i card form
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(Executive)ID-CARD FORM(TO BE FILLED IN BLOCK LETTERS)
Serial No: ..
HR No.: 200903613 Old I/Card No.: AO 0535Name: PRASHANT KANWAT Designation: J.T.OFathers Name: Mr. BHARAT SINGH KANWAT Date of Birth: 20-04-1985 Date of Superannuation: 30-04-2045
Office Address: IP TAX-II, O/o DGM D-TAX, EASTERN COURT, JANPATH, NEW DELHI - 110001
Phone (O): 011-23328791 (Resi.): 011-28035359 (Mobile): 9868111612
Two RecentPassport SizePhotographs(One paste here)35mm x 45 mmBlood Group: O+
Residential Address: 216, INDRAPRASTHA APARTMENTS SECTOR-12, POCKET-3 DWARKA, NEW DELHI-110078 Signature of Applicant: Purpose of ID Card:(i) New ID Card* (ii) Renewal of ID Card*(iii) Loss of ID Card: In case of loss of ID Card a copy of FIR and receipt of payment of 100/- to A.O. (Cash) is to be attached.(iv) Modification of Design./Office Address*Above data and reason for issue of Identity card is duly verified by Controlling Authority.
Signature of Controlling Authority Name of Controlling Authority: Stamp / Seal with date:
Signature and Seal of Issuing Authority with date:
*Please Note: 1. Please provide copy of relevant orders issued for the purpose.2. Card issued by AGM (HRD) NTR New Delhi will be accepted for surrender. Surrender/declaration certificate may be obtained from the previous unit in ORIGINAL in case of cards surrendered/expired, as the case may be.
(Executive)ID-CARD FORM(TO BE FILLED IN BLOCK LETTERS)
Serial No
HR No.: 198100281Old I/Card No.: AO 0267Name: SHASHI KANT ASTHANA Designation: S.D.EFathers Name: Late Mr. P.N. ASTHANA Date of Birth: 08-07-1956 Date of Superannuation: 31-07-2016
Office Address : IP TAX-II, O/o DGM D-TAX, EASTERN COURT, JANPATH NEW DELHI - 110001
Phone (O) : 23328781(Resi. ) : 28547290 (Mobile) : 9868185990
Two RecentPassport SizePhotographs(One paste here)35mm x 45 mmBlood Group: B+
Residential Address: JG-II/735C, LIG FLATS, VIKAS PURI, NEW DELHI-110018
Signature of Applicant : Purpose of ID Card :(i) New ID Card*(ii) Renewal of ID Card8(iii) Loss of ID Card : In case of loss of ID Card a copy of FIR and receipt of payment of 100/- to A.O. (Cash) is to be attached.(iv) Modification of Design./Office Address*Above data and reason for issue of Identity card is duly verified by Controlling Authority.
Signature of Controlling Authority:Name of Controlling AuthorityStamp / Seal with date :
Signature and Seal of Issuing Authority with date:
*Please Note : I. Please provide copy of relevant orders issued for the purpose.2. Card issued by AGM(HRD) NTR New Delhi will be accepted for surrender. Surrender/declaration certificate may be obtained from the previous unit in ORIGINAL in case Of cards surrendered/expired, as the case may be.
(Non-Executive / Executive)ID-CARD FORM(TO BE FILLED IN BLOCK LETTERS)
Serial No
HR No.: 200104443Old I/Card No.: 3102Name: SANJAY SINGH BISHT Designation: T.T.A.Fathers Name: Late Mr. HIRA SINGH Date of Birth: 12-04-1974 Date of Superannuation: 30-04-2034
Office Address : IP TAX-II, O/o DGM D-TAX, EASTERN COURT, JANPATH NEW DELHI - 110001
Phone (O) : 23328781(Resi. ) : 27632138(Mobile) : 9868258458
Two RecentPassport SizePhotographs(One paste here)Blood Group : A+
Residential Address : I 254, JAHANGIR PURI, DELHI-110033
35mm x 45 mmSignature of Applicant : Purpose of ID Card :(i) New ID Card*(ii) Renewal of ID Card*(iii) Loss of ID Card : In case of loss of ID Card a copy of FIR and receipt of payment of 100/- to A.O. (Cash) is to be attached.(iv) Modification of Design./Office Address*Above data and reason for issue of Identity card is duly verified by Controlling Authority.
Signature of Controlling Authority:Name of Controlling AuthorityStamp / Seal with date :Signature and Seal of Issuing Authority with date :
*Please Note : I. Please provide copy of relevant orders issued for the purpose.2. Card issued by AGM(HRD) NTR New Delhi will be accepted for surrender. Surrender/declaration certificate may be obtained from the previous unit in ORIGINAL in case Of cards surrendered/expired, as the case may be.
(Non-Executive)ID-CARD FORM(TO BE FILLED IN BLOCK LETTERS)
Serial No: ..
HR No.: 200011761 Old I/Card No.: 1578 Name: SUMER CHAND RAMOLA Designation: TELECOM MECHANICFathers Name: LATE Sh. BHAGWAN CHAND RAMOLA Date of Birth: 15-07-1970 Date of Superannuation: 31-07-2030
Office Address: IP TAX-II, O/o DGM D-TAX, EASTERN COURT, JANPATH, NEW DELHI - 110001
Phone (O): 011-23328785 (Resi.): 011-28520809 (Mobile): 9868242683
Two RecentPassport SizePhotographs(One paste here)Blood Group: B+
Residential Address: RZ-368/394, GALI NO.-9 SHIVPURI, WEST SAGARPUR NEW DELHI-110046 Signature of Applicant: 35mm x 45 mmPurpose of ID Card:(i) New ID Card* (ii) Renewal of ID Card*(iii) Loss of ID Card: In case of loss of ID Card a copy of FIR and receipt of payment of 100/- to A.O. (Cash) is to be attached.(iv) Modification of Design./Office Address*Above data and reason for issue of Identity card is duly verified by Controlling Authority.
Signature of Controlling Authority Name of Controlling Authority: Stamp / Seal with date:
Signature and Seal of Issuing Authority with date:
*Please Note: 1. Please provide copy of relevant orders issued for the purpose.2. Card issued by AGM (HRD) NTR New Delhi will be accepted for surrender. Surrender/declaration certificate may be obtained from the previous unit in ORIGINAL in case Of cards surrendered/expired, as the case may be.
(Executive)ID-CARD FORM(TO BE FILLED IN BLOCK LETTERS)
Serial No: ..
HR No.: 200700191 Old I/Card No.: AO 0286Name: RAJIV KUMAR YADAV Designation: J.T.OFathers Name:Mr. R.M.S. YADAV Date of Birth: 04-03-1982 Date of Superannuation: 31-03-2042
Office Address: IP TAX-II, O/o DGM D-TAX, EASTERN COURT, JANPATH, NEW DELHI - 110001
Phone (O): 011-23328781 (Resi.): 011-22564656 (Mobile): 9868156757
Two RecentPassport SizePhotographs(One paste here)35mm x 45 mmBlood Group: O+
Residential Address: A-12/277B, BRIJPURI DELHI-110094
Signature of Applicant: Purpose of ID Card:(i) New ID Card* (ii) Renewal of ID Card*(iii) Loss of ID Card: In case of loss of ID Card a copy of FIR and receipt of payment of 100/- to A.O. (Cash) is to be attached.(iv) Modification of Design./Office Address*Above data and reason for issue of Identity card is duly verified by Controlling Authority.
Signature of Controlling Authority Name of Controlling Authority: Stamp / Seal with date:
Signature and Seal of Issuing Authority with date:
*Please Note: 1. Please provide copy of relevant orders issued for the purpose.2. Card issued by AGM (HRD) NTR New Delhi will be accepted for surrender. Surrender/declaration certificate may be obtained from the previous unit in ORIGINAL in case of cards surrendered/expired, as the case may be.
(Non-Executive)ID-CARD FORM(TO BE FILLED IN BLOCK LETTERS)
Serial No: ..
HR No.: 200904933 Old I/Card No.: 1591 Name: ABHISHEK KANDURI Designation: T.T.AFathers Name: Mr. K.S.R.MOORTHI Date of Birth: 13-08-1984 Date of Superannuation: 31-08-2044
Office Address: IP TAX-I, O/o DGM D-TAX, EASTERN COURT, JANPATH, NEW DELHI - 110001
Phone (O): 011-23328782 (Resi.): --- (Mobile): 9013495185
Two RecentPassport SizePhotographs(One paste here)35mm x 45 mmBlood Group: O+
Residential Address:
Signature of Applicant: Purpose of ID Card:(i) New ID Card* (ii) Renewal of ID Card*(iii) Loss of ID Card: In case of loss of ID Card a copy of FIR and receipt of payment of 100/- to A.O. (Cash) is to be attached.(iv) Modification of Design./Office Address*Above data and reason for issue of Identity card is duly verified by Controlling Authority.
Signature of Controlling Authority Name of Controlling Authority: Stamp / Seal with date:
Signature and Seal of Issuing Authority with date:
*Please Note: 1. Please provide copy of relevant orders issued for the purpose.2. Card issued by AGM (HRD) NTR New Delhi will be accepted for surrender. Surrender/declaration certificate may be obtained from the previous unit in ORIGINAL in case of cards surrendered/expired, as the case may be.
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