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employment

is contingent
successful
background
completion
check.
of upon
this
FORM
BACKGROUND CHECK
Guidelines/Check List



Your Job Offer is subject to successful completion of Background Verification.
Fill-Up this form accurately by attaching all necessary documents (ANNEXURE 1) as
proof.
Ensure consistency in the information provided by you in the form.
No Form will be accepted if any of the necessary documents are missing.

FULL NAME:
(As per 10th certificate)

DOB:(YYYY-MM-DD)

(Attach Proof)
Permanent Address:
(Attach Proof)

Land Mark:

State

Present Address:

Guardian/Father’s Name:

Occupation:

Mother’s Name:

Occupation:

Email Id:

Mobile No:

Nationality:

Marital Status:

Alternative No:

Pin code:

& email id) Passport (Attach Proof) Passport Number PAN Number (Attach Proof): Name as in Passport: Validity (Expiry Date) .Education Details Course (Attach Proof) University/Institution/College Name Duration Post-Graduation: (If Any) Graduation (Discipline): Class XII (Stream) Experience Details (If Any) Company Name (Attach Proof) Designation Domain Duration GAP Duration Details (If Any): GAP Duration: Reasons/Details: References (No Relatives to be mentioned) Name (Title & Designation) Relation with you Contact Details (Phone no.

.

 I understand and agree that any employment or offer of employment is subject to receipt of satisfactory references concerning employment and educational history.  I understand that I must provide satisfactory documentation of my authorization to work in India as a condition of employment with Golden Hills. regardless of when such misstatement. including but not limited to academics. I release all concerned from any liability on account of such disclosures.  I authorize Golden Hills and its representative. I should make my recruiter aware of this.  I certify that the information furnished on this application and during the application process is true. AND I AGREE TO THE ABOVE. personal history. or omission of facts on this form or on a resume will constitute grounds for refusal to hire. age. and criminal history information. sex. a satisfactory background check and submission of required documentation for personal records. credit reports.  Golden Hills is an Equal Opportunity Employer: Hiring and employment decisions are made without regard to race. achievement. disability. rescission of an offer of employment. complete and correct and understand that I am liable for inaccuracies and omissions. now and during my employment. Full Name: Signature: . misrepresentation. I UNDERSTAND. color. job performance. residential. I HAVE READ.  I understand that convictions for various crimes may restrict my eligibility for employment. veteran.DECLARATION FOR BACKGROUND FORM “Golden Hills” as referenced in this application. I authorize all who may have information relevant to this enquiry to disclose it to Golden Hills and/ or its representative. Additionally. religion.  I agree to provide copies of all relevant certificates and documentation requested. to authenticate information I have provided my CV/resume and this form. litigation. status. or disciplinary action up to and including termination. citizenship.  I understand that if I am aware of any medical issue which may interfere with my ability to complete this process or with the performance of my duties. or omission is discovered. or any other characteristics protected by law. attendance.  I understand and agree that any misstatement. national origin. driving records. is intended to refer to the Golden Hills Capital India Private Limited. misrepresentation.

Aadhar card OR Voters ID.Place: Date: ANNEXURE I Please provide the following documents for company records: 1. Previous Employment – for each employment experience listed: a) Appointment/Joining Letter issued b) Last 3 months Salary Slips of previous company c) Relieving Letter of previous 2 companies(if any) Note: All the documents needs to be self-attested. Driver’s License. Driver’s License. Aadhar Card OR Voters ID 4. 5. Address Proofs a) Any government address proof such as valid Passport Copy. b) Electricity Bill or Rental Agreement. . Photo – Two passport sized photograph of yourself 2. Educationa) 10th Mark Sheet b) 12th / Diploma Mark Sheet c) Graduation Mark Sheets (all semesters/years) d) Graduation / Convocation or Provisional Degree Certificate e) Post-Graduate Mark Sheets(all semesters/years) – If applicable f) Post-Graduate /Convocation or Provisional Certificate.if applicable 3. Identity Proofs a) PAN Card or Acknowledgement copy of the application b) Any government ID proof such as valid Passport Copy.