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Background Verification Form - Voltech Format

Bvf

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stephenrajleonidass2004
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119 views4 pages

Background Verification Form - Voltech Format

Bvf

Uploaded by

stephenrajleonidass2004
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 4

BACKGROUND VERIFICATION FORM

PERSONAL DETAILS:

Candidate Name

Father Name

Date of Birth Mobile No.

PAN Number*
Single Married Male Female
Marital Status Gender

Please tick the document submitted as proof:


Aadhar Pan Card Passport Driving License Election ID

*Mandatory

ADDRESS DETAILS:

Current Address: * Period of stay (mm/yy)

From

Land Mark
To
Alternative Contact Number:
Permanent Address: Period of stay (mm/yy)

From

Land Mark
To
Alternative Contact Number
Please tick the document submitted as proof:
Aadhar Pan Card Passport Driving License Election ID

Private & Confidential


ACADEMIC DETAILS:

College Name & Address

University Name & Address

Course Name

Academic Year From To

Type of Course

ID/Reg/ Roll. No
Please tick the document submitted as proof:
Marksheet Provisional Certificate Degree Certificate Transfer Certificate

EMPLOYMENT DETAILS: Previous1

Employer Name

Address

Employment Date From To Emp. Code

Designation
Supervisor Contact
Supervisor Name & Designation
details
Reason for Leaving
Temporary Contractual
Type of Position
Agency Details (if Contract/
Temporary)
Last Drawn
First Drawn Salary
Salary
Please tick the document submitted as proof:
Relieving Letter Service Certificate Offer Letter Any Other(Please Specify)

Private & Confidential


Reference Details:

Reference Name (No


relative/Friend to be given as Reference 1 Reference 2 Reference 3
Reference) *

Title/ Designation

Company Name & Location

Official E-Mail ID

Landline No.

Mobile Number *

Period for which Reference


Know the Applicant
Relationship with the
Applicant
(No Relative/Friends)

DECLARATION AND AUTHORIZATION:


Private & Confidential
I certify that the statements made in this application are valid and complete to the best of my knowledge.
I hereby consent and understand that if upon investigation, any of the information furnished by me is
found to be false, incomplete, inaccurate or misleading, it will result in termination of my employment
forthwith.

I hereby consent to and authorize Fedserv Operations and Services Ltd.or of its subsidiaries/ affiliates/
any person, organization or any agency engaged by or acting on behalf of the Fedserv Operations and
Services Ltd.to carry out verification of the information presented by me in this application from and also
to carry out my background verification including verification of my Address, contacting my present &
past employers, formal and informal reference check, criminal records, my educational, employment and
domiciliary details/records etc for the purpose of confirming my suitability as on employee of the
Company.

I also authorize and consent to procure/receive an investigation report or consumer report in connection
with such background/ pre-employment verification.

I shall allow access t and provide with the full details of my previous records and other pertinent
information connection with background verification/Pre-employment verification to Fedserv
Operations and Services Ltd. its affiliates. Subsidiaries and/or any Organization, Peron’s or agency on
presenting this authority form executed by me

I declare that I have read and understood the aforesaid statement and by my signature, I hereby record
my full and free consent to the above statements

I hereby attach the following document along with this application as

Date:

Place:

Name:

Signature:

Private & Confidential

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