Bank of Baroda

Date

The Asstt . Gen Manager (HRM) Bank of Baroda

Zonal Office

D D M M Y Y Y Y

EC No.

Dear Sir, Re : Issue of "Service-cum-ldent t ty Card on Ret i rement"

for retirees pr ior to

I have to inform you that I retired from Bank's service on

on superannuat ion / vo luntary ret irement. (Must str ike out wh ich is inappl icable),

I request you to Kindly issue me Service-cum -Identity Card. I give below the required details

1

D D M M Y Y Y Y

Full Name (IN CAPITAL LETTERS) Mr/Mrs/Ms

2. E C No.

3. Designation

4. Date of Birth

5. Date of Joining

6. Date of Retirement

7. Residential Address in Full

(Post Retirement)

(IN CAPITAL LETTERS)

8. Telephone / Mobile No.

9. Blood Group

10. Email I.D.

11. Emergency Contact No.

(other than self number)

Surname Firstname Middle Name

.Pin Code No.

RECENT COLOUR

PHOTOGRAPH

(PASSPORT SIZE'

(EMPLOYEE'S SIGNATURE IN BLACK INK)

Seal of the Branch / Office Verif ied by the Branch / Off ice

Signature of Branch / Office Authority

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