Government Employee Information
GENERAL INFORMATION
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Name :
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Father’s Name :
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Mother’s Name :
Gender : Marital Status : Freedom Fighter
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Religion :
Date of Birth : i BAS ID No . (if available):
Day Month Year
National ID No :
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TIN :
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Designation :
(In case of LIEN/Deputation please mention last position)
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Department :
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Present Posting Place :
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Permanent Address :
Thana/Upazilla : Post Code:
Zilla :
Please tick, if same as permanent address
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Present Address :
Thana/Upazilla : Post Code:
Zilla :
Land Phone (Home) : Land Phone (Office) :
Fax :
Mobile : E-mail :
EDUCATIONAL QUALIFICATION
SI No Name of Certificate Name of Institution Board/ Country Year of Result
/Diploma/Degree University passing
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SERVICE INFORMATION
Name of Cadre/Post :
Joining Date in Present Post :
Scale of Pay :
Basic Pay : Date of Increment :
Leave Earning Type (Please Tick) : Vacation Non-Vacation
BANK INFORMATION
Account Name: (As recorded in Bank Account )
Bank Name : Branch Name :
Account Number : Account Type : Savings Current
LEAVE
SI Leave Availed Nature of Leave Grounds Sanction Order
No From To Total Period No and Date
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HISTORY OF SERVICE
Date of Monthly Pay
Name of promotion/
Joining Nature of
Name of Post Cadre(if Encadrement/ Scale of Pay Remarks
Date Appointment Date Pay Other Pay
applicable) Selection Grade/
Time Scale
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LIEN/DEPUTION/ATTACHMENT
SI NO Name of Country Position Held Period Source of
Organisation From To Fund
Signature Date
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Pensioner Information
PPO INFORMATION
PPO NO :
Sanction Order No :
PPO Issued from (Office Name):
GENERAL INFORMATION
Name (In Bangla) :
(In English) :
Gender: Male Female Marital Status : Married Unmarried
Religion : Widow Divorce
Date of Birth : National ID No :
-
Day Month Year (In case of 13 digit ID please keep blank first 4 box)
Permanent Address :
Post Code:
Thana/Upazilla :
Zilla :
Please tick, if same as permanent address
Present Address :
Post Code:
Thana/Upazilla :
Zilla :
Mobile : E-mail :
Identification Mark :
PENSION INFORMATION
Pensioner Designation in Last Active Service :
Name of Office in Which Pensioner Last Worked in Active Service :
Pension Drawn from : Accounting Office : Bank :
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If pension is drawn from accounting office, please provide office If pension is drawn from bank, please provide bank information
information
Bank Name :
Accounting Office Name :
Branch Name :
Class of Pension : Compensation Invalid Retiring Superannuation
Date of commencement of pension :
Pension Type : Regular Family
FAMILY PENSION INFORMATION
Name of Deceased Government Servant :
Relation with the Deceased Government Servant :
Date of Expiry of Monthly Pension :
(Other than wife & handicapped Children)
PENSION RATE
Monthly Pension : Medical Allowance :
Other Allowance(if any):
BANK INFORMATION
Account Name (As recorded in Bank Account) :
Bank Name : Branch Name :
Account Number : Account Type : Savings Current
Signature Date