Here's the document converted to clean markdown format:

# EMPLOYEE ATTESTATION FORM [Administrative]

## Employee Information & Attestation

**Instructions:** Employees must fill and sign this form at the time of hire (after induction training by the first day the employee starts work) and after every risk review (for regular employees) by entering the correct information and signing and dating the form.

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### Personal Information

| Field | Value |
|-------|-------|
| **Last Name:** | |
| **First Name:** | |
| **Middle Name:** | |
| **Pay Roll ID:** | |
| **Designation:** | |
| **Work Location:** | |
| **Address:** | |
| **Phone No:** | |
| **Email Address:** | |
| **Department:** | |

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### Departmental Hazards & Risks Register

Brief description of work-related hazards/risks and control.

| Nature of Hazards | Hazards Source | Risk Level | Risk Control |
|-------------------|----------------|------------|--------------|
| **Ergonomic Injuries** (Back pain, Eye strain) | Prolonged sitting, poor posture, incorrect workstation setup | Medium | Use of ergonomic chairs and adjustable desks and regular breaks & stretching, and Health awareness Work method (manual lifting techniques, hoisting and lifting etc) |
| **Slips, Trips, and Falls** (Wet floors, Loose cables, cluttered walkways) | Spilled liquids, improperly stored materials, uneven surfaces | Medium | Keeping floors dry and clean, maintain clear, clutter-free walkways, hold on to the railings while climbing/descending stairs. |
| **Violent Crime** (Assault, Violence against individual, office bullying) | Contact with aggrieved and unsatisfied customers, Breakdown of social order, lawlessness, riot, absence of government authority, Pressure Groups, violent or threatening protests against Company, people or asset | Medium | Ensure professionality while dealing with customers, follow Emergency Response Procedures, use negotiation skills and Counseling tactics, ensure Standby security personnel and Post event dialogue |
| **Job Demand** (Excessive work load) | Poor job planning and inadequacy of Manpower, frequent deadlines, and poor work-life balance | Medium | Adequate planning of the job, Utilization of annual leave, training, and good designed shift patterns or rosters. |

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**\*\*\*NOTE: Hard hats, and safety footwear are required in all Kaduna Electric field locations (Mandatory)\*\*\***

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### Employee Attestation

I understand the hazards/risks associated with my Job and I will use the risks control which include the engineering and operational precautions indicated, including Personal Protective Equipment (PPE), for hazard containment and risk mitigation. This is for my own protection, and for the protection of other people, animals, and the environment.

I agree to abide by the requirements noted above, and any additional requirements.

**Date:** [Today's Date] ___________________

**Employee Signature:** ___________________

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### To be Completed by HOD/HOU

| Name: | Signature: | Date: |
|-------|------------|-------|
|       |            |       |

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**\*\*\*Note: This document will be reviewed periodically to reinforce safety awareness and ensure ongoing compliance.\*\*\***