Form XV

(See Rule 77)

Service Certificate

Name and address of contractor Allegis Services (India) Pvt. Ltd

RMZ NXT Campus 1B, #401-402,
EPIP Zone, Whitefield
Bangalore - 560 066

Name and address of Establishment Wipro Technologies, Bangalore

Nature and location of work Contract
In / under which contract is carried on Allegis Services (India) Pvt. Ltd
RMZ NXT Campus 1B, #401-402,
EPIP Zone, Whitefield
Bangalore - 560 066

Name and address of the workman Siva Kumar Potnuru

Name and address of principal Employer Wipro Technologies, Bangalore

Age or date of birth 26, 25/08/1985

Identification Marks
Father’s name Manohar Rao

Sl. Total period for which Nature of work done Rate of wage (with Remark
No. employed particulars of unit s
……….. ……. in case of piece
From To work)

1 19/10/2010 8/4/2011 Automatio 32000.00

n test
Engineer

Signature………………………