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    IITM Quarters Resident Form

    Uploaded by

    Mojahedul Islam Nayyer
    This document contains a form for Indian Institute of Technology, Madras to collect information regarding campus residents. The form requests details such as the name, employee ID, designation, and quarters of the licensee. It also collects information on dependents staying in the quarters like name, age, relationship and employment details. Non-dependents and vehicles are also listed along with part-time servants not staying in quarters. Finally, details of occupants of servants' quarters are documented.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    IITM Quarters Resident Form

    Uploaded by

    Mojahedul Islam Nayyer
    47 views2 pages
    This document contains a form for Indian Institute of Technology, Madras to collect information regarding campus residents. The form requests details such as the name, employee ID, designation, and quarters of the licensee. It also collects information on dependents staying in the quarters like name, age, relationship and employment details. Non-dependents and vehicles are also listed along with part-time servants not staying in quarters. Finally, details of occupants of servants' quarters are documented.

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    © © All Rights Reserved

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    This document contains a form for Indian Institute of Technology, Madras to collect information regarding campus residents. The form requests details such as the name, employee ID, designation, and quarters of the licensee. It also collects information on dependents staying in the quarters like name, age, relationship and employment details. Non-dependents and vehicles are also listed along with part-time servants not staying in quarters. Finally, details of occupants of servants' quarters are documented.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    47 views2 pages

    IITM Quarters Resident Form

    Uploaded by

    Mojahedul Islam Nayyer
    This document contains a form for Indian Institute of Technology, Madras to collect information regarding campus residents. The form requests details such as the name, employee ID, designation, and quarters of the licensee. It also collects information on dependents staying in the quarters like name, age, relationship and employment details. Non-dependents and vehicles are also listed along with part-time servants not staying in quarters. Finally, details of occupants of servants' quarters are documented.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 2

    FORM – A

    INDIAN INSTITUTE OF TECHNOLOGY, MADRAS


    INFORMATION REGARDING CAMPUS RESIDENTS

    Name of licensee * Employee ID No.


    Designation &
    Department *
    Quarters / Flat No. and
    Street/Road/Avenue *
    (* ALL IN CAPITALS)

    DETAILS OF DEPENDENTS STAYING IN THE ABOVE QUARTERS/FLAT


    Sl.No Name Age* Relationship to Details of employment, if any
    Licensee
    1.

    2.

    3.

    4.

    5.

    6.

    7.

    8.

    DETAILS OF NON-DEPENDENTS STAYING (IF ANY) IN THE ABOVE QUARTER/FLAT


    Sl.No. Name Relationship to Staying Details of Employment, if any
    the licensee since when
    1.

    2.

    3.

    4.

     For married members of the Family add M after age (e.g. 25 – M)

    Date: Signature of LICENSEE

    PTO
    ..2..

    DETAILS OF VEHICLES (INCLUDING BICYCLES)


    Sl.No. Name of the owner Type of Vehicle Registration No.
    1.

    2.

    3.

    4.

    DETAILS OF PART-TIME SERVANTS (NOT STAYING IN SERVANT QUARTERS)


    Sl.No. Name Age Sex Address
    (M/F)
    1.

    2.

    DETAILS OF OCCUPANTS OF SERVANTS’ QUARTERS IF ANY


    Start with the Head of the Family, If `Not OCCUPIED’, write `VACANT’
    Sl.No. Name Age* Relationshi Staying Details of Employment, if
    p to Head of Since when any Vehicles Particulars
    the family
    1.

    2.

    3.

    4.

    5.

    6.

    7.

    8.

     For married members, add M after Age (e.g. 25 – M). Changes in the information provided should
    be brought to the notice of CHIEF SECURITY OFFICER.

    Date: Signature of LICENSEE.

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