UNDERTAKING/ DECLARATION TO BE OBTAINED DURING INTERVIEW/JOINING

Date:
The General Manager
Human Resources Management Group
ICICI Bank Ltd
Mumbai

Dear Sir,

Subject:- Declaration and Undertaking

With reference to my application for an appointment in the services of ICICI Bank, I hereby
declare and undertake the following: (please tick against the appropriate statement). Please
note that each of the statements needs to be answered either way and can not be kept
blank.

1. There is no case pending against me in any Court of Law or in any Police Station. Further,
there was no FIR/Investigation against me in the past and I was never arrested and or
convicted by any Court of law.
If yes, please mention details of such pending case/s and or reasons leading to such
FIR/Investigation/arrest/conviction in the past- including period of detention, if any --
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2. There is no case pending against me for investigation with my previous employer(s). If

any, please provide details----
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3. I was and I am not a member of any Banned Outfits declared by the Government. If yes,
Please mention details
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 4. The information furnished by me on my previous employment/s, compensation earned
and qualification gained are without any discrepancy/ies

5. I authorize ICICI Bank to procure my credit information from Credit Information Bureau
of India Limited (CIBIL) or from any other recognized credit information company

6. I do hereby declare that no immediate blood relatives (i.e Father, Mother, Brother,
Sister, Husband, Wife, Son & Daughter) of mine is working in ICICI Bank. I also declare
that candidature of none of the above mentioned blood relatives is under consideration
for employment with ICICI bank presently

7. I do hereby declare that I am aware of my appointment and continuation in employment

is subject to successful completion of my graduation or post-graduation, as applicable
and submission of graduation/post-graduation certificates & mark sheets within 3
months from the date of joining.

8. I do hereby declare that I have cleared my CA final examination both groups taken
together in ……….. (Month),………….. (Year) in single sitting, on my first appearance of
the examination and not on multiple appearances. I also confirm that I have not
appeared for exams apart from the dates mentioned above (Applicable only for
Charted Accountants first attempt applicants)

9. I do hereby declare that I do not have any pending disciplinary process & compliance
related issues with my current/previous employers. If any, please provide details. I also
confirm that there has not been any action taken against me in last 6 months from date
…………….. To Date………….., In ………………………………………………(Current
Organization)………………………………………………….I also authorize ICICI Bank to verify
disciplinary / compliance related issues from my current/earlier employers.

I am aware that in case of any discrepancies found out by the Bank at a later date on any of
the above declarations made by me, my candidature as well as subsequent continuation in the
services of the Bank- as the cases may be- will be liable to be cancelled/revoked and or
terminated, at any time, without assigning any reason thereof and I shall be bound by any such
decision of the Bank.

Thanking You
Yours faithfully
Signature of the Applicant
Applicant Name:
Contact No: