PMO COOPERATIVE HOUSING SOCIETY LIMITED

PMO COOPERATIVE HOUSING SOCIETY LIMITED
PLOT No. C-58/20, SECTOR-62, NOIDA-201 307
INFORMATION REGARDING SERVICE PROVIDERS
Photograph
Name
Date of birth/Age
Father’s / Husband’s Name
Service provided [tick the
relevant]
MILK MAN/HOUSE MAID/PAPER VENDOR/LAUNDRY
/OTHERS [please specify]
Employed since when
Flat where service provided
Agency through which employed
[if any]
Present Residential Address
Permanent Address
Contact No.
(O)
(R)
Mobile:
Person to be contacted in
Noida/Delhi [in exigency]
Signature of the service provider
Date:
Counter signature of Resident- Member/
Tenant employing the service provider