You are on page 1of 14

Employment Application

Akshay Kumar Singh


ID: 00167280 True N
Application Submission Date: 19/03/2016
Personal Information
Name

Prefix: Mr
Legal Name: Akshay Kumar Singh
Preferred Name: Akshay Kumar Singh
Former Name:
Suffix:

Have you ever been known by any other name? NO


Date of Birth: 02/08/1988
Do you have a US Green Card? No

Father's Name
First Name: Govind
Middle Name: Prasad
Last Name: Singh
Gender: Male
Date of Birth: 03/05/1960
Relationship: Father
Living/Deceased: Living

NATIONAL ID
Country: India
Type: PAN
Description: Permanent Account Number
ID/Number: FSUPS5937M
Primary ID: Yes

Passport Details
Country issued: India
Passport Number: J7034326
Issue Date: 21/03/2011
Expiration Date: 20/03/2021

PERSONAL PHONE
Phone Type: Alternate 1
Country Code: 91 (India)
Phone Number: 7204429779
Extension:
Phone Type: Primary 1
Country Code: 91 (India)
Phone Number: 8971950045
Extension:

PERSONAL EMAIL
Email Type: Personal Email 1
Email Address: bhadoria.akshay.singh@gmail.com

Akshay Kumar Singh Page 1 of 14


Employment Application
Akshay Kumar Singh
ID: 00167280 True N

Current Addresses
Address Type: Primary
From: 01/02/2015
Address 1: 2/1-3, Shibilisha House, 1st cross,
Address 2: 3rd main
Apt #/Flat: Bilekahalli, near IIM Bangalore
City:
State: Bangalore
Postal: Karnataka
Country: 560076
India

Address Type: Campus


From: 01/02/2015
Address 1: C block, 2nd floor, Main Building,
Address 2: IIM Bangalore
Apt #/Flat: Bannerghatta Road
City:
State: Bangalore
Postal: Karnataka
Country: 560076
India

Address History
From: 02/08/1988
To: 31/01/2015
Address Type: Primary
Address 1: Bye-Pass Road, Near Pramila rest House
Address 2: Mahissouri
Apt #/Flat:
City: Jamui
State: Bihar
Postal : 811307
Country: India
From: 01/08/2007
To: 14/05/2012
Address Type: Campus
Address 1: Hostel block, IISER kolkata, BCKV campus
Address 2: Nadia
Apt #/Flat:
City: Mohanpur
State: West Bengal
Postal : 741252
Country: India

Akshay Kumar Singh Page 2 of 14


Employment Application
Akshay Kumar Singh
ID: 00167280 True N
From: 15/05/2012
To: 31/01/2015
Address Type: Campus
Address 1: M 308, Hostel Block, IIM Bangalore
Address 2: Bannerghatta Road
Apt #/Flat:
City: Bangalore
State: Karnataka
Postal : 560076
Country: India

Akshay Kumar Singh Page 3 of 14


Employment Application
Akshay Kumar Singh
ID: 00167280 True N
Education
High School/Secondary School/Equivalent
Attended From: 20/03/2004
Attended To: 20/03/2006
Country: India
School Type: High School
Name of High School/Secondary St Francis School, Deoghar
School/Equivalent:
State: Jharkhand
City: Deoghar
Does School Calculate Grade/GPA? Yes
Grade/GPA: 84.3 out of 100
Did You Complete? Yes
null

College/University
Attended From: 15/05/2012
Attended To: 24/03/2016
Country: India
Name of College: Indian Institute of Management Bangalore
Student ID: 1221020
University Not Applicable: Yes
State: Karnataka
City: Bangalore
Major 1: Other
Major 2/Minor:
Does School Calculate Grade/GPA? Yes
Grade/GPA: 3.34 out of 4
Degree/Diploma: Doctorate
Full Time: Yes
Degree/Diploma awarded? No
Expected Award Date: 24/03/2016
Attended From: 01/08/2007
Attended To: 14/05/2012
Country: India
Name of College: Other
College Name: Indian Institute of Science Education and
Research, Kolkata
Student ID: 07MS26
University Not Applicable: Yes
State: West Bengal
City: Mohanpur

Akshay Kumar Singh Page 4 of 14


Employment Application
Akshay Kumar Singh
ID: 00167280 True N
Major 1: Mathematics
Major 2/Minor:
Does School Calculate Grade/GPA? Yes
Grade/GPA: 8.4 out of 10
Degree/Diploma: Masters
Full Time: Yes
Degree/Diploma awarded? Yes
Date Awarded: 08/07/2013

Akshay Kumar Singh Page 5 of 14


Employment Application
Akshay Kumar Singh
ID: 00167280 True N

Employment History
OTHER

No Prior Work History Yes

Akshay Kumar Singh Page 6 of 14


Employment Application
Akshay Kumar Singh
ID: 00167280 True N
Compliance

QUESTIONS RELATING TO REGULATED BROKER-DEALERS

Have you ever:

1. Been expelled, suspended, or barred from membership or trading privileges in any


U.S. or non-U.S. self-regulatory organization (e.g., FINRA), securities exchange, or
commodities or futures exchange?

No

2. Been subject to an order of the U.S. SEC, U.S. CFTC or non-U.S. financial regulator
denying, suspending or revoking your registration or authority as a broker or dealer in
securities, commodities or futures by a U.S. or non-U.S. financial regulator?

No

3. Been found to be the cause of any organization or other natural person being
suspended from the securities, commodities or futures business?

No

4. Been found to have willfully violated any provision of the Securities Act of 1933, the
Securities Exchange Act of 1934, the Investment Advisers Act of 1940, the Investment
Company Act of 1940, the Commodity Exchange Act, or any rule or regulation under
any of such acts, or any of the rules of the Municipal Securities Rulemaking Board
(collectively, the "U.S. Financial Industry Laws") or found you to have been unable to
comply with any provision of the U.S. Financial Industry Laws?

No

5. Been found to have willfully aided, abetted, counseled, commanded, induced, or


procured the violation by any person of any provision of the U.S. Financial Industry
Laws?

No

6. Been found to have failed reasonably to supervise another person subject to your
supervision, with a view to preventing the violation of any provision of the U.S.
Financial Industry Laws?

No

7. Been barred by a U.S. state securities, banking or insurance regulator or a federal


banking regulator from engaging in the securities, insurance, banking, savings
association or credit union business, or had a final order issued by any such agency
against you based on fraudulent, manipulative or deceptive conduct?
Akshay Kumar Singh Page 7 of 14
Employment Application
Akshay Kumar Singh
ID: 00167280 True N
No

8. Been found by a non-U.S. financial regulator to have

8.1. misstated or omitted to state a material fact in any application to it or proceeding


before it?

No

8.2. violated any statute or regulation regarding transactions in securities or commodity


futures?

No

8.3. aided, abetted, counseled, commanded, induced, or procured the violation of any
such statue or regulation?

No

8.4. failed reasonably to supervise another person subject to your supervision, with a view
to preventing violations of any such statue or regulation?

No

9. Been convicted of, or pled guilty or nolo contendere to, any of the following in the last
10 years in a U.S. or non-U.S. court:

9.1. any felony (or equivalent non-U.S. crime)?

No

9.2. a misdemeanor (or equivalent non-U.S. crime) involving:

9.2.1. false statements, bribery, perjury or burglary?

No

9.2.2. the conduct of a business of a broker, dealer, investment adviser, bank,


insurance company, fiduciary, transfer agent or securities ratings agency?

No

9.2.3. larceny, theft, robbery, extortion, forgery, counterfeiting, fraudulent


concealment, embezzlement, conversion or misappropriation of funds or
securities?

No

9.2.4. concealment of assets, mail fraud, counterfeiting, forgery, fraud or false


Akshay Kumar Singh Page 8 of 14
Employment Application
Akshay Kumar Singh
ID: 00167280 True N
statements under Title 18 of the U.S. Code?

No

10. Been enjoined by a U.S. or non-U.S. court from

10.1. acting as an investment adviser, underwriter, broker or dealer in securities, transfer


agent, securities ratings agency or commodities or futures broker or dealer?

No

10.2. acting as an affiliated person or employee of any investment company, bank,


insurance company?

No

10.3. engaging in or continuing any conduct or practice in connection with the above or in
connection with the purchase or sale of any security?

No

11. Misstated or omitted to state a material fact in any application or report to, or
proceeding before, a U.S. self-regulatory organization?

No

Akshay Kumar Singh Page 9 of 14


Employment Application
Akshay Kumar Singh
ID: 00167280 True N
QUESTIONS RELATING TO REGULATED BANKS

Have you ever:

1. Been convicted of any criminal offense involving dishonesty or a breach of trust or


money laundering, or have you agreed to enter into a pretrial diversion or similar
program in connection with the prosecution for such an offense?

No

2. Been convicted of any criminal offense involving the illegal manufacture, sale,
distribution of or trafficking in controlled substances, or agreed to enter into a pretrial
diversion or similar program in connection with the prosecution for such an offense?

No

3. Been assessed a civil monetary penalty (CMP) or been temporarily or permanently


removed and/or prohibited from engaging in banking activities by a U.S. federal
banking regulatory agency?

No

4. Been employed by a financial institution that was subject to a Cease and Desist order
issued by a U.S. federal banking regulatory agency?

No

Akshay Kumar Singh Page 10 of 14


Employment Application
Akshay Kumar Singh
ID: 00167280 True N
OTHER RELATED QUESTIONS

1. At this time, are you subject to any pending inquiry, investigation, or proceeding
related in any way to investments or an investment-related business?

No

NOTE: For purposes of this question and the next question, the terms "investments" or
"investment-related" mean anything pertaining to securities, commodities, banking,
insurance or real estate, and include, without limitation, matters relating to your acting as,
or being associated with, such entities as a broker/dealer, investment company,
investment adviser, futures sponsor, bank, or savings and loan association.

2. Have you ever been the subject of an investment-related inquiry, investigation or


proceeding that was resolved adversely to you and is not otherwise disclosed in
response to all of the above questions?

No

3. At this time, do you have any open arrest record or pending criminal accusation
against you?

No

Other Information

1. Other than as disclosed on the Compliance tab of this questionnaire, have you ever been
convicted of, or plead guilty or nolo contendere ('no contest') to, a crime (felony,
misdemeanor or equivalent) in a domestic or foreign court? You should provide full
details below of any criminal history subject to any applicable laws limiting the extent of
the information you may be required to disclose. If applicable laws permit you not to
provide any such information click on "no."
No

Akshay Kumar Singh Page 11 of 14


Employment Application
Akshay Kumar Singh
ID: 00167280 True N
2. The firm's policy is to honor the legal obligations that a new employee may have to a
current or former employer -- obligations such as an enforceable non-compete or a non-
solicitation agreement, a notice period, or a confidentiality agreement. To facilitate our
hiring process and ensure we understand any limitations to which you may be subject,
are you aware of any such obligations with your current or a former employer?
No

3. Will you be involved in any outside business activity, including serving on a board of a
charitable or other organization, while you are employed at Goldman Sachs?
No

Registration

Failure to list all registrations / licences held may result in your registration being delayed or
not transferred to the firm

1. Do you hold any of the following Industry Exams? No

2. Do you hold or have you ever held a previous registration / license in the securities market? No

Akshay Kumar Singh Page 12 of 14


Employment Application
Akshay Kumar Singh
ID: 00167280 True N

Professional Status and Relationship Questions

Have you ever held a position with a Governmental Entity (and/or served as a fiduciary to a
Governmental Entity) within the past five (5) years in which you were responsible for or had
influence over (a) investment decisions for the entity, and/or (b) the selection or
remuneration of investment advisors for the entity? (c) decisions relating to regulatory
approvals or enforcement actions; and/or (d) decisions relating to the award of business?

No

Do you have an Immediate Family Member who, within the past five (5) years, has held a
position with a Governmental Entity (and/or served as a fiduciary to a Governmental Entity)
in which he or she was responsible for or had influence over: (a) investment decisions for
the entity; (b) the selection or remuneration of investment advisors for the entity; (c)
decisions relating to regulatory approvals or enforcement actions; and/or (d) decisions
relating to the award of business?

No

Other than as disclosed in response to the above 2 questions, in the last 12 months have
you or a Family Member held any position with a Government Entity?

No

Do you have a Family Member who is a Goldman Sachs employee or member of the Board of
Directors of The Goldman Sachs Group, Inc. ("GS Inc.")?

No

Do you reside in the same household as a Goldman Sachs employee or member of the
Board of Directors of GS Inc.?

No

Do you have any other relationship with a Goldman Sachs employee or member of the Board
of Directors of GS Inc. that could give rise to an actual or perceived conflict of interest?
Examples include a romantic relationship with anyone in your reporting line, or a business
relationship with a member of the Board of Directors or with an employee with whom you
may have business interaction in your Goldman Sachs role.

No

Akshay Kumar Singh Page 13 of 14


Employment Application
Akshay Kumar Singh
ID: 00167280 True N

Do you or an Immediate Family Member have any other relationship that could give rise to
an actual or perceived conflict of interest? Examples might include being (or being related
to) a Goldman Sachs client or prospective client, being in a position to influence
investments by a Goldman Sachs client or prospective client, being romantically involved
with a Goldman Sachs vendor or regulator, or being an intermediary of Goldman Sachs or
one of its clients.

No

Akshay Kumar Singh Page 14 of 14