7/30/2019 Pandey Biodata Form [1]

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OMB Control No. 0412-0520; Expiration Date: 05

CONTRACTOR EMPLOYEE BIOGRAPHICAL DATA SHEET

1. Name (Last, First, Middle) 2. Contractors NamePopulation Foundation of India, New Delhi

PANDEY, SANJAY, KUMAR

3. Employees Address (include ZIP code) 4. Contract Number 5. Position Under Contract

C-702, PNB APARTMENT, PLOT: 11,

SECTOR 4, DWARKA, NEW DELHI - 75 6. Proposed Salary 7. Duration of Assignment

PIN: 110 075

8. Telephone Number(include area code)

9. Place of Birth 10. Citizenship (if non-U.S. citizen, give visa status)

011-45610212/

098781648844

JAMSHEDPUR(JHARKHAND)

INDIAN

11. Names, Ages, and Relationship of Dependents to Accompany Individual to Country of Assignment

12. EDUCATION (include all college or university degrees) 13. LANGUAGE PROFICIENCY(See instructions on reverse)

NAME AND LOCATION OF INSTITUTION MAJOR DEGREE DATE LANGUAGE ProficiencySpeaking

ProficieRead

INDIAN INSTITUTE OF TECHNOLOGY,KANPUR

ECONOMICS

Ph.D. 1993 HINDI 5 5

UNIVERSITY OF ALLAHABAD ECONOMICS

M.A. 1987 ENGLISH 5 5

UNIVERSITY OF ALLAHABAD PHY,CHEM,MATHS

B.Sc. 1983 BHOJPURI 5 5

14. EMPLOYMENTHISTORY1. Give last three (3) years. List salaries separate for each year. Continue on separate sheet of paper if required to list all employment related to duti

of proposed assignment.2. Salary definition - basic periodic payment for services rendered. Exclude bonuses, profit-sharing arrangements, commissions, consultant fees, ext

or overtime work payments, overseas differential, or quarters, cost of living or dependent education allowances.

POSITION TITLE EMPLOYERS NAME AND ADDRESS

POINT OF CONTACT & TELEPHONE NUMBER

Dates of Employment (M/D/Y)From To

Annual SaDollars

COUNTRYPROGRAMMEREPRESENTATIVE

INSTITUTE OF INTERNATIONA;L EDUCATION, 210, SF,JORBAGH, NEW DELHI,

May ,2008

February2, 2009

$3,000/nth+TelResiden(Rs.6000/mh)+Vehicle(Rs.100month) reimburment

COUNTRYPROGRAMMEREPRESENTATIVE

INSTITUTE OF INTERNATIONA;L EDUCATION, 210, SF,JORBAGH, NEW DELHI,

JUL. 3,2006

April,2008

$2,000/nth+Tel+Mobileternet aResiden(Rs.5000/mh)+Vehicle(Rs.800month) reimbur

7/30/2019 Pandey Biodata Form [1]

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ment

EXECUTIVEDIRECTOR

JHARKHAND HEALTH SOCIETY, RCH DIRECTORATE,NAMKUM, RANCHI

JUNE 1,2005

JULY 2,2006

STATEPROGRAMMEREPRESENTATIVE

CARE, 381 A, ROAD NO. 4, ASHOKNAGAR, RANCHI FEB.15,1999

MAY 31,2005

PROGRAM OFFICER ACTIONAID, BIHAR OFFICE, PATNA MARCH,1996

FEBRUARY, 14,1999

15. SPECIFIC CONSULTANT SERVICES (Give last three (3) years)

SERVICES PERFORMED EMPLOYERS NAME AND ADDRESS

POINT OF CONTACT & TELEPHONE NUMBER

Dates of Employment(M/D/Y)

From To

Days atRate

Dailyin Do

16. CERTIFICATION: To the best of my knowledge, the above facts as stated are true and correct.Signature of Employee

SANJAY KUMAR PANDEY, Ph.D.

Date

17. CONTRACTORS CERTIFICATION(To be signed by responsible representative of contractor)Contractor certifies in submitting this form that it has taken reasonable steps (in accordance with sound business practices) to verify the informationcontained in this form. Contractor understands that USAID may rely on the accuracy of such information in negotiating and reimbursing personnel undthis contract. The making of certifications that are false, fictitious, or fraudulent, or that are based on inadequately verified information, may result inappropriate remedial action by USAID, taking into consideration all of the pertinent facts and circumstances, ranging from refund claims to criminalprosecution.

Signature of Contractors Representative Date

AID 1420-17 (9/94)