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Background Verification Form

Employer – 1
Details To Be Provided By Reporting
Details To Be Provided By Candidate
Manager or Colleague

Candidate Name

Candidate Employee ID

Employment Status with this


employer
Resigned/ Working/ Notice

Candidate Designation

Period of Employment
Remuneration / Salary
Per Day/Per Month
Name

Reporting Manager or Colleague Designation


Details (from current or previous
Email Id
company)
(Mandatory)
Phone
Number

Reason for Leaving


Suitable date to do Back Ground
Verification
Any integrity or disciplinary issue
(Kindly Mention
(Yes or No, if Yes please specify)
Status of Exit Formalities
Completed / Pending
(Reasons/details if pending)
Eligible for rehire

Additional Comments

Employer – 2

We hereby assure that the details received from your end shall remain confidential and not used for any other
purpose.
Details To Be Provided By Reporting
Details To Be Provided By Candidate
Manager or Colleague

Candidate Name

Candidate Employee ID

Employment Status with this


employer
Resigned/ Working/ Notice

Candidate Designation

Period of Employment
Remuneration / Salary
Per Day/Per Month
Name

Reporting Manager or Colleague Designation


Details (from current or previous
Email Id
company)
(Mandatory)
Phone
Number

Reason for Leaving


Suitable date to do Back Ground
Verification
Any integrity or disciplinary issue
(Kindly Mention
(Yes or No, if Yes please specify)
Status of Exit Formalities
Completed / Pending
(Reasons/details if pending)
Eligible for rehire

Additional Comments

We hereby assure that the details received from your end shall remain confidential and not used for any other
purpose.

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