept. / Branch Name
PART-G (Joining/posting at various office(s) after RPSC Selection)
77 / Please Enter from First Govt. Joining to Later on till present posting:
(e.g. Lecturer à Sr. Lecturer àHOD/ADT à Principal/Joint-Director etc.)
Sr.
No / Institute/Office Name (Joining Place)
Govt. Order no & Date / Date of
Joining / Post of
Joining / By
Appointm-ent/
Promotion/
Transfer/ Deputation
Department / Branch Name
1 / First Joining in Service after RPSC Selection:
(Place of Joining Inst./Office name)
Order no Order Date / (doj) / (post) / Appointment
Before NoonAfter Noon
(Before/After Noon)
posting Dept. / Branch Name
2 / (Place of Joining Inst./Office name)
Order no Order Date / (doj) / (post) / AppointmentPromotionTransferDeputation
Before NoonAfter Noon
(Before/After Noon)
posting Dept. / Branch Name
Sr.
No / Institute/Office Name (Joining Place)
Govt. Order no & Date / Date of
Joining / Post of
Joining / By
Appointm-ent/
Promotion/
Transfer/ Deputation
Department / Branch Name
3 / (Place of Joining Inst./Office name)
Order no Order Date / (doj) / (post) / AppointmentPromotionTransferDeputation
Before NoonAfter Noon
(Before/After Noon)
posting Dept. / Branch Name
4 / (Place of Joining Inst./Office name)
Order no Order Date / (doj) / (post) / AppointmentPromotionTransferDeputation
Before NoonAfter Noon
(Before/After Noon)
posting Dept. / Branch Name
5 / (Place of Joining Inst./Office name)
Order no Order Date / (doj) / (post) / AppointmentPromotionTransferDeputation
Before NoonAfter Noon
(Before/After Noon)
posting Dept. / Branch Name
6 / (Place of Joining Inst./Office name)
Order no Order Date / (doj) / (post) / AppointmentPromotionTransferDeputation
Before NoonAfter Noon
(Before/After Noon)
posting Dept. / Branch Name
7 / (Place of Joining Inst./Office name)
Order no Order Date / (doj) / (post) / AppointmentPromotionTransferDeputation
Before NoonAfter Noon
(Before/After Noon)
posting Dept. / Branch Name
8 / (Place of Joining Inst./Office name)
Order no Order Date / (doj) / (post) / AppointmentPromotionTransferDeputation
Before NoonAfter Noon
(Before/After Noon)
posting Dept. / Branch Name
9 / (Place of Joining Inst./Office name)
Order no Order Date / (doj) / (post) / AppointmentPromotionTransferDeputation
Before NoonAfter Noon
(Before/After Noon)
posting Dept. / Branch Name
10 / (Place of Joining Inst./Office name)
Order no Order Date / (doj) / (post) / AppointmentPromotionTransferDeputation
Before NoonAfter Noon
(Before/After Noon)
posting Dept. / Branch Name
11 / (Place of Joining Inst./Office name)
Order no Order Date / (doj) / (post) / AppointmentPromotionTransferDeputation
Before NoonAfter Noon
(Before/After Noon)
posting Dept. / Branch Name
12 / (Place of Joining Inst./Office name)
Order no Order Date / (doj) / (post) / AppointmentPromotionTransferDeputation
Before NoonAfter Noon
(Before/After Noon)
posting Dept. / Branch Name
13 / (Place of Joining Inst./Office name)
Order no Order Date / (doj) / (post) / AppointmentPromotionTransferDeputation
Before NoonAfter Noon
(Before/After Noon)
posting Dept. / Branch Name
14 / (Place of Joining Inst./Office name)
Order no Order Date / (doj) / (post) / AppointmentPromotionTransferDeputation
Before NoonAfter Noon
(Before/After Noon)
posting Dept. / Branch Name
Note: If above 14 columns are not sufficient than please take printout of blank page no 5 and fill it by PEN separately.
PART-H (Martial’s Status and Family details)
78 / Martial’s Status / MarriedSingleDivorced
79 / If Married then fill below Entries about Spouse and Children’s:
Spouse (Wife/Husband) Name
Spouse Date of Birth / (e.g. dd-MM-yyyy)
Spouse Mobile No
Is Spouse in Govt. / PSU Job? / NoYes If YES then fill following Entries
Spouse Department Name
Spouse Department Address
Spouse Post
No of Children’s / 012345
Children’s Details:-
Sr.
No / Name of Children / Date of Birth
(dd-MM-yyyy) / Son /
Daughter
1 / SonDaughter
2 / SonDaughter
3 / SonDaughter
4 / SonDaughter
5 / SonDaughter
80 / Information about Father / AliveNot Alive / Occupation: AgricultureAdvocateBusinessmanGovt. JobPSU JobPrivate JobRetired
81 / Information about Mother / AliveNot Alive / Occupation: House wifeAgricultureAdvocateBusinessmanGovt. JobPSU JobPrivate JobRetired
PART-I (Salary Bank Account’s details)
82 / Bank Name
83 / Bank Address
84 / Account Number
85 / IFSC Code / (used for RTGS and NEFT transactions)
86 / MICR Code
87 / SWIFT Code
PART-J (Present & Permanent Address details)
88 / Present Address
(Accommodation)
(as mentioned in HRA Order Issued by Principal / HO) / Address:
Type: SelfGovernmentRentedOther
89 / Permanent Address
(as per service record)
WITH PICODE / Address:
District: / State:
Phone: (STD code) / (phone number)

Place:

Date:

(Full Signature of Employee)

This is certified that above all Entries related to Service Book are checked and found correct.

(OA/UDC Establishment)

(Counter Signed by Principal / Head of Office)

Directorate of Technical Education, Rajasthan,
Jodhpur [Polytechnic Staff Master Data]
[DTE-PSMD]– November, 2013 / (Signature/Initials of Employee by Pen)