PUNJAB STATE POWER CORPORATION LIMITED (POWERCOM) INPUT PERFORMA FoR IDENTITY CARD (USE BLACK PEN TO FILL FORM) Employee's Code (fase be sted) (Atte in HR Database) Colored Passport Size Photograph Duly Attested First Name Middle Name Last Name PASTEONLY Father's Name Date Of Birth aS Be Daa wy Income Tax A/C No, (PAN No.) Category ick the Appropriate Box) Ga SCC eae aR From Sper PCat ATER Serre) ~ Priority Fighter ‘Man Challenged Ground Blood Group Dio Joining 7 Colored Passport DD MM ayy Size Photograph Present Designation Present Office eee DO NOT WRITE Permanent SN PHOT PASTEONLY Distt Pin: Correspondence Dist Pin Telephone No. Office Residence Mobile Reason for Issuing Identity Card Se ee New ee 2.04 Fining) Designation) onicey Transfer of Departure) |(Previous Office) [(Dr of Join, At New Office) (Office Where joined. ) Promotion™ [DeotDepareme) Previous Pos) @revions Ofte) _ fOr ot Foi. Present Post | once Where ind Damaged* (Kins aeach damaged Original — Card Lost BA6No) Ort of B19 |FIRNO) Di of lous of FIR NG) ach pro fsck prow Autestea By Note Signature of Officer 1. Antesing Officer must ensure before atcing hat the entries inthe frm are covet 2 Attesg officer should aot be below the rank of Senior ExecativeEnginecr Name Of Officer “3 Attach original -Card in cate of mages / Teast /Promrio. 4 Fra Passport Size Phorograph without atestng shouldbe artched withthe Form. Designation 5 In case of NoEmpid. Please submit HR Form fo $¢ TformationTechnolegy. 6:Donot staple the photo. Offi Stamp