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7/25/2019 EVF (1)

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EMPLOYMENT VERIFICATION FORM

Instructions- Provide complete and correct information- Te information provided sould matc !it te resume su"mitted- All fields are mandator#

-$o not use sort forms%A""reviations

- &se uppercase letters !en fillin' te forms

Te "ac('round cec( !ill cover)

o * #rs e+perience

o Re,uired $ocuments -all.)

/ervice Certificate or Relievin' Letter

Latest /alar# /lip

If #our previous emplo#er is closed0 !e need

•

Form 12 or • 3an( statement tat specifies te compan# name

a'ainst te deposit- 4i'est Academic educational details

o Re,uired $ocuments -all.

$e'ree certificate

Final #ear mar( seets

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PER/ONAL $ETAIL/

Title -Mr5%Mrs5%Ms5.Name -Last.

-First. -Middle.

Fater6s Name)

Nationalit#

$ate of 3irt-####%mm%dd.

7ender)Male

Female

Marital /tatus) Married

&nmarried

Maiden Name -applica"le for married ladies.)

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Mandator# ONLY for Criminal Cec( Process

CONTACT $ETAIL/

Permanent Residential Address-Num"er and /treet.

Period of /ta# From To

Intermediate Residential Address-Num"er and /treet.


Current Residential Address-Num"er and /treet.


Nearest Police /tation)

Contact Telepone No5 -/pecif#Location Codes.

OfficeTeleponeNo5

Mo"ile%Pa'er EmailAddress

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Current Intermediate Permanent

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E$&CATIONAL RECOR$8of #our i'est and completed education,ualification -Please attac /elf8attested cop# of de'ree certificate and mar(seet for tis.8Incase studied directl# trou' te universit#0 tou'

correspondence or trou' distance education0 please mention clearl#5Colle'eName%Address

&niversit#Name% Address

From-Mont%#r.

To -Mont%Yr. 7raduated Pro'ram 9%Class

/tudent IdNo5%EnrolmentNo5

Yes

No

Part8

timeFull8Time

T#pe of $e'reecertificate0

7raduation$ate-mont%#r.

/u":ect Ma:or

Cop# of Certificate Attaced Yes No

/ocial /ecurit# Num"er -Mandator# if /tudied in &5/5A.

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EMPLOYMENT /ECTION) Please 'ive te details of #our previousemplo#ments5 Please provide

- telepone num"ers !it te location code- #our emplo#ee id%code%num"er !it eac previous emplo#er - please provide follo!in' documents)

o form 12 or

o 3an( statement tat specifies te compan# name a'ainst te

deposit

- Please ensure tat #our details ere matc !it te resume tat #ousu"mitted

4o! man# #ears ave #ou !or(ed; <<<<<<<<<<<<<<<<<<<<

4o! man# emplo#ers ave #ou !or(ed for -includin' #our current

emplo#er.; <<<<<<<<<<<<<<<<<<<<<<<<<<<

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EMPLOYMENT 1 -Current%Most recent.

Emplo#ment 4istor#8Please attac a self attested cop# of #our relievin'letter%/ervice certificate for tis5 Please do not use a""reviations forcompan# names5

Compan# Name) Position 4eld)

Address -main office and "ranc!ere !or(ed.

Compan#Telepone)

Emplo#ment Period -dd%mm%####.

$O= )

$OR )

Reported to-Name >Position.)

Name of 4RMana'er

?eter emplo#ment is of permanent or temporar# nature

Permanent Temporar# Contract Emp Code%Personnel No)

/ocial /ecurit# Num"er -Mandator# if !or(ed in &/A.)

Responsi"ilities)

Last Montl# 7ross /alar#

-Please attac te self8attested cop#of #our last pa# slip5.

Reasons for Leavin'

Can a verification "e done no!; Yes No

If No0 !en can it "e done;

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EMPLOYMENT @ -prior to te current%latest emplo#ment.




Compan#Telepone)

Emplo#ment Period -dd%mm%####.$O=

$OR


Name of 4RMana'er


Permanent Temporar# Contract Emp Code%Personnel No)


Responsi"ilities)



Reasons for Leavin'


If No0 ?en can it "e done;

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EMPLOYMENT * -prior to emplo#ment @.




Compan#Telepone)

Emplo#ment Period -dd%mm%####.

$O= ) 8 8

$OR )


Name of 4RMana'er


Permanent Temporar# contract Emp Code%Personnel No)


Responsi"ilities)



Reasons for Leavin'


If No0 ?en can it "e done;

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$eclaration

I ere"# certif# all of te statements made on te PRIM&/ 7lo"alTecnolo'ies Pvt5 Ltd emplo#ment verification form are true and completeand I understand tat omission or misrepresentation of an# fact ma# resultin refusal of emplo#ment or immediate dismissal5

I reco'nie tat in connection !it emplo#ment !it PRIM&/ 7lo"alTecnolo'ies Pvt5 Ltd5 I ma# "e te su":ect of a "ac('round en,uir# "#PRIM&/ 7lo"al Tecnolo'ies Pvt5 Ltd or its representative and I ere"#autorie te same5

/i'nature )

Name in Capital )

$ate )

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Letter of Autoriation

To !om it ma# concern

I ere"# autorie PRIM&/ 7lo"al Tecnolo'ies Pvt5 Ltd representative toverif# information provided in m# resume and application of emplo#mentand to conduct en,uiries as ma# "e necessar# at te compan#6s discretion5I autorie all persons !o ma# ave information relevant to tis en,uir# todisclose it to PRIM&/ 7lo"al Tecnolo'ies Pvt5 Ltd or its representative5 Irealie all persons from lia"ilit# on account of suc disclosure5

/i'nature )

Name in Capital )

$ate )

evf (1)

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