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
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