To
Sir,
Sr. Executive Director (HR)
HLL Lifecare Ltd.
Corporate & Regd. Office Latex
Bhavan, Poojappura,
Thiruvananthapuram-695012, Kerala
Paste your recent
passport size
photograph here
Sub: Application for the post of ________________________________________________
Job Code: __________________________________________________________________
Ref: ______________________________________________________________________
BIO DATA
1. Name in full (In Block Letters)
: __________________________________________________
2. Fathers / Husbands Name
: _________________________________________________
3. Age and Date of Birth
(Self attested copy shall be enclosed)
: _________________________________________________
4. Sex
: Male / Female
5. Religion and Nationality
: _________________________________________________
5(a) Mention whether SC/ST/OBC
PH/Ex-Servicemen
(if yes, Attach copy of certificate)
: _________________________________________________
6. Educational Qualification (Begin with highest qualification):
Name of
Examination
Degree
Board/University /
Institute
Specialization/Branch
Month and
Year of passing
% of
Marks
(Please enclose Self attested copies of original certificates and mark list)
7. Experience (Beginning with current employment)
Name of Organisation
Post Held
:
Period of
Service
From
To
(Please attach Self attested copies of experience certificates)
Salary
drawn
Reason for
leaving
8. Please enclose a Brief invariable on the exact nature of your experience /achievements and how you
consider yourself suitable for the post applied.
9. Present Salary Break-up
(Please attach copy of the latest salary slip)
Amount in Rs.
Scale of Pay
Basic Pay
DA
HRA
CCA
Conveyance
Canteen Allowance
Medical
Educational Allowance
PF
Others (please specify)
1.
2.
3.
10. Are you a member of Provident Fund: Yes / No
If yes, EPF Account No.
11. a) Permanent Address
: __________________________________________________
: __________________________________________________
__________________________________________________
__________________________________________________
b) Present Address
: __________________________________________________
__________________________________________________
__________________________________________________
12. Phone Number
: Mobile__________________ Land Line _________________
13. E-mail address
: __________________________________________________
14. Mother Tongue
: __________________________________________________
15. Languages Known (Please tick which ever is applicable):
Language
Read Write
Speak
16. Have you previously applied for a position at HLL? If yes give details
17. References of persons in responsible position (Name & Address)
Sl. No
Name
Address with Ph. No.
1
2
18. Any other particulars concerned : __________________________________________________
The application is liable for rejection if not filled in the prescribed Performa with full details of experience and also
if not furnished the copies of certificates and testimonials in support of qualification (including mark sheet),
experience, age, caste (for SC/ST/OBC/PH) etc.
Declaration
I certify that the above information is correct and true to the best of my knowledge and belief. In the event of any
information being found false or incorrect, action can be taken against me. Further declare that I have never been
arrested/prosecuted and convicted by a Criminal Court or involved any other case registered by the Police.
Yours faithfully,
Place:
Date:
(Signature of the candidate)