Confidential
RELATIVE DECLARATION FORM
Name:______________________________________ Employee Code: _________________
Position:____________________________________ Section / Department:_______________________________
Relatives Declaration :
Do you have any immediate relatives** associated with Engro Polymer & Chemicals in any of the following capacity?
Working Status(A) Engro employee Consultant
Contractual (Direct or through third party) Vendor
Trainee Supplier
** Immediate Relative includes following: (B)
Spouse Parent Brother Sibling of spouse Grandparent Aunt / Uncle
Child Step Parent Sister Sibling in law Step Grandparent Step Aunt / Uncle
Step Child Parent in Law Step Brother Step sibling in law Grandparent in law Aunt / Uncle in law
Adopted Child Step Parent in Law Step Sister Cousin Grand Child Niece
spouse first cousin Step Grand child Nephew
Sibling: Brother(s) / sister(s)
Emp. No. Name Company / Division / Department Working as Relation (B) Working Status (A)
(if (chose from the list
(Position title or designation) (chose from the list above)
available) above)
Declaration
I hereby affirm that all of the above are true and correct, and that I have accounted for all of
my relatives employed by EPCL and that I have not withheld any facts or circumstances.
Date:_________________________ Employee Signature:_______________________
Submit this form to HR representative directly in a sealed envelop(preferably)