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This background verification form collects personal and employment details of an applicant named Ashish Srivastava. It includes sections on personal details, education history, employment record from the past 7 years, references, an information release form, and a checklist of documents required for verification. The form is being used to conduct verification of Ashish Srivastava's background details as part of an employment screening process.
This background verification form collects personal and employment details of an applicant named Ashish Srivastava. It includes sections on personal details, education history, employment record from the past 7 years, references, an information release form, and a checklist of documents required for verification. The form is being used to conduct verification of Ashish Srivastava's background details as part of an employment screening process.
This background verification form collects personal and employment details of an applicant named Ashish Srivastava. It includes sections on personal details, education history, employment record from the past 7 years, references, an information release form, and a checklist of documents required for verification. The form is being used to conduct verification of Ashish Srivastava's background details as part of an employment screening process.
PERSONAL DETAILS Name of Applicant !andator"# ASHISH SRIVASTAVA S!name !andator"# SRIVASTAVA "iddle !andator"# #i!$t !andator"# ASHISH "aiden Name : % Ha&e yo e&e! 'een (no)n 'y anot*e! name+ NO Place of Birt$% L,C-NO.# Date of Birt$ /0012AN103405 Se6: "ALE Nationality: Indian #at*e!7$ Name !andator"# A8C8SRIVASTAVA 9a$$po!t No8 HO653::3 SSN No8 /"andato!y ;o! ,S add!e$$5 Home 9*one O;;ice 9*one "o'ile : 3354033333 Email id% a$*i$*<telecom=>mail8com Permanent Addre&& %' 1516, Vidhi Tower, Mahagunpuram, NH-24, near Columbia Asia Hospial, !ha"iabad, #$ %$ - 2&1&&2 Same% 1516, Vidhi Tower, Mahagunpuram, NH-24, near Columbia Asia Hospial, !ha"iabad, #$ %$ - 2&1&&2 City : ?HA@IAAAD State : ,89 9in Code : B0000B Nea!e$t Landma!( : near Columbia Asia Hospial Name o; t*e contact pe!$on at t*e add!e$$ : HE"A SRIVASTAVA Relation$*ip o; contact pe!$on : .I#E Landline No8 "o'ile No8 3B64B45<66 Nat!e O; Location: O)ned 9!e;e!!ed time o; t*e day ;o! condctin> t*e &e!i;icationC i; any : AND TI"E Re$idin> Since /"andato!y5: B003 Re$idin> Till / "andato!y5:Till Date ED()ATION RE)ORD ED()ATION RE)ORD (Start with the latest/ highest qualification; please attach photocopies of the documents ) All fields are mandatory Name & Address of School/College /Institute Name & Address of ni!ersity its affiliated "ype of #egree/#ipl oma o$tained% State &'( for fulltime and &)( for part*time within $rac+ets #ates Attended 'rom "o ,oll Num$er/,egis tration Num$er/-.am Seat num$er HIMT, Greater Noida HI"TC Greater Noida, Affiliated to U.P.T.U, Lucknow "CA/#5 2,LD B003 2,NE B006 030330<00B ?8N8L8D Ra$to>i Inte! Colle>e Alla*a'ad Aoa!d Inte!mediate/ #5 2ly 0335 2ne 033: 3B4:6< "8A8V Inte! Colle>e Alla*a'ad Aoa!d Hi>*Sc*ool /#5 2ly 0333 2ne 0335 5030B< E!PLO*!ENT RE)ORD If you are still employed in this organi/ation0 please fill in the date $efore which you would not li+e the !erification to $e initiated in the &"o( column% If you are not sure or would li+e to intimate this date later0 please write 1Still -mployed1 -mployer 2 Full Name Emplo"ee ID From mm+""# To mm+""# Add!e$$ C%B< C SEC E 53 C NOIDA P$one Num,er City NOIDA State ,89 Cont!y India 9o$tal Code B00300 2o' TitleF TECHNICAL O9ERATION ANALDST Rea$on o; Lea&in>: Sala!y De&ignation So;t)a!e De&elope! #inal Sala!y /Annal CTC5 Super-i&or Name . Title /R !anager Name Super-i&or 0& P$one Num,er /R !anager P$one Num,er E!PLO*!ENT RE)ORD -mployer 3 Full Name Emplo"ee ID From mm+""# To mm+""# Add!e$$ P$one Num,er City State Cont!y India 9o$tal Code 2o' Title Rea$on o; Lea&in> Contact 2o' De&ignation #inal Sala!y /Annal CTC5 Super-i&or Name . Title /R !anager Name Super-i&or 0& P$one Num,er /R !anager P$one Num,er E!PLO*!ENT RE)ORD -mployer 4 Full Name Emplo"ee ID From mm+""# To mm+""# Add!e$$ P$one Num,er City State Cont!y 9o$tal Code 2o' Title Rea$on o; Lea&in> De&ignation #inal Sala!y /Annal CTC5 Super-i&or Name . Title /R !anager Name Super-i&or 0& P$one Num,er /R !anager P$one Num,er E!PLO*!ENT RE)ORD -mployer 5 Full Name Emplo"ee ID From mm+""# To mm+""# Add!e$$ P$one Num,er City State Cont!y 9o$tal Code 2o' Title Rea$on o; Lea&in> De&ignation #inal Sala!y /Annal CTC5 Super-i&or Name . Title /R !anager Name Super-i&or 0& P$one Num,er /R !anager P$one Num,er E!PLO*!ENT RE)ORD -mployer 6 Full Name Emplo"ee ID From mm+""# To mm+""# Add!e$$ P$one Num,er City State Cont!y 9o$tal Code 2o' Title Rea$on o; Lea&in> De&ignation #inal Sala!y /Annal CTC5 Super-i&or Name . Title /R !anager Name Super-i&or 0& P$one Num,er /R !anager P$one Num,er E!PLO*!ENT RE)ORD -mployer 7 Full Name Emplo"ee ID From mm+""# To mm+""# Add!e$$ P$one Num,er City State Cont!y 9o$tal Code 2o' Title Rea$on o; Lea&in> De&ignation #inal Sala!y /Annal CTC5 Super-i&or Name . Title /R !anager Name Super-i&or 0& P$one Num,er /R !anager P$one Num,er REFEREN)E VERIFI)ATION REFEREN)E VERIFI)ATION Note E T*e !e;e!ence p!o&ided $*old 'e c!!ently employed o! en>a>ed in a p!o;e$$ional acti&ity8 11Plea&e en&ure t$at t$e contact num,er& of t$e reference are acti-e num,er& and are reac$a,le for -erification REFERENCE (1) (1)Full name of the Reference (professional) Telephone # and email ID Organization Relationship with the candidate Friend REFERENCE (2) (1)Full name of the Reference (professional) Telephone # and email ID Organization Relationship with the candidate REFERENCE (3) (1)Full name of the Reference (professional) Telephone # and email ID Organization Relationship with the candidate Information Relea&e Form To 2$om It !a" )oncern% 9lea$e p!int Sa*GGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGG La$t name #i!$t name "iddle name I *e!e'y at*o!iHe Vendo! o! t*ei! !ep!e$entati&e$ to &e!i;y in;o!mation p!e$ented on my employment application1!e$me and to p!oc!e an in&e$ti>ati&e !epo!t o! con$me! !epo!t ;o! t*at p!po$e8 I *e!e'y >!ant at*o!ity ;o! t*e 'ea!e! o; t*i$ lette! to acce$$ o! 'e p!o&ided )it* ;ll detail$ n o; my p!e&io$ employment !eco!d *eld 'y any company o! '$ine$$ ;o! )*om I p!e&io$ly )o!(ed8 T*i$ in;o!mation $*old inclde t*e date$ o; employmentF t*e nat!e o; t*e po$ition *eldC Idetail$ o; my $ala!y pon depa!t!eJ and an app!ai$al o; my pe!;o!manceC capa'ilitie$ and c*a!acte!8 In additionC plea$e p!o&ide any ot*e! pe!tinent in;o!mation !eKe$ted 'y t*e indi&idal p!e$entin> t*i$ at*o!ity8 I *e!e'y !elea$e ;!om lia'ility all pe!$on$ o! entitie$ !eKe$tin> o! $pplyin> $c* in;o!mation8 n o; my Kali;ication1de>!ee /copy o; my ce!ti;icate$ attac*ed5 n in;o!mation in !e$pect to my c*a!acte! ;!om t*e !eco!d$ maintained 'y local at*o!itie$
Si>nat!e: Date:
Checklist For Education Verification: Clear cop of the degree certificate and final ear mar! sheet would "e re#uired For Bangalore Uniersit!: $ clear photo cop of "oth sides of the Degree Certificate (The re%erse side of the certificate has some information which the uni%ersit would re#uire) Copies of the &ar! 'heets()rade Card for all the ears of attendance* +ame of the college through which the candidate has graduated* For E"#lo!"ent Verification: Clear ,hotocop of the relie%ing(e-perience certificates .mploee Code of the organization where%er a%aila"le For Cri"inal Verification $uthorization letter dul signed " the candidate/ authorizing a third part to conduct a criminal %erification* &andator Re#uirement 0ist for Criminal 1erification* Common &andator Re#uirement for all locations 1) ,hoto identit proof (2e would re#uire an one of the "elow mentioned documents*) ,assport cop (First/ &iddle and last page) ,an card 1oter3s identit card Dri%ing 0icense 4) $ddress proof (2e would re#uire an one of the "elow mentioned documents) Clear Ration card cop (First/ &iddle and last page) ,assport Cop (First/ &iddle and last page) &T+0(5'.' "ill clearl stating the address/ wherein the %erification needs to "e conducted $ttested cop of 0ea%e and 0icense agreement ($ll pages) 0etter from compan clearl specifing the permanent address 6ostel $ccommodation 7 $ttested cop confirming the current address on the 6ostel letterhead* ,aing )uest $ccommodation 7 $ttested letter " the secretar or chairman of the societ on a societ letterhead 8) Residing with a Friend 7 $ttested cop of the friends lea%e and license agreement 9 attested cop issued " the Friend confirming the candidates address details :) Contact details of the su";ect would "e re#uired* For Cri"inal Background Verification $s is the process followed " most of the police departments across India for criminal "ac!ground %erification/ it is possi"le that the police authorities ma contact ou or %isit our stated residence and at times e%en as! ou to present ourself at the concerned police station* It is part of the standard %erification procedure ,lease do not gi%e in to an attempts at coercion " the authorities and in the e%ent of an occurrence/ please inform our respecti%e human resource officials immediatel*