Registration

PERSONAL DETAILS

First Name*

Middle Name

Last Name

Date of birth*

Mobile Number*

Landline Number

Gender*

Email*

Adhar Number

Passport Number

Blood Group

Medical Category*

Native District*

Native Taluk*

Native Village*

Father's Name

Nominee Name

Relation

Religion

Caste

Community

Disability

Percentage of Disability

Photo* File size cannot exceed 200kb.

Current Address *

Permanent Address Same as current address

FAMILY DETAILS

Name*

DOB

Relation*

Married

Occupation

Income

PROFESSIONAL DETAILS

Service Persoanl Number*

Defence Service*

Rank*

Trade*

Regiment/Corps

Unit last served

Exservice ID Number*

Exservice ID Card Date

Issued Office

Enrollement Date*

Retirement Date*

Total Service

Pension Order Number*

Pension Order Date

Record Office Details

Address Line1

Address Line2

City

Country

State

District

Pincode

EDUCATIONAL DETAILS

Institution*

Course Type*

Course*

Year*

Percentage

University/Board

EXPERIENCE DETAILS

Organisation

Designation

From Date

To Date

Employement Type

Current Experience

BANK DETAILS

Bank Name*

Branch Name*

Account Number*

IFSC Code

Account Type

LANGUAGE DETAILS

Language*

Read

Write

Speak

OTHER DETAILS

First Choice District

Second Choice District

Third Choice District

PF Number

UA Number

Insurance Number

Job Skills

Sports/Games/Hobbies

Document Type (All document shall be of maximum size 1MB and should be in PDF format)

Pension Pay Order (PPO) original *

ESM Identity Card *

Discharge Book (Pages containing Personal Data and Family Details only) *

Adhaar Card *

Bank Pass Book (SBI only – First page where account number and bank details are available) *

In the case of widow, Non-Remarriage Certificate obtained from respective village office (validity 6 months)

Hard copy of the application should be handed over in person or dispatched by post so as to reach the Kexcon office

Employee Registration Already Registered?