COMPASSIONATE GROUND APPOINTMENT
Note: The application should be filed within 1 year only from the date of death of the government servant.
PRELIMINARY APPLICATION FORM
Deceased employee nominee details are not found in our records. Kindly contact respective EEDS office..
Deceased employee death date is not found in our records. Kindly contact respective EEDS office.
(I) Deceased Employee Details
KGID Number
*
:
Name
*
:
Designation
*
:
Division
*
:
District
*
:
Block
*
:
Last Working School/Office
*
:
Death date
*
:
Residential Address
*
:
(II) Applicant Details
Name (English)
*
:
Name (Kannada)
*
:
Date of Birth
*
:
Age
*
:
Gender
*
:
--Select--
Male
Female
Transgender
Deceased Employee Name
*
:
Please enter correct deceased name
Mobile No
*
:
Alternate Mobile No :
Relationship
*
:
--Select--
Widow
Widower
Son
Married Daughter
Unmarried Daughter
Divorced Daughter
Wife
Brother
Sister
Other to specify
Husband
Specify relation with deceased
*
:
Caste
*
:
--Select--
SC
ST
Category 1
OBC
General
Physically challenged
*
:
Yes
No
Type Of Disability
*
:
Document Type Of Disability
*
:
District
*
:
Block
*
:
Permanent address
*
:
Residential address
*
:
SSLC Marks Card/Other Equivalent Marks Card/TC
*
:
NOC From Family:
Birth certificate/Any Of The Acceptable Certificate
*
:
(III) NOMINEE DETAILS AS PER SR/EEDS
Sr No.
Name
Relation
Date of Birth
Gender
Note:- please upload attachment is an image (JPEG, PNG, GIF,JPG) or PDF and size is less than 2 MB.
In case of any query regarding this application,kindly contact
submit
Deceased employee nominee details are not found in our records. Kindly contact respective EEDS office..