EMPLOYMENT VERIFICATION FORM
Please provide complete and correct information. All fields are mandatory.
Please do not use short forms/Abbreviations.
PERSONAL DETAILS
Title (Mr./Mrs./Ms.) (First) (Middle)
Name (Last)
Father’s Name:
Nationality
Date of Birth
(yyyy/mm/dd)
Gender:
Male Marital Status: Married
Female Unmarried
Maiden Name (applicable for married ladies)
CONTACT DETAILS
Permanent Residential Address
(Number and Street)
Period of Stay From To
Nearest Police Station:
Current Residential Address (Number
and Street)
Period of Stay From To
Nearest Police Station:
Contact Telephone No. (Specify Office Mobile/ Email Address
Location Codes) Telephone Pager
No.
Current Intermediate Permanen
t
EDUCATIONAL RECORD-of your qualification (Please attach Self-attested copy
of SSC/INTER/degree/PG certificate and mark sheet for this)-Incase studied
directly through the university, though correspondence or through distance
education, please mention clearly.
Colleg/School
Name/Address
University
Name/ Address
From To Graduated Progra %/ Student Id
(Month/yr) (Month/Yr) m Class No./Enrolment
No.
Type of Degree Graduation Subject Major
certificate, Date
diploma (month/yr)
Copy of Certificate Attached
Social Security Number (Mandatory if Studied in U.S.A)
EMPLOYMENT SECTION: Please give the details of last employment.
Ensure that you are descriptive wherever necessary-e.g. If Co. is closed do
mention it. Telephone number with specific location code. Employee
Code/ID/Number is Mandatory. If your previous employer did not provide
the latter, please mention and state reasons for the same.
EMPLOYMENT 1 (LATEST)
Employment History-Please attach a self attested copy of your relieving
letter/Service certificate for this. Please do not use abbreviations for
company names.
Company Name: Position Held:
Address (main office and branch Company
where worked) Telephone:
Employment Period (yyyy/mm/dd) Reported to Name of HR
(Name & Manager
Position):
Whether employment is of permanent or temporary nature (Contract
positions are temporary)
Permanent Temporary Employee Code/Personnel No:
Social Security Number (Mandatory if worked in USA):
Responsibilities:
Last Monthly Gross Salary Reasons for Leaving
(Please attach the self-attested copy
of your last pay slip.)
Can verification be done now? Yes No
If No, When can it be done?
EMPLOYMENT 2 (LATEST)
Employment History-Please attach a self attested copy of your relieving
letter/Service certificate for this. Please do not use abbreviations for
company names.
Company Name: Position Held:
Address (main office and branch Company
where worked) Telephone:
Employment Period (yyyy/mm/dd) Reported to Name of HR
(Name & Manager
Position):
Whether employment is of permanent or temporary nature (Contract
positions are temporary)
Permanent Temporary Employee Code/Personnel No:
Social Security Number (Mandatory if worked in USA):
Responsibilities:
Last Monthly Gross Salary Reasons for Leaving
(Please attach the self-attested copy
of your last pay slip.)
Can a verification be done now? Yes No
If No, When can it be done?
Note: Please send us your passport and pan card scan copies along with
your Education and Employment documents.
REFERENCES DETAILS:
(PLEASE GIVE DETAILS OF TWO PROFESSIONAL AND ONE ACADEMIC REFERENCE.
THEY SHOULD NOT BE RELATIVES OR FRIENDS.)
REFERENCE 1 REFERENCE 2 REFERENCE 3
NAME
ORGANIZATION
/ INSTITUTION
POSITION
ADDRESS
TELEPHONE
NO.
RELATIONSHIP
YEARS YOU
HAVE KNOW
EACH OTHER