Interview Location

Please affix
your latest
Passport
Candidate id Photograph
Here
INFOSYS LIMITED
Electronics City, Hosur Road, Bangalore - 560 100, India.
Tel.: (080) 28520261. Fax: (080) 28520362.

Please  in the wherever applicable.

Please answer each column fully and neatly in your own hand-writing.

APPLICATION FOR EMPLOYMENT

NAME IN FULL
(in block letters)
(As it appears on passport / legal document)

ROSHAN
....................................................................... .................................................... ROY
…………………………………………………..…..
FIRST MIDDLE LAST

ADDRESS FOR COMMUNICATION

9558943196
B/149, Mathuranagri, B/H Reliance Mall, Akshar
.........................................................................................................
Mobile No. .....................................................................................

Chowk, Old Padra Road roshanroy149@gmail.com

E-mail: ...........................................................................................
.........................................................................................................
(Personal E-Mail ID only)
PERSONAL DETAILS

.........................................................................................................
CITIZENSHIP(S)

.........................................................................................................
Indian
…………………………………….

Vadodara
City: ..................................... DO YOU HAVE A PASSPORT?

390020
PIN / POSTAL CODE..........................
YES NO

Gujarat
State: .................................................Country: India
...............................

7016738632
Day Time Contact No. .............................................. (Optional)

DATE OF BIRTH (as per passport / legal document): GENDER:

(dd/mmm/yyyy)
MALE FEMALE
21/DEC/1993
…………………………………………...

VER 8.2 1 of 3 HRD/REC/F/016

SIGNATURE OF THE APPLICANT

 XII STD/ POST
LEVEL X STD GRADUATION OTHERS
DIP./EQUIV. GRADUATION
Bachelors in
Name of the Qualification Awarded Diploma Engineering
Gujarat Technical Gujarat Technical
State Board/University Gujarat State Board Institute Institute

Parul Institute of
Basil School Polytechnical Technology &
Name of the School/College
Institue Management

Gujarat Gujarat Gujarat

State

Electronics & Electronics &

Branch/Stream/Area of Specialization NA
EDUCATION

Communication Communication

* Total Marks Scored in Final Year

* Maximum Marks

* Percentage / CGPA 40.46% 62% 59.69%

Year & Month of Final Examination March 2009 January 2014 July 2017

*ALL PERCENTAGES / CGPA SHOULD BE AS PER THE DEGREE CERTIFICATE OR FINAL YEAR MARKS SHEET (Documents
will

GAPS IN EDUCATION (If any) NA

…………….years. NA
Reason:………………………………………………………………………………………

PLEASE WRITE ‘NA’ IF NOT APPLICABLE

SPECIFY CLEARLY IN CASE OF PART TIME CONTRACT WORK EXPERIENCE 90 Days
NOTICE PERIOD REQUIRED……………………….

PERIOD (MMM/YYYY) EXPERIENCE/

RELIEVING
FROM TO DURATION REASON FOR
PAYROLL ORGANIZATION* DESIGNATION LETTER
(in months) SEPARATION
AVAILABLE
(Y/N)

VALIDATION FOR
KVS TECHNOLOGIES MAY-2017 JULY-2018 14
ENGINEER MORE Y
EXPOSURE

FOR
SARLA ADVANTECH AUG-2018 FEB-2019 7 VALIDATION BETTER Y
ENGINEER PROSPECTIVES
WORK EXPERIECE

SENIOR WANTING
ALEMBIC PHARMACEUTICALS MAR-2019 AUG-2022 41
EXECUTIVE TO SWITCH TO NA
IT FROM PHARMA

Are you under any legal obligation to your current employer: YES NO
NA
IF YES, Please Specify: ……………………………………………………………………………………………………………………..…………

* Please do specify “Payroll Organization” if you are working on a contractual basis

Disclaimer: Please be informed that work experience provided by you will be validated through Background check

VER 8.2 2 of 3 HRD/REC/F/016

SIGNATURE OF THE APPLICANT

 NEXT REVISION EXPECTED YOUR EXPECTATION AT
ANNUAL CURRENT
DATE: ……………………. INFOSYS

Fixed Salary 7,58,905 13,50,000

COMPENSATION AND BENEFITS

Variable Pay NA 50,000

Free Transportation
1………………………………. 1………………………………. 1……………………………….
Other Benefits
Subsidized Food
2………………………………. 2………………………………. 2……………………………….
Compensation for buying phone &
Monthly mobile bill
3………………………………. 3………………………………. 3……………………………….

ANNUAL GROSS 758905 14,00,000

COMPENSATION

HAVE YOU UNDERGONE ANY SELECTION PROCESS WITH INFOSYS or INFOSYS GROUP YES NO
COMPANIES (like INFOSYS BPO, ETC.) PREVIOUSLY?
IF YES, HAVE YOU INFOSYS OTHER GROUP COMPANIES
RELEVANT DATES RELEVANT DATES

- TAKEN ANY TEST? YES NO ………………….. YES NO …………………..

MISCELLANEOUS

- SELECTED FOR INTERVIEW? YES NO .………………….. YES NO …………………..

- MADE AN OFFER? YES NO .………………….. YES NO …………………..

- JOINED & QUIT? YES NO .………………….. YES NO …………………..

ARE YOU EMPLOYED AS: 1. A DIRECTOR / PARTNER IN ANY OTHER COMPANY? YES NO

IF YES, PLEASE PROVIDE DETAILS………………………………………………………………………………………………………………...

ARE YOU CURRENTLY EMPLOYED WITH ANY OF THE INFOSYS GROUP COMPANIES YES NO
IF YES, INFOSYS BPM OTHERS Please specify ………………………………….

Have you at any time been convicted by a court of India for any criminal offence and sentenced YES NO
to imprisonment, or any criminal proceedings are pending against you before a court in India,
or has an order prohibiting your departure from India, been issued by a court,
If yes, please give details of the same................................................................................................................................................
............................................................................................................................................................................................................
I authorize Infosys to conduct investigation to verify facts of all statements made in this application and my supporting documents. I
authorize Infosys to secure information about my experience from former employers, educational institutions, government
establishments/agencies or any references I have provided, and for those parties to provide information concerning my qualifications
for employment and I hereby release all parties from any liability arising from such investigation.

I certify that the academic marks / CGPA are as per the University Guideline (percentage/CGPA mentioned on the Degree certificate or
DECLARATION

final year marks sheet)

I understand that if I am employed with the company, any false statement, misrepresentation, or omission of facts on this application or
on any supporting documents, regardless of when discovered if found to be false, may result in my immediate dismissal. The company
will have the right to withdraw my letter of appointment or to terminate my training/subsequent appointment at any time without notice or
compensation.

My signature below certifies that I have read, understand, and agree to the foregoing and to the best of my knowledge and belief; the
information on the application form is true and correct.

06/06/2022
Date : ......................................... Vadodara
Place : ..................................... Signature: ..............................................................

VER 8.2 3 of 3 HRD/REC/F/016

SIGNATURE OF THE APPLICANT