BACKGROUND CHECK FORM                                       Business Associates (BA)
Guidelines /Checklist
       Fill-up the BGC Form completely and accurately with copies of all relevant supporting documents asproof
       Ensure consistency in information furnished by you initially in TCS ApplicationForm
TCS Confidential Background Check Form – Business Associates (BA) Version 8.0 Page 1 of 10
                  Ensure consistency with information furnished by you initially to TCS
   (1)   Tick on the boxes below before submitting the BGC form, ensuring that you have submitted all requireddocuments.
   (2)   No BGC forms will be accepted in the absence of any of the required documents as mentionedbelow.
   Mandatory General Requirements:
             Signed & Attached Document on General Consent to Background InvestigationLetter
               (BGC Consent Letter enclosed within the BGCform)
          My recent Passport size photograph pasted at the appropriateplace
   Address Check & Criminal Check Requirements:
          Complete & Correct Address filled-in as required in BGC Form with Flat/Room No. clearlymentioned
          Prominent landmark near the address mentioned for easylocation
          Self-attested & signed - Document for Address Proofsubmitted
                 What could be submitted for Address Proof?
                     o Proof for Present & Permanent Address to beattached
                     o Provide Separate Proof, if address isdifferent
                     o Attach copy of any one of the following documents as Proof forAddress
                  (a) Ration Card (b) Electricity Bill (c) Landline Telephone Bill (d) Mobile phone bill
                  (e) House Lease Agreement (f) AadharCard
                       o   Address Proof – For House Rental Agreement
                                 Copy of Agreement submitted (If Agreement signed between you andOwner)
                                 Copy of Agreement + Declaration Letter in Stamp Paper from Agreement Holder
                                     (BloodRelation)statingthatIamresidinginthesameaddressasmentionedinthe
                                     Agreement (If Agreement signed between your Family Member (Blood Relation)
                                     and Owner)
                                     Letter from Society of the address (If Agreement signed between any other person
                                     (Non-blood Relation) or you are staying in Bachelor’sAccommodation)
   ID Check Requirements
          Self-attested & signed - Document for ID Proofsubmitted
                 What could be submitted for IDproof?
                 (a)Valid Passport     (b)DrivingLicense      (c) PAN Card (d) Aadhar Card (e) Voter’s IDcard
TCS Confidential Background Check Form – Business Associates (BA) Version 8.0 Page 1 of 10
                  Ensure consistency with information furnished by you initially to TCS
   Reference Check Requirements – For each Reference
             References provided are either Supervisor/Person holding Responsible Position in a reputed
              Organization
                    o No Relatives/Friends to bementioned
                    o Reference to know Applicant for a minimum period of 2years
             Full Name & Address of References provided legibly
             Contact email ID & telephone numbers of Referencesprovided
                    o Provide atleast two contactnumbers
   Educational Check Requirements
             Self-attested – copies of Highest Degree /Provisional Degreesubmitted
             Self-attested – copies of all Highest Degree mark sheetsattached
             Self-attested – copies of SSC, HSC \ Diploma mark sheet’s &certificate
   Previous Employment Check Requirements:
             Self-attested – copies of the documents from BACompany
                o Offer letter –Mandatory
                o Deputationletter
       Self-attested - Documents for all Previous Employment Proofsubmitted
               What could be submitted for Previous Employment Proof?
                   o Relieving Certificate from your Previous Employer(s) -Mandatory
                   o Experience Certificate & Salary Certificates – Last 3 months –Mandatory
                   o Offer Letter &RelievingCertificate
                   o Bank statement with Bank seal\signature as proof of salarydeposited
                   o PF statement / PF number assigned by the previousemployer(s)
         Note: Your BGC Status will be Positive only after successful completion of employment checks
               Including your Current Employer
   Gaps during Education / Employment Check Requirements:
       Self-attested&signed–DocumentstoexplaingapsduringEducation/Employment
               What could be submitted as Proof for gaps duringEducation/Employment?
                     o   Affidavit (on 100 RS Stamp paper) with Notary Authorization for total gap above 6months
   Applicant to please detach and destroy this checklist while submitting the completed BGC Form
TCS Confidential Background Check Form – Business Associates (BA) Version 8.0 Page 1 of 10
                  Ensure consistency with information furnished by you initially to TCS
BACKGROUND CHECK FORM Business Associates (BA)
                                                                                                 Paste your
Total Work Experience :                            Have you served as BA in TCS earlier?       recent Passport
                                                                   NO                          Size Photo here
Total Gap (Break) during / between                 If yes, mention your BA No. assigned
Education / Employment:                            earlier :
Name of the Applicant (Full name expanding initials):
Father’s Name:                                                              Mother’s Name :
BA Company Name: Future Focus Infotech Pvt Ltd                              TCS Joining Branch:
Designation: Business Associate                                             Date of Joining:
Contact Landline Phone No.            Mobile Phone No.9028797787            Email id:
Date of Birth (Attach Proof):        Marital Status:                        Nationality:
PAN No :                             Aadhar No :
A. Present Residential Address : (Attach Proof)
Period of Stay From :                 To:                                   Landmark:
City/Town:                          State:                             Pincode:
B. Other Residential Address: [Furnish other addresses of your residence in the last seven (7) years]
Other Residential Address 1:       Other Residential Address 2:       Other Residential Address 3:
From :           To:               From :          To:                From :               To:
                                                                      City/Town:
                                                                      State:
                                                                      Pin code:
                                                                      Landmark:
    Attach Additional Sheet, if you have stayed in more than 3 Other Residential addresses (locations)
C. Permanent Address: (Attach Proof)
Period of Stay From :                 To:                             Landmark:
City/Town:                            State:                                Pincode:
Contact Landline Phone no.:                             Mobile Phone no.:
      TCS Confidential Background Check Form – Business Associates (BA) Version 8.0 Page 1 of 10
                        Ensure consistency with information furnished by you initially to TCS
                                                   Reference Details:
                     Details                             Reference 1                    Reference 2
   Reference Name (NoRelatives/Friends
                     to be given asReference)
                          Title &Designation:
(Supervisor/PersonholdingresponsiblePosition
                  in a ReputedOrganization.):
      Is the above mentionedReference/
   Supervisor from the currentCompany                        No                            No
   Full Address (with Company Name):
  Contactdetails               Official emailID:
                      Landline Telephone No.:
                             Mobile Phone No.:
     Period for which the Reference knowsthe
                 Applicant (Minimum 2years)
               Relationship with theApplicant
                        (NoRelatives/Friends)
Passport Details (Attach Proof):
   (i)      Name as in Passport:
   (ii)     Passport No:                                   (iii) Place of Issue:
   (iv)     Date of Issue:                                 (v) Date of Expiry:
          TCS Confidential Background Check Form – Business Associates (BA) Version 8.0 Page 1 of 10
                            Ensure consistency with information furnished by you initially to TCS
Educational Qualifications (Attach Proof)
Name as in Certificate:
                Qualification                                      Highest Degree                         Qualification prior to Highest Degree
                            Mode of Education
           (Full time/Correspondence/Partime):
       Name of Examination Passed(B.E./M.Tech,
                                          etc.):
                  Specialization / Main Subjects:
                      Name of Institute / College/
                                      University:
                                         Address:
                          (Give Complete Address)
 Institute /
 College /
 University
 Details
                           Office Landline Ph No.:
                               Name of Affiliated
                                      University:
                             AffiliatedUniversity
                                        Location:
                                      Date From:
 Period of Study                         Date To:
                   Seat No. / Roll No./ Regn No.:
                                Year of Passing:
           % of marks & Class / Grade obtained:
                      TCS Confidential Background Check Form – Business Associates (BA) Version                 8.0 Page 5 of 10
                                        Ensure consistency with information furnished by you initially to TCS
Employment Details (Starting from your Current/Immediate Last Employment) (Attach Proof):
Name of the BA Company : Future Focus Infotech Pvt Ltd
Previous Employer’s Description                          Current BA Company                                          Previous Employment 1
Period         Date of emp. From:
                      Date of emp. To:
Employee                  Designation:
Details                   Employee #:
HR                          HR Name:                     Amar Kotekar
Details               HR Designation:                    Account Manager
               Office Landline Ph No.: 07400488981               Do not provide Mobile Ph No                                      Do not provide Mobile Ph No
                                Email:                 amar.k@focusite.com
Supervisor           Supervisor Name:
Details        Supervisor Designation:
               Office Landline Ph No.:                           Do not provide Mobile Ph No                                      Do not provide Mobile Ph No
                                Email:
                      Last drawn CTC:
                   Reasons for leaving:
Employer              Employer Name: Future Focus Infotech Pvt Ltd
Details
                              Address:    Office no.303, 3rd floor,Center Point
                              (GiveCo     Building,Near Mitra Mandal Chowk,
                    mpleteAddressincl.    Parvati,Pune
                    Postalcode,promin
                                   ent
                            landmark)       Town/City:Pune                                            Town/City:
                                            State: Maharashtra         PinCode: 411009                State:                     PinCode:
               Office Landline Ph No.:                           Do not provide Mobile Ph No                              Do not provide Mobile Ph No
                      Company Status: Is companycurrentlyfunctioning?     Yes / NO           Is companycurrentlyfunctioning?     Yes / No
                    TCS Confidential Background Check Form – Business Associates (BA) Version                 8.0 Page 5 of 10
                                      Ensure consistency with information furnished by you initially to TCS
 Previous Employer’s Description                      Previous Employment 2                                       Previous Employment 3
Period of       Date of emp. From:
employment         Date of emp. To:
Employee              Designation:
Details               Employee   #:
HR Details               HR  Name:
                     HR Designation:
              Office Landline Ph No.:                               Do not provide Mobile Ph No                                Do not provide Mobile Ph No
                               Email:
Supervisor          Supervisor Name:
Details       Supervisor Designation:
              Office Landline Ph No.:                               Do not provide Mobile Ph No                                Do not provide Mobile Ph No
                               Email:
                     Last drawn CTC:
                  Reasons for leaving:
Employer             Employer Name:
Details
                             Address:
              (Give CompleteAddress
                                 incl.
                     Postalcode,prom
                      inentlandmark)
                                           Town/City:                                              Town/City:
                                           State:                     PinCode:                     State: Karnataka           PinCode:
              Office Landline Ph No.:                               Do not provide Mobile Ph No                                Do not provide Mobile Ph No
                     Company Status: Is companycurrentlyfunctioning?           Yes                 Is companycurrentlyfunctioning?   Yes
                 TCS Confidential Background Check Form – Business Associates (BA) Version                 8.0 Page 5 of 10
                                   Ensure consistency with information furnished by you initially to TCS
  Previous Employer’s Description                          Previous Employment 4                                       Previous Employment 5
 Period of       Date of emp. From:
 employment         Date of emp. To:
 Employee              Designation:
 Details               Employee   #:
 HR Details               HR Name:
                          HR Designation:
                   Office Landline Ph No.:                               Do not provide Mobile Ph No                                Do not provide Mobile Ph No
                                    Email:
 Supervisor              Supervisor Name:
 Details           Supervisor Designation:
                   Office Landline Ph No.:                               Do not provide Mobile Ph No                                Do not provide Mobile Ph No
                                    Email:
                          Last drawn CTC:
                       Reasons for leaving:
 Employer                 Employer Name:
 Details
                                   Address:
                    (Give CompleteAddress
                                       incl.
                           Postalcode,prom
                            inentlandmark)
                                                Town/City:                                              Town/City:
                                                State:                     PinCode:                     State:                     PinCode:
                  Office Landline Ph No.:                            Do not provide Mobile Ph No                              Do not provide Mobile Ph No
                         Company Status: Is companycurrentlyfunctioning?        Yes / No         Is companycurrentlyfunctioning?     Yes / No
Note: (i) You may attach additional sheets, if required, to provide more details on your Previous Employments
                      TCS Confidential Background Check Form – Business Associates (BA) Version                 8.0 Page 5 of 10
                                        Ensure consistency with information furnished by you initially to TCS
   Gaps during Education/Employment (Attach Proof):
                         From               To                                 Reasons for gap
   Gap Period 1
   Gap Period 2
   Gap Period 3
 SECURITY DETAILS:
 A, Are you involved in any pending and / or closed Civil / Criminal / case / proceedings /
    charges / enquiry prior to joining TCS ?
                                                                                            No
 B, Are you involved in any pending and / or closed Disciplinary / malpractices and / or any
    other charges / proceedings / enquiry / case pending against me in any University or any
    other educational authority / institution prior to joining TCS ?
                                                                                             No
C, If the answer to any of the above mentioned questions is ‘ Yes’ give full particulars of the case /arrest / detention
 / fine / conviction / sentence / punishment etc. and / or the nature of the case pending in the Court / University /
 Educational Authority etc., at the time of filling up this form.(Attach additional sheet, if required)
                              DECLARATION (To be signed by the Applicant)
     I certify that the information furnished in this form is factually correct and complete in all respects to the best
     of my knowledge and belief.
     Signature of Applicant                                Name
     Place                                 Date
      TCS Confidential Background Check Form – Business Associates (BA) Version 8.0 Page 9 of 10
                        Ensure consistency with information furnished by you initially to TCS
TCS Confidential Background Check Form – Business Associates (BA) Version 8.0 Page 9 of 10
                  Ensure consistency with information furnished by you initially to TCS
                      Declaration and General Consent to Background Investigation
                                   Declaration to be signed by the BA
In connection with rendering services to Tata Consultancy Services Ltd. (the "Company"), as a Business
Associate (BA) from
 Future Focus Infotech Pvt Ltd.                                                             (BA
Company),I hereby agree as follows:
Icertifythattheinformationfurnishedinthisformaswellasinallotherformsfilled-inbymeinconjunctionwith     my
rendering of services as a BA is factually correct and subject to verification by TCS including Reference
Check and BackgroundVerification.
IacceptthatmyservicesasaBAcanberevokedand/orterminatedwithoutanynoticeatanytimeinfutureif                   any
information has been found to be false, misleading, deliberately omitted/suppressed.
AsaconditionofCompany'sconsiderationofmyrenderingofservicesasaBAtotheCompany,Iherebygive                     my
consent to the Company to investigate or cause to be investigated through any third parties my personal,
educational and pre or post employment history, criminal history and any other checks, including Drug test as
required for complying with TCS and or Client specific BGC requirements. I understand that the background
investigation will include, but not be limited to, verification of all information given by me to the Company. I
confirm that the Company is entitled to share such investigation report with its clients to the extent necessary
in connection with the Services, which I may be required to provide to such clients. I confirm and undertake
thattheCompanyshallincurnoliabilityorobligationofanynaturewhatsoeverresultingfromsuchinvestigation            or
sharing of the investigation results as above.
I certify that I am at present in sound mental and physical condition to undertake my rendering of services as
aBAwithTCS.IalsodeclarethatthereisnocriminalcasefiledagainstmeorpendingagainstmeinanyCourt of law in
India or abroad and no restrictions are placed on my travelling anywhere in India or abroad for the purpose of
business of the company.
I hereby declare and undertake that
I shall not resort to any unethical, unfair practices to augment my chances of selection with TCS by adopting
unlawful means directly and / or indirectly within and outside TCS and shall strictly adhere to the selection
process made applicable by TCS
My candidature for Contract Services in the Company is liable to be rejected in the event it comes to the
knowledge of TCS that I have resorted to unethical, unfair practices to augment my chances of selection with
TCS. I am fully aware that TCS is an equal opportunity employer and the decision of TCS to hire me is solely
will be made on my credentials duly validated and on the assessment of my capability to perform a role for
which I am interviewed by TCS.
I Agree : Yes
Signature       :                             Name:
Place           :                             Date:
  TCS Confidential Background Check Form – Business Associates (BA) Version 8.0 Page 10 of 10
                    Ensure consistency with information furnished by you initially to TCS