New Hire Information Form
Country* India
Legal Entity* IN19 Alcon Lab Pt Ltd
Associate's Data (As Per Country National ID Card)
Title* Mr
Associate First Name* Ravikarthik
Associate Middle Name Attchphot
Associate Last Name* G
5-2-1 ID / Personnel Number * (Existing Associates)
Marital Status 0 Single Attach photo here
Marriage Date (DD.MMM.YYYY)
Date of Birth ((DD.MMM.YYYY))* 24.01.1986
Birth Place* Bengaluru
Birth State 10 Karnataka
Permanent Account Number (PAN) * AUOPG6106F
Nationality by Birth * IN Indian
2nd Nationality / Current Nationality IN Indian
UAN Number* 1003-2023-0511
Aadhar card number* 6401-1583-6797
Religion Hindu
Associate Address Data Permanent Address Mailing address Emergency Contact
Emergency contact
person name and
Care of Gurumurthy.V (Father) Gurumurthy.V (Father) relationship
Street and House Number* #8, 6th Cross Road, S.K.Nagar, #8, 6th Cross Road, S.K.Nagar,
Second Address Line Nandini layout Post, Bengaluru 5600 Nandini layout Post, Bengaluru 56009
City* Bengaluru
District* Bengaluru Urban
Post Code* 560096
State/Region* 10 - Karnataka Please select...
Country* IN - India Please select...
Contact no. of
emergency contact
Contact No. 8884935283 peson
Tenure at address 30 years
Family Members / Dependents Record #1 Record #2
Relation* Father Mother
First/Middle Name* Gurumurthy Gajalakshmi
Last Name* V R
Birth date* (DD.MMM.YYYY) 05.07.1951 28.08.1959
Gender* Male Female
Nationality
Record # 3 Child 1
Relation* Spouse Child
First/Middle Name*
Last Name*
Birth date* (DD.MMM.YYYY)
Gender* Please select... Please select...
Nationality Please select... Please select...
Child 2 Child 3
Relation* Child Child
First/Middle Name*
Last Name*
Birth date* (DD.MMM.YYYY)
Gender* Please select... Please select...
Nationality Please select... Please select...
**Please provide details of all educational & professional qualification attained starting with your first qualification
Only degree/diploma equivalent qualifications or higher are to be provided
Record # 1 (highest degree) Record # 2(Professional Cource)
Name of Degree* 02 Bachelors / First University Degre Please select...
Course Name (Please specify) B.E(Information Science)
Education Type* Information Technology Please select...
Educ. Institute Name*
Country* IN - India Please select...
City
Date Started* (DD.MMM.YYYY) 15.06.2004
Date of Completion* (DD.MM.YYYY) 25.07.2009
ID/Roll Number 1AT04IS063
Work History
* *Please provide complete employment history
Ensure that you are descriptive wherever necessary; e.g. if the company has closed/ceased operations/moved location, do mention it
Employee Code/ ID/ Number of your previous employer is mandatory
Start with your most recent/current employer, followed by details of the employment preceding that
Record # 1 Record # 2
Employer* LTIMINDTREE Technosoft Corporation
Date from* (DD.MM.YYYY) 19.02.2021 18.02.2019
Date to * (DD.MM.YYYY) 26.02.2024 04.09.2020
Position* Senior Manager - Program & Projec Technical lead
Functional* Information Technology Information Technology
City* Bengaluru Bengaluru
Country* IN - India IN - India
ID/Roll Number
If Temporary or Contractual, please provide name of agency
Reason for Leaving Better Career Growth Better career Growth
Last Salary (CTC) Drawn / Current CTC
Details of Agency (if deployed from another agency / if working on 3rd
party
Name of Supervisor* Jayavel.S
Designation & Department of Supervisor Principal Director , Travel and health
Supervisor's Contact No.
Supervisor's Email Id jayavel.s@ltimindtree.com
Can a reference be taken now?
If 'No', please indicate date when reference can be taken
Record # 3 Record # 4
Employer* Cerner Healthcare Hewlett Packard Enterprise
Date from* (DD.MM.YYYY) 13.04.2017 24.05.2010
Date to * (DD.MM.YYYY) 2.11.2018 03.04.2017
Position* Senior Test Automation Engineer Information Testing-1
Functional* Information Technology Information Technology
City* Bengaluru Bengaluru
Country* IN - India IN - India
ID/Roll Number
If Temporary or Contractual, please provide name of agency
Reason for Leaving
Last Salary (CTC) Drawn / Current CTC
Details of Agency (if deployed from another agency / if working on 3rd
party
Please select (Yes/No) if the documents have been submitted for employment history:
Yes Relieving Letter / Resignation Acceptance Resignation Acceptance
Yes Service Certificate
Please select... Appointment Letter
Please select... Others (please specify)
Please select... None
Associate's Other Personal Data
Blood Group O+ve
Former / Maiden Names (if applicable)
Personal Email Address ravikarthik.gurumurthy@gmail.colm
Date(s) of Name Change
Languages Known (Pls. specify): English, Kannada
Speak Yes
Read Yes
Write Yes
Other Information
Are you currently engaged in any other business either as a proprietor, partner, officer, director, trustee, employee, agent, retainer, contractor, consultant, free lancer or
otherwise. If yes, please give details.
No Details if Yes:
Have you ever been dismissed from the services of any previous employer(s)? If yes, please give details.
No Details if Yes:
Have you ever been convicted in a court of law or of a criminal offence? If yes, please give details and status of prosecutions against you.
No Details if Yes:
Have you ever had any civil judgments made against you? If yes, please give details.
No Details if Yes:
Have you ever been employed with Alcon? If yes, please give details.
No Details if Yes:
Do you have any of your relatives employed in Alcon? If yes, please give details.
No Details if Yes:
Comments
Requestor
Declaration:
““I hereby declare that the information I have given is true and correct to the best of my knowledge. I understand that a misrepresentation or omission
of facts called for herein shall be sufficient cause for cancellation of consideration for employment or dismissal from the Company’s service if I have been employed,
without liability to the Company."
"I confirm that I understand the purpose and I agree to the Employment Check on my personal information as outlined above.
I hereby authorize and agree to assist Alcon or any authorized third party supplier acting on behalf of Alcon, to verify the information provided by me to the extent
permitted by law, in connection with my application for employment with Alcon Laboratories (India) PVT LTD.
I consent to Alcon, or any authorized third party supplier acting on behalf of Alcon, holding and processing both electronically and manually the personal information that it
collects for the above mentioned purposes and only for the duration permitted by applicable local laws and regulations.
Associate Name Signature Date
Ravikarthik. G 28.03.2024
