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Employee Verification Form

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yosuvayosuva680
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120 views8 pages

Employee Verification Form

Uploaded by

yosuvayosuva680
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 8

1

EMPLOYMENT VERIFICATION FORM

CLIENT NUMBER: ……………………………………


DATE OF JOINING:

Please provide complete and correct information. All fields are mandatory.

Please do not use short forms/Abbreviations.

Please fill up this form in uppercase letters and take a printout.


And scan the documents and share the same to us in the mail.

PERSONAL DETAILS

Title (Mr) (First) (Middle)


Name (Last)
Father’s Name:

Nationality

Date of Birth
(yyyy/mm/dd)

Gender:Female
Marital Status:

Maiden Name (applicable for married ladies)


2

CONTACT DETAILS

Permanent Residential Address


(Number and Street)

Period of Stay

Nearest Police Station:

Current Residential Address (Number


and Street)

Period of Stay

Nearest Police Station:

Contact Telephone No. (Specify Office Mobile/ Email Address


Location Codes) Telepho Pager
ne No.
Current Intermediate Permanent

EDUCATIONAL RECORD-of your highest and completed education qualification


(Please attach Self-attested copy of degree certificate and mark sheet for this)-
Incase studied directly through the university,

Correspondence or through distance education, please mention clearly.


College
Name/Addr
ess

University
Name/
Address

From To Program Student Id


(Month/yr) (Month/Yr) Informat No.Enrolment No.
ion
Part-
time
Full-
Time
3

Type of Graduation Subject Major


Degree Date
certificate, (month/yr)

Copy of Certificate Attached Yes :

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 Position
Name: Held:

Company Address: Company Tel:,Fax:


Telephone:

Employment Period Reported to Name of HR Manager


(Name &
Position):
Process
executive

Whether employment is of permanent or temporary nature (Contract


positions are temporary)

Social Security Number (Mandatory if worked in USA):

Responsibilities:
4

Last Monthly Gross Reasons for Leaving:


Salary:

(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?

EMPLOYMENT 2

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:

Company Address: Company Ph:


Telephone:

Employment Period (yyyy/mm/dd) Reported to Name of HR


(Name & Manager
29/12/2021 Position):
28/10/2022

Whether employment is of permanent or temporary nature (Contract


positions are temporary)

Social Security Number (Mandatory if worked in USA):

Responsibilities:
5

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?

EMPLOYMENT 3

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:

Company Address: Company


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)

Social Security Number (Mandatory if worked in USA):

Responsibilities:
6

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?

Professional Reference Check (From 2 Previous Employers)

Reference 1 Reference 2

Name
Organization/
Institution
Position

Address
Telephone
No
Relationship
Years you
have know
each other
7

Declaration

I hereby certify all of the statements made on the Sureminds Solutions Pvt
Ltd employment verification form are true and complete and I understand
that omission or misrepresentation of any fact may result in refusal of
employment or immediate dismissal.

I recognize that in connection with employment with Sureminds


SolutionsPvt Ltd. I may be the subject of a background enquiry by
Sureminds Solutions Pvt Ltd or its representative and I hereby authorize
the same.

Signature :

Name in Capital :

Date :
8

Letter of Authorization

To whom it may concern

I hereby authorize Sureminds Solutions Pvt Ltd representative to verify


information provided in my resume and application of employment and to
conduct enquiries as may be necessary at the company’s discretion. I
authorize all persons who may have information relevant to this enquiry to
disclose it to Sureminds Solutions Pvt Ltd or its representative. I realize all
persons from liability on account of such disclosure.

Signature :

Name in Capital :

Date :

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