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FROM: PE ‐ 01

(Revised)

APPLICATION FOR EMPLOYEE'S REGISTRATION

1. Name (in block Letters)
as shown in the National Identity Card

2. Sex M/F

3. Father's / Husband's Name

Day Month Year


4. Date of Birth      (in Words)

5. National Identity Card No. ‐ ‐

5.A Nadra National Identity Card No. ‐ ‐

5.B Family Code

6. Present Address

Permanent Address

Certificate of the Employer

Worker's Signature   /

7. Employment of the above employee began on

8. Date of applicability of the scheme

9. National Identity Card Checked and details
shown on this form are certified correct.

10. Name of Establishment Worker's Thumb Impression /

Registration No. ‐ Sub code if any

Seal of the
Establishment
Signature of Employer
Name
Designation
FOR OFFICIAL USE ONLY

EOBI Registration Card No.

PI‐03 issued/not issued

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