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Annexure I EMPLOYEES’ FORM: PE-01 OLD-AGE BENEFITS (Revised) INSTITUTION APPLICATION FOR EMPLOYEE’S REGISTRATION 1 Name (In block letters) as shown in the National Identity Card 2 Gender Male Female 2A Handicapped yes No 2B Nature of Disability* Visual Hearing Speaking Limbs (Only if 2A is Checked as Yes) Other (Please specify) 3 Father (F)/Husband’s (H) Name F H Day Month Year (Please check one) 4 Date of Birth In words 5 National Identity Card No. 5A NADRA National Identity Card No. (Please attach photocopy of both sides) 5B Family Code 6 Present Address Permanent Address CERTIFICATE OF EMPLOYER Day Month Year 7 Employment of above employee began on Worker’s thumb impression 8 Date of the applicability of the scheme Worker’s Signature 9 National Identity Card inspected and details Shown on this form are certified correct 10 Name of establishment Registration No. Sub Code if any Seal of the Signature of Employer Establishment Name Designation Day Month Year Date FOR OFFICE USE ONLY EOBI Registration Card No. Initial Day Month Year Contribution Card Issued Day Month Year P103 Issued/ Not Issued *Attach certificate from Provincial council for the Rehabilitation of Disabled Person

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  • Annexure I EMPLOYEES FORM: PE-01 OLD-AGE BENEFITS (Revised) INSTITUTION

    APPLICATION FOR EMPLOYEES REGISTRATION

    1 Name (In block letters)

    as shown in the National Identity Card 2 Gender Male Female 2A Handicapped yes No 2B Nature of Disability* Visual Hearing Speaking Limbs (Only if 2A is

    Checked as Yes) Other (Please specify)

    3 Father (F)/Husbands (H) Name F H Day Month Year (Please check one) 4 Date of Birth

    In words 5 National Identity Card No. 5A NADRA National Identity Card No. (Please attach photocopy of both sides) 5B Family Code 6 Present Address Permanent Address CERTIFICATE OF EMPLOYER Day Month Year 7 Employment of above employee began on Workers thumb impression 8 Date of the applicability of the scheme Workers Signature 9 National Identity Card inspected and details Shown on this form are certified correct 10 Name of establishment

    Registration No. Sub Code if any

    Seal of the Signature of Employer Establishment

    Name

    Designation

    Day Month Year Date

    FOR OFFICE USE ONLY EOBI Registration Card No.

    Initial Day Month Year

    Contribution Card Issued Day Month Year

    P103 Issued/ Not Issued

    *Attach certificate from Provincial council for the Rehabilitation of Disabled Person


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