PRE- EMPLOYMENT DECLARATION
To: Date: __________
Healthcare At Home India Pvt. Ltd.
Tapasya Corp. Heights, 3rd Floor,
2A, Noida-Greater Noida Expressway,
Subarea, Sector-126, Noida-201301
Dear Sir / Madam,
I____________________________S/O_____________________________________resident of
_______________________________________do hereby confirm and declare here under that:
1. That I am a citizen of India by birth and my Dob is ________________
2. To the best of my knowledge and belief, all information provide by me in support of my application including
disclosed in response to the requirements raised by company HR, relating to my candidature (like education
certificates, work experience certificates etc.) and any other documents produced before HCAH in connection
with my recruitment in HCAH are true and nothing is concealed therefrom.
3. I also authorize and give my consent to company that if company finds any false or incorrect statement or
information in connection with my application, Company may reject my application for employment and can
terminate my employment with immediate effect or revoke any such letters like offer letter issued to me.
4. That I have not, at any time during the period of five years immediately preceding the date of this
affidavit/declaration, been convicted by any court in India for any offense involving moral turpitude and
sentenced in respect thereof to imprisonment for not less than two years.
5. That no proceedings in respect of any criminal offense alleged to have been committed by me are pending
before any criminal court in India and I am a fit to be admitted/enrolled as a candidate related to any types of
Govt-Private employment and vacancies.
6. That, for employment in HCAH I agree to undergo a background screening and criminal history record check. I
consent to such screening and checks in connection with my application for employment. I also agree that my
pre-employment declaration may be checked by HCAH with the relevant authorities or sources.
7. That, I understand that any false statement or wrongful information or negative background check related to
my candidature will amount to misconduct and I am liable to disciplinary action, including the possibility of
termination of employment what company deems fit.
Thanks & Regards,
________________
Employee Name
Signature: ________________
Communication Address: Health Care at Home India Pvt. Ltd., Tapasya Corp. Heights, 3 rd Floor, 2 A, Noida-Greater Noida
Expressway. Subarea, Sector 126, Noida - 201301
Registered Office: Health Care at Home India Pvt Ltd., 4th Floor, Punjabi Bhawan, 10-Rouse Avenue, New Delhi - 110002
CIN: U85190DL2012PTC242876 | Toll Free: 1800-102-4224 | www.hcah.in
