Service Book Proforma

Photograph
I.D. No. ………………………… Leave A/C No. ………………………… should be attested
AADHAR No…………………………………………... by the Head of the
Deptt. / Office
MOB :- …………………………………………………..

1. Name of the employee (in Block letters) ………………………………………………………………………………………

2. Designation ………………………………………………………………………………………
3. Department/Office ………………………………………………………………………………………
4. Address
(a) Permanent (For the purpose of HTC) ………………………………………………………………………………………

(b)Present ………………………………………………………………………………………
5. Date of Birth [figure & words] ………………………………………………………………………………………
6. Name of supporting document for date of Birth………………………………………………………………………………..
7. Educational Qualification ………………………………………………………………………………………
8. Religion ………………………………………………………………………………………
9. Father’s Name ………………………………………………………………………………………
10. Mother’s Name ………………………………………………………………………………………
11. Wife’s / husband’s name (if Married) ……………………………………………………………………………………..
12. Date of first continuous appointment ………………………………………………………………………………………
13. Date of Confirmation on each post with Proof…………………………………………………………………………………..
14. Basic Pay at present ………………………………………………………………………………………
15. Pay band with grade pay / Scale of Pay ………………………………………………………………………………………
*16. Left/Right hand thumb and finger impression of the employee concerned
__________________________________________________________________________________
Thumb Fore Middle Ring Little
Signature
Finger Finger Finger Finger
Attesting Officer
With Seal & Date
_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________
* 17. Right / Left hand thumb and finger impression of wife/Husband (if married) of the employee concerned
_________________________________________________________________________________________________________________
Thumb Fore Middle Ring Little Signature
Finger Finger Finger Finger Attesting Officer
With Seal & Date
_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

*18. Signature / LTI / RTI *18. (a) Signature /RTI/LTI of the wife/Husband
of the employee concerned of the employee concerned

Chairperson of the Deptt./Head of the Office

(Signature & Seal)
_________________________________________________________________________________________________________________

IMPORTANT NOTE: In case, the employee concerned is working as regular Dean / Chairperson / Principal of College at the time of
submission of this form, he/she may indicate clearly this position in bracket against designation and the same
should be signed / attested by his/her leave sanctioning authority.

Documents to be enclosed
 Photocopy of the proof of date of birth duly self attested
 Copy of 1st continuous appointment order with joining report & extensions, if any.
 Copy of confirmation order, if any.
 Copy of latest pay slip, Aadhar Card & I.D. Card.
Note:- The unmarried employees are requested to complete the required entries of column No. 11, 17 and 18 (a) soon after
his / her marriage on a separate paper.
* In case of Male, left hand thumb & finger impression and for female Right hand thumb & finger impression are required.
 DETAILS OF FAMILY
(Details of marital status of family members as on date)

ID No. ……………………… Mob: ……………………………...

Name of the University Servant……..………………………………………………………….
Department/Office……………………...…………………………………………………….....
Designation………………………………...……………………………………………………
Date of Birth of the employee………………..…………………………………………………
Date of first continuous appointment…………..……………………………………………….
Details of the members of family as on…………………………………………………………
S. Name of the members of Date of Relationship with
Remarks
No. family Birth the employee
1.

2.

3.

4.

5.

6.

7.

8.

9.

1. Verified that the above declaration is true to the best of my personal knowledge and belief,
that nothing material has been concealed therein and that no part of this declaration is false.
2. I hereby undertake to keep the above particular upto date by notifying to the Joint Registrar
Service Book and Pension Section, Registrar Office.

Place……………………………. Signature of the University

Servant

Date…………………………

Forwarded to the Joint Registrar (Service Book & Pension Section), Registrar’s Office,
Aligarh Muslim University, Aligarh.

Dated……………………… Signature of the Head of the

Department/Office

Dated……………………