TCS EMPLOYMENT APPLICATION FORM

Basic Details

EP Reference # : EP2013IR565605

Personal Details :
Name : Mr. Appala Naidu Surisetti

Father's Name : Mr. Surisetti RajaRao Naidu

Date of Birth : 05/06/1991

Gender : Male

Nationality : India

Country of Residence : India PAN # : ANIPN1685P

E-mail ID: appalanaidu1991@gmail.com

Languages Known :(Mother

Tounge appearing first)

Language Speak Read Write

Telugu Yes Yes Yes

English Yes Yes Yes

Hindi Yes Yes Yes

ADDRESS DETAILS :

Present Address : Door#2-56/33/6/1, Ground Floor, Sai Nagar, Madhapur

City : Hyderabad State : Andhra Pradesh

Country : India Pin Code : 500081

Landline/Mobile: 919492534120

Is the permanent and present No

address same?

Permanent Address: Flat No- 303, Sai Bhaskar Homes, Vuda Phase 2, Chinnagantyada, gajuwaka

City : VISAKHAPATNAM State : Andhra Pradesh

Country : India Pin Code : 530026

Landline/Mobile: 919032820727

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 ACADEMIC DETAILS :

Qualification : Starting from the latest qualification earned till class X or equivalent

Is your PG a 5 year integrated course: No

Degree/Diploma Passing Specialisation/Major University/Institute Course Duration % of Awards and Scholarships

Year Subject Type From To Marks(Agg.
of all
semester/
grade
obtained

Bachelor Degree BACHELOR OF 2012 MECHANICAL J. N. T. U. College of Engg., Kakinada Full time Sep-2008 Apr-2012 75.61
ENGINEERING ENGINEERING

12th/Pre- STANDARD XII / H.S.C. 2008 MATHEMATICS Prabha Junior College Full time Jun-2006 Apr-2008 75.20
University/Diploma

10th/SSC SSC 2006 General Bhashyam Public School Full time Jun-2005 Apr-2006 81.67

Break in Studies

Break in Study (Reason and Duration) : Nil

EMPLOYMENT DETAILS TILL DATE : Needs To be supported by relieving/release letter at the time of joining

Name of Company Address of Company Duration Post/Designation Duties/Nature of Annual Gross Employee Id
Work Salary
Start Date End Date

Others -Moldtek Jubliee Hills 06-Jul-2012 22-Dec-2013 Jr. Design Engineer BIW Fixture ` 252000 IT1103

Technologies Pvt Ltd Design

Break During Employment (Reason and Duration) : Nil

Break between Study & Employment (Reason and Duration) : Nil

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 Total IT Experience 18 Months

Total Non IT Experience 0 Months

Are you currently Employed Yes

Service Bond Details No

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 TCS RELATED DETAILS :

TCS Test/Interview :

Position Date Place Final Result

REFERENCE DETAILS :

Reference 1

Name Venkateshwara Rao

Designation Team Lead

Organisation Name Moldtek Technologies Pvt Ltd

Address Nizampet, Hyderabad

Contact Number 08050364566

Email ID venkateshwararao@moldtekindia.com

Nature of Acquaintance Colleague

Period of Acquaintance 0 Years , 8 Months

Reference 2

Name Nilakanta Sahoo

Designation Team Lead

Organisation Name Moldtek Technologies Pvt Ltd

Address Madhapur, Hyderabad

Contact Number 09849324175

Email ID nilakantha@moldtekindia.com

Nature of Acquaintance Colleague

Period of Acquaintance 1 Years , 6 Months

Joining Details :

Expected Cost to Company(CTC) : ` 500000

DECLARATION :

Declaration and General Consent to Background Investigation:

In connection with my application to render services to Tata Consultancy Services Ltd (the "Company"), I hereby agree as follows:

I certify that the information furnished in this form as well as in all other forms filled-in by me in conjunction with my employment is factually correct and subject to

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 verification by TCS including Reference Check and Background Verification.

I accept that an appointment given to me on this basis can be revoked and/ or terminated without any notice at any time in future if any information has been found to be
false,misleading, deliberately omitted/ suppressed.

As a condition of Company's consideration of my application for employment with the Company, I hereby give my consent to the Company to investigate or cause to be
investigated through any third parties my personal, educational and pre or post employment history. I understand that the background investigation will include, but not be
limited to, verification of all information given by me to the Company. I confirm that the Company is entitled to share such investigation report with its clients to the extent
necessary in connection with the Services, which I may be required to provide to such clients. I confirm and undertake that the Company shall incur no liability or obligation
of any nature whatsoever resulting from such investigation or sharing of the investigation results as above.

I certify that I am at present in sound mental and physical condition to undertake employment with TCS. I also declare that there is no criminal case filed against me or
pending against me in any Court of law in India or abroad and no restrictions are placed on my travelling anywhere in India or abroad for the purpose of business of the
company.

Your Electronic Signature is :

Name : Mr. Appala Naidu Surisetti

Date :Wed, 25 Dec 2013

Place :Hyderabad

TCS is an equal opportunity employer that aims to integrate global diversity and inclusion at each level within our organization.Hiring decisions
are solely made on the capability of an individual to perform a role. Any personal details like gender,age and nationality,that may be provided by
you during the course of application or selection process will be used for administrative records and all qualified applicants will receive
consideration for employment without regard to this information.

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