Employment Application Form

Please affix your

passport size photo here

Please read the below instructions carefully before you start filling in the requested information:
1) Please read all instructions for each section and fill in as instructed. All fields are to be filled
legibly, completely and accurately in CAPITAL letters to reduce delay in processing your
candidature with IBM. Please fill the applicable fields ONLY and not applicable fields
needs to be left BLANK.
2) Please bring the following documents with you to the personal interview at IBM:
i) Completed IBM Employment Application Form
ii) Proof of Salary Documents
Offer letter with compensation break up
OR
Latest increment letter from present organization with compensation break-up
iii) Updated Resume
iv) Valid Photo ID (Passport, PAN Card, Voter’s ID card, Driver’s License)
Past IBM Interview Details (Fill in CAPITAL Letters)

Have you attended any IBM Interview in the last 3 Months Yes No
If Yes, please provide the below details:
D D M M M Y Y Y Y
Date of Interview

Position Applied ###

Work in Progress Received Offer Rejected/Declined

Location Of Interview ###

IBM subsidiary Name IBM India Pvt Ltd IBM Daksh IBM NetSol

Page 1 of 6, Employment Application form, version 6.0, wef - 01st Feb 2013 1
 SOURCE INFORMATION (Fill in CAPITAL Letters)

How did you know about this vacancy in IBM? (Select any one of the below) Direct - IBM Website

Agency IBM Employee Referral Accepted Not Joined Candidate

Agency name Name of the Employee

Employee Number (If Applicable)

It is important that you mention the
Jobsites employee ID or Email ID accurately, please
confirm with the referrer if you are not sure
of the information
Job Site Name E- Mail ID

By submitting the IBM Employee Referral name you confirm that the referrer is known to
you personally or professionally. This relationship may be a result on account of
participation in various social networks which are either formal (examples of formal
networks are Linkedin, Facebook, Twitter, industry and competency associations) or
informal (examples of informal networks are former employment with the same company,
friends circle, alumni from same educational institution or study circles) .
You also confirm that the referrer has made you aware that by referring your candidature
to IBM for an opportunity of employment, he/she may be eligible to receive a referral
bonus.

IBM Application ID * C
* If you have already registered on our IBM Job Portal please provide the IBM Candidate Applicant ID also called GOM Candidate Applicant
ID. If you are referred by an Agency, please ask your agency for the Applicant ID

PERSONAL INFORMATION (Fill in CAPITAL Letters)

* Enter your name as per your Passport, Driver's Licence OR PAN Card (For Indian Nationals)
Title
Mr. Ms.

First Name

Middle Name

Last Name

D D M M M Y Y Y Y
Date of Birth
**e.g. 01 - JAN - 1900

Mobile Number
**Country code - Mobile Number
Telephone -
**Country code - City Code - Telephone Number
Personal
Email ID

Pan Card (If you are an Indian National)

Driver's Licence #

Passport Number D D M M M Y Y Y Y
Expiry

Place of Issue
Refer to the passport for this information
Page 2 of 6, Employment Application form, version 6.0, wef - 01st Feb 2013 2
 PERSONAL INFORMATION…… CONTINUED (Fill in CAPITAL Letters)

Nationality

City of Birth

Country of Birth

Current Address

City PIN Code

State
Country
Permanent Address (If different from the above)

City PIN Code

State
Country

PROFESSIONAL REFERENCES (Fill in CAPITAL Letters)

Please provide details of three professional references with whom you have had a business/Working relationship

of which one reference has to be mandatorily your previous Manager's details

Please exclude Friends, Colleagues, Juniors, Relatives at work and Clients

Nature of
Name Contact Number professional Current occupation Comments*
Relationship

*Please use the comments column to indicate if you do not wish IBM to contact one or any of the above for pre-reference checks.

Page 3 of 6, Employment Application form, version 6.0, wef - 01st Feb 2013 3
 EDUCATION DETAILS (Fill in CAPITAL Letters)
Please complete all fields, even if you have already provided a resume. Provide details on COMPLETED degree programs only.
Highest Qualification (Completed)** e.g.: M.Sc, B.Com
** Highest education declared has to be minimum 02 year degree or diploma awarded by a University or a Board or its affiliates

PLEASE MENTION COMPLETE DETAILS OF SCHOOL / COLLEGE / INSTITUTION AND UNIVERSITY NAME ALONG WITH COMPLETE ADDRESS WITH CITY & POSTAL CODE IN CAPITAL LETTERS

Class/ Registration / Name of the

Division/ Roll / Final Degree
Qualification Course Tenure Complete Name & Address of School / College / Institution and Percentage/ Year Seat Awarded
Name of the University Grade Number (e.g.. B.com /
*University name is mandatory where applicable(DO NOT ABBREVIATE) Points BA/ Mtech)
M M M Y Y
Start Date
SSLC ( 10th) End Date

Year of Passing
* E.g. JAN09
M M M Y Y
Start Date
HSLC (12th) End Date

Year of Passing
* E.g. JAN09

M M M Y Y
Start Date
Graduation
End Date

Year of Passing University Name

* E.g. JAN09

M M M Y Y
Post Start Date
Graduation
End Date

Year of Passing University Name

* E.g. JAN09

M M M Y Y
Others - PhD, Start Date
Additional
Degrees End Date

Year of Passing University Name

* E.g. JAN09
M M M Y Y
Professional
Qualification Start Date
(Other than
already End Date
mentioned
above) like CA, Year of Passing
CFA etc
* E.g. JAN09
State reasons for GAP in education, if any :
Professional Training (includes in progress degrees) - please mention the details

______________________________________________________________________________________________________________________________________________
Page 4 of 6, Employment Application form, version 6.0, wef - 01st Feb 2013 ###
4
 EMPLOYMENT HISTORY (Fill in CAPITAL Letters)
Provide your job history for a minimum of the last five (5) years (if applicable). Starting with you present or most recent employer. Additionally, include your last three 3 employers (if applicable) even if your
total service exceeds 5 years in the last 1 or 2 companies. Please include information on Self employment within the same period.
Do you have prior employment experience? Yes No

PLEASE MENTION COMPLETE DETAILS OF ORGANISATION NAME, COMPLETE ADDRESS WITH STREET NAME, AREA, CITY & POSTAL CODE IN CAPITAL LETTERS
Employment Type
(Permanent Full
Serial Employee
Organisation Name and address /Contractual) and Tenure Time /
No Number
Band / Grade Part Time
details
Organisation Name
D D M M M Y Y
Address Start Date
1
End Date
Pin Code * E.g. 01-JAN-1900

Organisation Name
D D M M M Y Y
Address Start Date
2
End Date
Pin Code * E.g. 01-JAN-1900

Organisation Name
D D M M M Y Y
Address Start Date
3
End Date
Pin Code * E.g. 01-JAN-1900

Below is continuation of the above table. E.g. Continue to fill in details of "Serial No 1" (Above) in "Serial No 1-Continue" row below.

Serial Reporting Manager's Name and

Designation Reasons for Leaving If Employment Type is Contractual, Please Provide Agency Name, COMPLETE Address and Contact Number
No contact number)*

Organisation Name

Complete Address

1-
Continue

Pin Code Contact Number

Organisation Name

Complete Address

2-
Continue

Pin Code Contact Number

Organisation Name

Complete Address

3-
Continue

Pin Code Contact Number

*Current Reporting Manager will be contacted ONLY AFTER the candidate joins IBM
Total years of experience - (please do not include any training or internship experience) Years Months
State GAP in Employment if any:

Page 5 of 6, Employment Application form, version 6.0, wef - 01st Feb 2013 5
 Present Employment Compensation Details** (Fill in CAPITAL Letters)
** The information stated here must be supported with documentary evidence (Offer letter from present organization including Compensation break up details or most recent increment
letter)

Please mention below your annual compensation details

(A). Fixed Pay

(B).Variable Pay (C). Other allowances
including statutory
(Rs.) (Rs.)
benefits (Rs.)

Annual Current CTC

= Total of A + B + C Comments
(Rs.)

OTHER DETAILS (Fill in CAPITAL Letters)

Have you worked for IBM earlier? Yes No

If "YES", please provide following details:
Tenure (DD-MMM-YYYY)
Status Employee No. /
Business Unit Location Date of Joining Last working day Manager's Name (Regular/FTH/Contractor) Contractor Code

Are you willing to relocate as part of your employment with IBM? Yes No
If "YES", please indicate your preference _______________________________________________________________________

If you are related to IBM India Private Limited employees and/or Directors (sibling / spouse/ children/in law relationships), please provide names and relationship.

Name Designation Business Unit Relationship

Consistent with IBM's policy on workforce diversity and in order to accommodate employee's special needs in the work environment,
please indicate if you are physically challenged ** Yes No
If yes, please provide description of disability and accommodation required:
** IBM Corporation is an Equal Employment Opportunity Employer

Do you have any non-compete obligations or conflict situations or other restrictive clauses with any party including any of your
previous employers that prevent you from working for IBM India Private Limited? Yes No

Have you worked for the Government, whether as a civilian employee or member of the military? Yes No
All Candidates must indicate if they have worked for the Government, whether as a civilian employee or member of the military. If so, you must also indicate whether you had any
responsibilities or were involved in activities relating to IBM or an affiliated Company. You must also state whether you are aware of any legal restrictions on what work you may do for IBM
or an affiliated Company, and if so, what those restrictions are.

Name of Government Organization and Department

Tenure

Job Responsibilities

Restictions ( if any)

Declaration

• If applicable, I hereby confirm that in my duties as a government employee, I have (or have had) no matters involving IBM (in any capacity
whatsoever), or if I do, that I have officially withdrawn from participating in those matters while I am discussing potential employment with IBM.
All details of any such matters that I have been involved with, where IBM or any of its affiliates have been involved, are listed above.
• I confirm that the information provided by me in this application form is complete and accurate.
• I understand that if any information provided by me with respect to my application for employment is found to be untrue, inaccurate or
misleading, IBM INDIA Private Limited may withdraw any offer of employment made to me or terminate my employment (If I have already joined
IBM India) without notice.
• I understand that all the details provided in this application are subject to verification.
• I hereby authorize IBM India Private Limited and its representatives (including reference check agencies/third party vendors) to verify
information provided in my application for employment and to conduct enquiries as deemed necessary by the company.
• I authorize all persons who have information regarding my education, employment, and all other details provided in this form,
to disclose it to IBM or its representative.

Signature:

Place: Date:

Page 6 of 6, Employment Application form, version 6.0, wef - 01st Feb 2013 6
 BACKGROUND CHECK APPLICATION FORM
IBM India Pvt Ltd.
INSTRUCTIONS :
** Fields which are coloured in grey needs to be updated manually. Rest of the fields gets auto populated from the first 6 sheets of Employment Applicaion
Form (EAF). Auto populated fields are being locked, hence the candidates will not be able to edit them in BGC Form. For any changes in data EAF needs to
be updated. Ensure to sign mandatorily at the bottom of the form.

Name of Applicant Surname Middle First Name

Date of Birth -- Gender
Nationality Passport No
Father's Name
IBM GOM Code / IBM Employee ID C
Proof of name change attached if applicable Yes NA
Social Security # / National Insurance #
EDUCATION (Please mention only highest completed education as declared in Employment Application Form)
Name of Degree / Diploma Also indicate
Specialization of the
Degree / Diploma

Name & Location of School/College/Institute (also

mention whether course attended is
Regular/correspondence)
Name & Location of university to which the
college/Institute is affiliated to

Dates attended From MM / YYYY To MM / YYYY

Year of passing
Roll Number / Registration Number / Exam Seat Number
Note : If you are a Fresher, please specify " NA" in all the fields below.

EMPLOYMENT RECORD: Starting with your present or most recent employer, please list last 2 employments. When listing consulting or temporary
assignments under "Employer", state the name of the consulting or temporary agency that placed you at the client site

CURRENT / MOST RECENT EMPLOYER ( Company Name ) :

Employee ID :
From (DD / MM / YYYY) : -- To (DD / MM / YYYY) : --

Complete Address

Postal Code
Job Title : Employment status(Regular/Temporary) :
Reason for Leaving :
Outsourcing Agency Details : -
Name
Full Address

Pin code

PREVIOUS EMPLOYER (PRIOR TO THE MOST RECENT) ( Company Name ) : \

Employee ID :
From (DD / MM / YYYY : -- To (DD / MM / YYYY : --

Complete Address

Postal Code
Job Title : Employment status(Regular/Temporary) :
Reason for Leaving :
Outsourcing Agency Details : -
Name
Full Address

Pin code

INFORMATION RELEASE AUTHORIZATION ( TO BE SIGNED BY THE CANDIDATE)

I certify that the statements made in this application are valid and complete to the best of my knowledge.
I understand that false or misleading information may result in termination of employment.
If upon investigations, any of this information is found to be incomplete or inaccurate, I understand that I will be subject
to dismissal at any time during my employment. I hereby authorize IBM and /or any of its subsidaries or affiliates,
and any persons or organizations acting on its behalf to verify the information presented on this application form and to procure an investigative report or
consumer report for that purpose. I hereby grant authority for the bearer of this letter
to access or be provided with full details of my previous records.
In addition, please provide any other pertinent information requested by the individuals presenting this authority. I hereby release from liability all persons or
I authorize to contact my present employer
I have read, understand and by my signature consent to these statements.

Signature : Date & Place :