Job Application Form

Applicant No/ Employee ID Location Date of Joining/Interview

Please provide complete and correct information. All fields are mandatory.
Please do not use short forms / abbreviations.

Personal Details

Full Name (First, Middle, Last)

Former Name(s) / Maiden Name (if applicable) Gender:

 Male  Female

Father’s Name Date of Birth of Candidate PAN No:

Aadhaar No:.

Permanent Address Tel No Present Address Tel No Mobile No of Candidate

Permanent Address Present Address

Where Applicable please write Where Applicable please write

Village Village

Taluka Taluka

Nearest Railway Station Nearest Railway Station

*Permanent address is address owned by You/Spouse/Mother/Father

Classification | INTERNAL
 Education Details

Educational Record (1) - Highest Qualification only

College/Institute Name &

Address

University Name and Address

Type of degree/qualification Graduated - Yes Program – Full Time

 Yes  Full Time
 No  Part Time
 Correspondence

Subject Major - Graduation date (month /

year)

For CA/CS/ICWA

Passing Certificate Attached  Yes  No

All Group Mark sheets Attached  Yes  No

Practice Certificate  Yes  No  Not applied

Membership Certificate  Yes  No  Not applied

SSN No. (mandatory if studied in USA or Canada):

Page 2 of 5
 Employment Details

Details of Employer 1 (Current Employer)

(Please specify if your company did not give you any employee code or if you were on payroll of a temporary staffing company)
Note - Employment verification will be initiate post joining the organization
Company Name: Position Held & Department

Permanent/ Temporary
Address (main office) Address (Branch where worked) Main Office Telephone (if Branch Telephone (if
available): available):

Employment Period: (date, month, year) Employee Code/ Personnel No: Remunerations (Gross
Salary/month or P.A)

From To

Reason(s) for Leaving Future Prospects

Additional details (Specify )

REPORTING MANAGER DETAILS

Designation:
Name:
Office Land Line Contact No:
Department:

Is your current & past employment reporting manager the Email ID of Reporting Manager:

same person No (Yes/No)

Mobile No:

Referee DETAILS Designation:

Name:
Office Land Line Contact No:

Department:
Email ID of Referee:

Mobile No:
HUMAN RESOURCES MANAGER DETAILS
Designation:
Name:

Contact No

Email ID of Human Resources Manager :

Page 3 of 5
 Details of Employer 2 (Past Employer)
(Please specify if your company did not given you any employee code or if you were on payroll of a temporary staffing company)

Company Name: Position Held & Department

Permanent/ Temporary
Address (main office) Address (Branch where worked) Main Office Telephone (if Branch Telephone (if
available): available):

Employment Period: (date, month, year) Employee Code/ Personnel No: Remunerations (Gross
Salary/month or P.A)

From To

Reason(s) for Leaving Future Prospects

Additional details (Specify )

REPORTING MANAGER DETAILS

Designation:
Name:
Office Land Line Contact No:
Department:

Is your current & past employment reporting manager the Email ID of Reporting Manager:

same person No (Yes/No)

Mobile No:

Referee DETAILS Designation:

Name:
Office Land Line Contact No:

Department:
Email ID of Referee:

Mobile No:
HUMAN RESOURCES MANAGER DETAILS
Designation:
Name:

Contact No

Email ID of Human Resources Manager :

Page 4 of 5
 Declaration and Authorization

☐ With regards to our internal processes, we are required to initiate a CIBIL check to proceed with the next
steps. In line with the same, we seek your consent to proceed with your CIBIL check.

☐ I hereby confirm that none of my direct or extended “Relatives” (“Relatives” shall include spouse, siblings,
children, parents, grandparents, grandchildren, aunts, uncles, nieces, nephews, cousins, step relations and in-
laws), are directly or indirectly employed in Electronica Finance Limited. If so, please submit written declaration
to HR.
If any relative is working, then please provide his name & relation

☐ I hereby confirm that there is no civil or criminal case going on in my name in any of the courts and across
any jurisdiction in India. If so, please submit written declaration to HR.
If any civil or criminal case going on then, please provide details _

☐ I hereby authorize Electronica Finance Limited to contact any former employers as indicated above andcarry
out all Background Checks not restricted to education and employment deemed appropriate through this
selection procedure. I authorize former employers, agencies to release any information pertaining to my
employment and I release them from any liability in doing so.

☐ I hereby confirm that, I was not employed with Electronica Finance Limited in the past. If so, please
provide following details:
Employee code_____________, Reporting Manager______________________ Date of joining: ____________
Last working date: ______________. .

☐ I confirm that the above information is correct to the best of my knowledge and I understand that any
misrepresentation of information on this application form may, in the event of my obtaining employment, result
in action based on company policy.

Signature:

Name:

Date:

Page 5 of 5