Employee Data Sheet Form

Employee Data Sheet Form

1.Employee Details

PF Number:
First Name:
Middle Name:
Last Name:
Date of Birth(dd-mm-yyyy):
Gender:
Marital Status:
Aadhar Number:
PAN Number :
Mobile Number:
Alternate Contact Number:
Email ID:
Address Line1:
Address Line2:
State :
City:
Pin Code:

2.Employment Details

2.1Services Detail:

Unit: / System calculated
Department: / System calculated
Designation:
Staff Category:
Controlling Unit:
Billing Unit:
Cessation Reason:
Cessation Date: / System calculated
Pension Start Date: / System calculated

2.2Employee Group Details for GIS purpose:

Date of Appointment/ Regularization:
Employee Group / From Month / From Year / To Month / To Year

2.3PRFO Details:

PF Ro Date:
PF Ro Amount:
PF Ro No.

2.4Balanced leave Details:

LAP in days
HLAP in days

2.5Employee Zero Pay Months for GIS purpose:

Governed Under REIS: / Yes / No
If Yes , REIS Amount
If No :
From (mon/year) / To (mon/year)

3.Qualifying Services

3.1Net Qualifying Services:

Gross Qualifying Services / System calculated
Non Qualifying Services / System calculated
Total Qualifying Services / System calculated
NetQualifying Services( In Year) / System calculated

3.2Railway Employment Details Before Regularization:

Employment Category / From Date / To Date

3.3Non Qualifying Service Details:

Reason / No of Days

3.4Previous Employment Details:

Organization Name / From date / To Date / Services Duration in Days / Is Railway Qualifying Services?

4.Pay Details

4.1Pay Details:

Pay Commission:
Pay Scale:
Grade Pay:
Last Basic Pay:

4.2Staff Category details during the average Emolument period

Staff Category / From Date / To date / LWP / No of Days Worked / Pay Rate
System calculated

5.Family Details

5.1Dependent Family Members Details:

Name / DOB (dd/mm/yyyy) / Relationship / Identification Mark / 1. Employment Status,
2. Marital Status / PAN No., AADHAR Number / Email Id , Contact Number / Bank Details (If Eligible for Pension)

6.Bank Details

6.1Bank Details for Settlement Payment:

State
Bank
Branch
IFSC Code
Account Number
Mode of Payment
Name as per Bank

6.2Bank Detail for Pension Payment:

Is Pension Payment Bank Details same as settlement Payment Bank Details? Yes /No: NO
If No :
State
Bank
Branch
IFSC Code
Account Number

7.Pension Details

7.1Pension Details:

(to be filled by Personnel Dept.)

Pension Type / System calculated
Pension Category / System calculated
Complementary Pass details / System calculated
Number of Passes / System calculated
Pass Class / System calculated

7.2Fixed Medical Allowance :

FMA opted / Yes/No

7.3Govt. Accommodation Details:

Railway Accommodation Availed / Yes/No
If Yes
Accommodation type
Quarter No
Location
Date of vacation

7.4Department proceeding:

Provisional Pension / Yes/No
Proceeding Type / Proceeding Status / Proceeding advice Ref. No.

8.Recovery Details

8.1Outstanding Dues:

(to be filled by Personnel Dept.)

Amount / Allocation Head Description / Allocation Head code
10 / I-CARD / System calculated

9.Commutation Details

Commutation opted : Yes/No

Commutation Opted
If Yes, Commutation Percentage
Commutation Start date
Commutation Restoration Date
Medical Examination date (if applicable)

RESULTS

Qualifying Service
Average Emolument
Pension Type
Pension Amount
Family Pension Amount(Enhanced)
Family Pension Amount(Normal)
Commutation
DCRG / 10,00000
Leave Encashment
GIS
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