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Employee Verification Form

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yosuvayosuva680
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61 views

Employee Verification Form

Uploaded by

yosuvayosuva680
Copyright
© © All Rights Reserved
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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