Personal Information
Name :
Local Address :
Permanent Address :
Native Place Address :
Contact Numbers : / nd
Education :
] 1. Uneducated ☐ 2. Below 10th Class ☐
- 10th ☐ 4. 12th ☐
Date of Birth : / 04/05/1987 /
Age : / 30-35 /
Height : / 5’5” to 6’0” /
Religion : / Hindu /
Nationality : / Indian State : Uttar Pradesh
Passport No :
Marital Status : /
- Single ☐ 2. Married ☐ 3. Divorcee ☐
Dependents : / 1. Father ☐ 2. Mother ☐ 3. Wife ☐
4. Husband ☐ 5.No. of Children ……
Staying with family/
Relatives/Friend/Alone : / FAMILY
Language Proficiency
Mother Tongue :
Speak Read Write Understand
Marathi ☐ ☐ ☐ ☐
Hindi ☐ ☐ ☐ ☐
English ☐ ☐ ☐ ☐ / Native Fluent Normal Poor
☐ ☐ ☐ ☐
☐ ☐ ☐ ☐
☐ ☐ ☐ ☐
Other Languages Known:
Hobbies & Habits
Hobbies : / Sports ☐ Driving Vehicles ☐ Reading Book & Newspaper☐
Listening Songs ☐ Watching TV ☐ Cooking ☐
Self Care ☐
Habits : / Smoking ☐ Gutkha ☐ Drinking ☐
Pan ☐ Tobacco ☐ None of the above ☐
Duty Hours
Timing : / 8 ☐ 10 ☐ 12 ☐ 24☐
Willing to work in night
shift : / Yes ☐ No ☐
Work On Holiday With (OT) / Yes ☐ No ☐
Experience & Efficiency
Nature of Experience : / Governess ☐ Nanny ☐
Baby Care ☐ Japa Maid ☐
Cook ☐ House Maid☐
House Maid + Baby Care ☐ Patient Care Taker ☐
Ward Boy Senior Care ☐ Pets Care ☐
Gardening Work ☐ Car Wash ☐
Other Work Efficiency :
Work Experience (years) : / 10 years of experience
0 Expert in Cooking
Can cook dishes : / Indain ☐ Mughalia ☐ Continental☐
Maharashtrian☐ Gujrati ☐ Rajastani☐
Bengali ☐ Punjabi ☐ South Indian☐
North Indian ☐
Veg ☐ Non Veg☐
Previous Employment Details
Name of the Last Employer :
Address of the Last Employer: / -
Employer Contact Number : / -
Reason for leaving previous job :
Medical Insurance & Bank Details
Physical Handicap, if any : / Yes ☐ No☐
If yes please mention :
Do youhave any InsurancePolicy? / Yes ☐ No☐
Which type of Policy do you have?
Insurance Company :
Policy Number :
Nominee :
Bank Details :Bank Name :
Ac/No.:
Branch: / -
-
-
Mention Relatives Name & Address.
Name : / Relation : Mother
Address :
Mobile :
Name : / Relation : Choose an item.
Address :
Mobile :
Police Record (if any)
Have you ever been convicted ? / Yes ☐ No☐
If yes, please explain :
Referral Details
Who gave you the information about our
Company?
Name of the Source : /
- Existing Candidate ☐ 2.Previous Candidate ☐
- Media & Newspaper ☐ 4.Pamphlet /Brochure ☐
7.Other (Please Explain) ☐
Ref By : Name :
Contact :
Please mention your Salary Expectation: ( 12 K )
I,______hereby declared that the information above in English is explained me by the Attainder in my Mother Tongue and also I declare that the information furnished by me is true and correct to the best of my knowledge and belief.
Signature of the Candidate: ______Date: ( 19/6/017 )
Acceptance
* 1.I______hereby declare that M/s. Tathastu Home
Services Pvt. Ltd have not charged me for the services of placement offered to me.
* 2.It is hereby agreed by and between me and the M/s. Tathastu Home Services Pvt. Ltd
(hereinafter referred as T.H.S. for short) that I would immediately rescind/ resign from my job
upon request made by the M/s. Tathastu Home services Pvt. Ltd for the reason non payments
of THS’s due by my employer towards registration and service charges, and reinstate myself to
the job offered by THS. I hereby undertake to fully co-operate with the policy of T.H.S.
Signature of the Candidate: ______.
For Official use:Application No.:
Whether selected for interview: Yes☐ No☐
If no, reason for the same:
Proficiency of the Candidate1.☐ 2.☐ 3.☐
Candidate selected for the Post: Date of Joint:14/06/2017
Attach following document copies with this form:
1. / Two passport size photographs. / ☐ / 9. / Employment ID / ☐
2. / Ration Card. / ☐ / 10. / Leave & License. / ☐
3. / Electricity Bill. / ☐ / 11. / Driving License. / ☐
4. / Aadhar Card. / ☐ / 12. / Badge Xerox, if applicable / ☐
5. / Voter ID. / ☐ / 13. / Bio-Data. / ☐
6. / Pan Card. / ☐ / 14. / Relative doc. / ☐
7. / Passport. / ☐ / 15. / Education Certificate, if any. / ☐
8. / Bank Pass Book. / ☐ / 16. / Merit Certificate / ☐
Name of the Attainder : ______
Signature: ______
D-2, Soc 39, S.V.P Nagar, Mhada, Four Bungalows, Andheri (W), Mumbai-400 053. Landline: 022-26315857.