Axom Sarba Siksha Abhijan Mission
Rashtriya Madhyamik Shiksha Abhiyan, Assam
Department of Education (Elementary & Secondary), Govt. of Assam
Human Resource Management & Information System (HRMIS)
Personal Details
UDISE Code
Teacher / Employee Code
Teacher / Employee Name
Gender
Date of Birth
Category of Caste (Gen/OBC/SC/ST(H)/ST(P))
Religion
Present Address
Permanent Address
AADHAAR No.
Mobile No.
Email Id
Mother's Name
Father's Name
Marital Status
Spouse Name
Personal Identification Marks
Blood Group
Do you have any kind of disability?
Date from when you are suffering from such
disability
Certificate No.
Disability Certificate Issuing Authority
Academic Qualifications
Stream/ Discipline Board/ Passing Roll Marks
Qualification Subjects Studied School / College
University Year No. Obt
HSLC NA General
HS
BSc(H)
BSc(Pass)
MSc
BA(H)
BA(Pass)
MA
BCom(H)
BCom(P)
MCom
Professional and Other Qualifications
Note: [Link], [Link], B.T,TET , Any Other; If TET Qualified please also enter Roll No and the marks obtained in TET
Board/ University School / College Passing Year Roll No. Marks Obt
Qualification Mode Status Subjects
Studied
Service Details
Name of the Post Held
Medium of School
Subjects
Category of Post
Pay Scale
Grade Pay
Appointment Letter No. and Date
Post Creation No and Date
Date of effect of Service Provincialisation (If Provincialised then)
Date of joining in Service
Date of joining in Present post
Date of Retirement
Period spent on Non-Teaching assignment
Salary Account and Other Official Account Details
Permanent Account (PAN) No.
Account No. (Salary Account)
Account Name (Salary Account)
Bank Name
Branch Name (Salary Account)
IFSC
Name of the district where your salary account no is active
Name of the state where your salary account no is active
Salary Payment Mode
Gross Provident Fund (GPF) No.
Group Insurance Scheme (GIS) No.
National Pension Scheme (NPS) No.
Contributory Provident Fund (CPF) No
Permanent Pension Account No.(PPAN)
Permanent Retirement Account No. (PRAN)
Service Record(s)
UDISE Code of the School where you have
worked
Name of the School where you have
worked
Period from when you have worked in the
above School
Awards Received
Name of Award Date of receiving award Purpose of award Awarded by Remarks (If any)
Promotion Details
New Cadre Effective Date Scale Category Grade Pay Next Increment
Date
From To
(Designation) (Designation)
Other Details
Suspension From To
If reinstated from Suspension Date
Department Proceedings From To
Penalty From To
Criminal Case Details
Police Case Details
Declaration: I hereby declare that all the information furnished in the application are true, complete and correct to the best of my knowledge and belief. I
also undertake that I have not submitted applications for two different schools. I understand that in the event of any information being found untrue /false /
incorrect, Govt. of Assam has the right to take legal action against me including termination of my job without assigning any reason thereof.
Signature of Teacher / Employee