CONSENT FOR CREDIT VERIFICATION

Date:
To,
Kotak Mahindra Old Mutual Life Insurance Ltd., Mumbai.
This is in reference with my application for a suitable position in Kotak Mahindra Old Mutual Life Insurance Ltd.
I am aware that the organization offers various benefits like an emergency loan etc. when these become due.
I, therefore, authorize Kotak Mahindra Old Mutual Life Insurance Ltd. to do any necessary verification towards this,
including a CIBIL check, or any other credit verification.
Yours truly,
______________________
(Signature)
Name: ___________________________

DECLARATION ON RELATIVES EMPLOYED IN KOTAK LIFE

I do NOT have any relatives* working as employees or agents for Kotak Life.
Signature: _________________________

Name:

*Relative is defined as mother, father, mother in law, father in law, brother, sister, brother in law, sister in law, son,
step son, daughter, step daughter, husband, wife
Kotak Life reserves the right to take strict action including dismissal from services if this declaration on relatives is
found to be false or inaccurate.

INFORMATION ON DISMISSAL, DISCHARGE OR TERMINATION FROM PREVIOUS EMPLOYMENTS

Have you ever been dismissed or discharged or terminated or laid-off in any of the organizations you worked for?
Please mention details below

If no information is provided, it will be assumed that you have never been dismissed or discharged or terminated or
laid-off in any of the organizations you worked for. Kotak Life reserves the right to take strict action including
dismissal from services if after reference checks, this information is found to be untrue or inaccurate.

Signature: _________________________

Name: