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RESINOVA CHEMIE LTD.
Corporate office : 15/78, Civil Lines, (Opp. Ragendra Swarup Auditorium), Kanpur-208 001 (U.P.)
PERSONAL DECLARATION FORMAT OF CANDIDATE: NON-MARKETING
INSTRUCTIONS: 1. Do not leave any column blank.
(To be followed Strictly) 2. You must afix your passport size photograph at the given space.
3. Please sign at the bottom of each page.
4. Correct Information are to be filled.
5. All columns to be filled in Capital Letters.
6. Please mention your name in below column similar as mentioned in your Aadhar card.
1. Name (In Block Letters)
2. Father's Name:
3. Place of Birth: Date Of Birth Age Affix your latest
passport size
4. Height in Cms. 5. Nationality photograph
6. Present Address:
7. Contact Number(s)
8. Permanent Address:
9. Alternate Contact No.(s) Wife: Brother:
Father: Landline No.(Home):
10. E-mail ID (write in capital letter)
11. Education
Degree Year of Board/ University Place %age/ Stream Subject
Passing Grade
High School (X)
Intermediate (XII)
Graduation
Post Graduation
12. Technical/Business Degree University Grade Division Passing Year
Management
Qualification:
13. Computer Awareness:
14. Language Proficiency: (Starting from mother tongue)
Language Read Speak Write
15. Details of vehicle owned by you:
16.Valid Driving License No. and Place of Issue:
17. Perferred Location:
18. Are you willing to relocate? If yes (Give state wise preference, Not District/Citywise) .: Do not fill option 2-5, if ticked option 1
Any where in India 2 3 4 5
20.Professional Experience (Starting from Current)
Working Period Salary (Current Job & last job
(Mention Date, Month only) (Don not include
Your & Year) TA/DA/Mob./
Name of Company Company' Your Working Nature of Job Designation Incentive) Reason For
s Head Location Leaving
Office
Total Take
From To CTC Deductions Home
from CTC Salary
Signature of Candidate Date :
21.Salary Drawn in Current Job
(Do not include TA/DA/Incentive/Mobile etc.)
22.Break Up of Salary Drawn {Mention Head (s) wise Bifurcation} -
23.If selected, what are your expectations regarding percentage % hike in present CTC ? Also mention your notice period in present company.
24.Have you attached salary slip with this format if not, by when it may be submitted ?
25.Are you related to any staff member of Resinova Chemie Ltd.?(If yes) How? Specify name of Staff Member.
26.Do you know any staff member in Resinova Chemie Ltd? If yes, Specify name. (Apart from name mentioned in 23)
27. Are you related to any of our distributors? If yes, write name and city of distributor.
28.Have you ever appeared for any interview in Resinova Chemie Ltd. earlier? If yes, when and for which post?
29. How did you come to know about position that you are applying for - Advertisement/Consultant/Job Portal?
30. Any body deformity/disability/Acute or Chronic Disease? If yes, give details
31. Mention, Any specific identification mark on your body
32. Family Particulars:-Must mention DOB of your parents/wife/childern for registration in PF/ESI.
Relationship Name DOB Age Occupation(Complete Details) Complete Address
Father
Mother
Brother(s)
Sisters(s)
Wife
Son(s)
Daughter(s)
33.References : (Do not Mention details of any relative, mention funcational details only)
S. No. Name Name of Company working with Designation Addre Contact No.
ss
34. Declaration:
I Son of
Resident of
I, declare that all the above contents & entries are correct as per my knowledge ,in case information is found false ,RCL is free to take any disciplinary
action/terminate my services. Further, I declare that I shall obey the rules, regulations and standing orders of the company and my seniors and maintain
discipline and integrity (in case I am selected).
Date:
Place: Signatures of Candidate
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