Interview Location

Bangalore

Candidate Id

1005144497

Please ✓ in the ❑ wherever applicable.

Please answer each column fully and neatly in your own hand-writing.

APPLICATION FOR EMPLOYMENT

PERSONAL DETAILS
NAME IN FULL
(in block letters)
(As it appears on passport / legal document)

MOHAMMED ZAID

FIRST MIDDLE LAST

ADDRESS FOR COMMUNICATION

No. 153 Mobile No : +91-9742900782

Muslim Block Pan Card No : ACFPZ4453R

E-mail: [email protected]

(Personal E-Mail ID only)

City BANGALORE CITIZENSHIP(S) :

PIN / POSTAL CODE 562117 Indian

State : Karnataka DO YOU HAVE A PASSPORT?:

YES: R NO: ❑
Country India

DATE OF BIRTH (as per passport / legal document) :

(dd/mm/yyyy) GENDER:

27/04/1998 MALE R FEMALE ❑ OTHERS ❑

Do not wish to disclose ❑

VER 9.1 1 of 4 HRD/REC/2023

SIGNATURE OF THE APPLICANT

 EDUCATION
LEVEL DIPLOMA/EQUIV GRADUATION POST OTHERS
(If applicable) GRADUATION
(If applicable)
Name Of The Qualification Pre-University Course Bachelor Of
Awarded Engineering
State Board / University Karnataka Board Of The Pre Visvesvaraya
University Education Technological
University
Name of School/College Jain Vidyaniketan PU college AMC
Engineering
College
Bangalore
State
Branch/ Stream / Area Of Others Electrical &
Specialization Electronics Engg
*Percentage / CGPA 75.0 64
Year & Month Of Final May 2016 November 2020
Examination
*ALL PERCENTAGES / CGPA SHOULD BE AS PER THE DEGREE CERTIFICATE OR FINAL YEAR MARKSHEET (Documents
will be checked during interview round.)

GAPS IN EDUCATION (If any) 0 years. Reason: None

WORK EXPERIENCE
PLEASE WRITE 'NA' IF NOT APPLICABLE
SPECIFY CLEARLY IN CASE OF PART TIME/CONTACT WORK EXPERIENCE NOTICE PERIOD REQUIRED : 0 Days

PERIOD (MM/YYYY)
PAYROLL FROM TO DURATION DESIGNATION REASON FOR EXPERIENC
ORGANIZATION* (in months) SEPARATION E/
RELIEVING
LETTER
AVAILABLE
(Y/N)

TheMathCompany 01-06-2023 14-06-2023 Frontend developer Better career N

opportunities
Sirapatech pvt ltd 14-05-2021 14-06-2022 13 Junior frontend Career opportunities Y
developer

GAPS IN EXPERIENCE (If any) 0 years. Reason: None

* Please do specify "Payroll Organization" if you are working on a contractual basis

Disclaimer : Please be informed that work experience provided by you will be validated through Background check

VER 9.1 2 of 4 HRD/REC/2023

SIGNATURE OF THE APPLICANT

 COMPENSATION AND BENEFITS
ANNUAL CURRENT NEXT REVISION YOUR EXPECTATION AT
EXPECTED DATE: INFOSYS
13-06-2023
Fixed Salary in Lakhs 4.50
(INR)
Variable Pay in Lakhs 0.00
(INR)
Other Benefits in Lakhs
(INR)
Annual Gross 4.50 4.50 9.00
Compensation in Lakhs
(INR)

MISCELLANEOUS
ANY HISTORY WITH INFOSYS GROUP? YES ❑ NOR

IF YES, HAVE YOU INFOSYS OTHER GROUP COMPANIES

RELEVANT DATES RELEVANT DATES

- TAKEN ANY TEST? YES ❑ NO R ..................... YES ❑ NO R NA

- SELECTED FOR INTERVIEW? YES ❑ NO R ..................... YES ❑ NO R NA
- MADE AN OFFER? YES ❑ NO R ..................... YES ❑ NO R NA

- JOINED & QUIT? YES ❑ NO R ..................... YES ❑ NO R NA

ARE YOU SERVING/ENGAGED AS A DIRECTOR, PARTNER, SOLE PROPRIETOR OR IN ANY OTHER YES ❑ NO R
EQUIVALENT POSITION IN ANY COMPANY, FIRM OR BUSINESS ENTITY?
IF YES, PLEASE PROVIDE THE DETAILS
ARE YOU CURRENTLY EMPLOYED WITH ANY OF THE INFOSYS GROUP COMPANIES? YES ❑ NO R
IF YES, INFOSYS BPM ❑ OTHERS ❑
HAS ANY WARRANT FOR YOUR ARREST OR SUMMONS FOR YOUR APPEARANCE BEEN ISSUED OR YES ❑ NO R
AN ORDER PROHIBITING YOUR ENTRY INTO OR EXIT FROM ANY COUNTRY, BEEN ISSUED BY A
COURT OF LAW OR ANY GOVERNMENTAL AUTHORITY?
IF YES, PLEASE PROVIDE THE DETAILS
HAVE YOU AT ANY TIME BEEN SUBJECT TO OR ARE BEING SUBJECT TO ANY INVESTIGATIONS BY YES ❑ NO R
THE FINANCIAL MARKET REGULATOR SUCH AS SECURITIES AND EXCHANGE BOARD OF INDIA?
IF YES, PLEASE PROVIDE THE DETAILS

VER 9.1 3 of 4 HRD/REC/2023

SIGNATURE OF THE APPLICANT

ARE YOU AWARE OF YOU BEING SUBJECT OF ANY INVESTIGATION BY ANY GOVERNMENTAL YES ❑ NO R
AUTHORITY?
IF YES, PLEASE PROVIDE THE DETAILS
ARE THERE ANY CRIMINAL PROCEEDINGS PENDING AGAINST YOU BEFORE ANY COURT OF LAW IN YES ❑ NO R
INDIA OR OUTSIDE INDIA?
IF YES, PLEASE PROVIDE THE DETAILS
ARE YOU SUBJECT TO ANY *SANCTIONS LAWS? YES ❑ NO R
[*SANCTIONS LAWS MEANS ALL APPLICABLE FINANCIAL, ECONOMIC AND TRADE SANCTIONS
(WHETHER PRIMARY OR SECONDARY), AND EXPORT CONTROL LAWS AND REGULATIONS (OR ANY
SIMILAR RESTRICTIONS) IMPOSED BY THE UNITED NATIONS OR THE GOVERNMENTS OF
AUSTRALIA, THE UNITED KINGDOM, EUROPEAN UNION AND THE UNITED STATES OF AMERICA OR
ANY OTHER COUNTRY]
IF YES, PLEASE PROVIDE THE DETAILS

DECLARATION

I authorize Infosys to conduct investigation to verify facts of all statements made in this application and my supporting
documents. I authorize Infosys to secure information about my experience from former employers, educational institutions,
government establishments/agencies or any references I have provided, and for those parties to provide information
concerning my qualifications for employment and I hereby release all parties from any liability arising from such
investigation.

I certify that the academic marks / CGPA are simple average for all subjects / semesters / years including electives, optional
subjects, additional subjects, practicals and languages.

I understand that if I am employed with the company, any false statement, misrepresentation, or omission of facts on this
application or on any supporting documents, regardless of when discovered if found to be false, may result in my immediate
dismissal. The company will have the right to withdraw my letter of appointment or to terminate my training/subsequent
appointment at any time without notice or compensation.

My signature below certifies that I have read, understand, and agree to the foregoing and to the best of my knowledge and
belief; the information on the application form is true and correct.

Date : ........................... Place : .......................... Signature: .............................

VER 9.1 4 of 4 HRD/REC/2023

SIGNATURE OF THE APPLICANT