TCS Confidential

TCS BACKGROUND CHECK FORM

Basic Details

TCSL Applicant ID : 1224220

CT Reference Number : DT20184258732

Name Of Applicant : Bharathi Baliboyina

Date Of Birth : 28/08/1998

Nationality : India

Email ID : vijjubharathi456@gmail.com

Pan Card No. : EOKPB3534L

Present Residential Address

House No./Apartment Name/Block No. : C/O T.SATYANARAYANA REDDY D.NO.7-639
Road/Street/Lane : GIRLS HOSTEL STREET

City : ANAPARTHI State : Andhra Pradesh Country : India Pincode : 533342

Telephone : 91 7416773829 Mobile : 91 9347964560

Landmark
DHARANI KOTA
Period of Stay
From : 28/08/1998 To : 23/06/2019

Permanent Residential Address

House No./Apartment Name/Block No. : C/O T.SATYANARAYANA REDDY D.NO.7-639
Road/Street/Lane : GIRLS HOSTEL STREET

City : ANAPARTHI State : Andhra Pradesh Country : India Pincode : 533342

Telephone : 91 7416773829 Mobile : 91 9347964560

Landmark
DHARANI KOTA
Period of Stay
From : 28/08/1998 To : 23/06/2019

Other Residential Address [Longest Stay in last Seven[7] Years]

House No./Apartment Name/Block No. : C/O T.SATYANARAYANA REDDY D.NO.7-639
Road/Street/Lane : GIRLS HOSTEL STREET

City : ANAPARTHI State : Andhra Pradesh Country : India Pincode : 533342

Telephone : 91 7416773829 Mobile : 91 9347964560

Landmark
DHARANI KOTA
Period of Stay
From : 28/08/1998 To : 23/06/2019

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 TCS Confidential

Academic Details

Degree
Course Name Duration Duration Course University/Institute Board Of Major Subject CGPA/Marks Total Percentage

From To Type Education Obtained Marks/CGPA

Graduate BACHELOR OF 01/06/2015 24/06/2018 Full Time Maris Stella College, APPLIED 3765.0 4350.0 86.55

SCIENCE ( Vijayawada. CHEMISTRY

B.Sc

Qualification )

XII STANDARD XII 02/06/2014 11/05/2015 Full Time M.N.R Junior College State Board OTHERS 499.0 530.0 94.15

/ H.S.C.

X SSC 04/06/2012 29/05/2013 Full Time Sri Maharshi State Board OTHERS 8.8 10.0 88.0

Vidyaniketan

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 TCS Confidential

Security Details

Are you involved in any pending and / or closed Civil / Criminal / case / proceedings / charges / enquiry prior to joining No

TCS.

Are you involved in any pending and / or closed Disciplinary / malpractices and / or any other charges / proceedings / No

enquiry / case pending against me in any University or any other educational authority / institution prior to joining TCS.

''If the answer to any of the above mentioned question is YES give full particulars of the case / arrest /detention / fine
/conviction / sentence / punishment etc. and / or the nature of the case pending in the Court / University / Educational
authority etc. at the time of filling this form.''

Reference Details

Details Reference 1 Reference 2

Reference Name: RAVI SASIDHAR RAKSHITH SHETTY

Designation: ASSOCIATE CONSULTANT ASSISTANT CONSULTANT

Company/Institute Name: TCS TCS

Contact Number: 9916329994 9886111766

Email ID: ravi.sasidhar@tcs.com rakshith.shetty@tcs.com

Relationship with the Applicant: no relative no relative

Period for which the reference 2.0 2.0

knows the applicant:

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 TCS Confidential

DECLARATION :

Candidate Name : Bharathi Baliboyina

TCSL Applicant ID : 1224220

Declaration and General Consent to Background Investigation

In connection with my application to render services to Tata Consultancy Services Ltd (the Company), I hereby agree as follows:

I certify that the information furnished in this form as well as in all other forms filled-in by me in conjunction with my employment is factually correct and subject to

verification by TCS including Reference Check and Background Verification.

I accept that an appointment given to me on this basis can be revoked and/or terminated without any notice at any time in future if any information has been found to be

false, misleading, and deliberately omitted/suppressed. As a condition of Company's consideration of my application for employment with the Company, I hereby give my

consent to the Company to investigate or cause to be investigated through any third parties my personal, educational and pre or post-employment history. I understand

that the background investigation will include, but not be limited to, verification of all information given by me to the Company. I confirm that the Company is entitled to

share such investigation report with its clients to the extent necessary in connection with the Services, which I may be required to provide to such clients. I confirm and

undertake that the Company shall incur no liability or obligation of any nature whatsoever resulting from such investigation or sharing of the investigation results as

above.I certify that I am at present in sound mental and physical condition to undertake employment with TCS. I also declare that there is no criminal case filed against

me or pending against me or I am involved in any case in any Court of law in India or abroad and no restrictions are placed on my travelling anywhere in India or abroad

for the purpose of business of the company.

I hereby declare and undertake thatI shall not resort to any unethical, unfair practices to augment my chances of selection with TCS by adopting unlawful means directly

and / or indirectly within and outside TCS and shall strictly adhere to the selection process made applicable by TCS.

My candidature for employment in the Company is liable to be rejected in the event it comes to the knowledge of TCS that I have resorted to unethical, unfair practices to

augment my chances of selection with TCS.I am fully aware that TCS is an equal opportunity employer and the decision of TCS to hire me is solely will be made on my

credentials duly validated and on the assessment of my capability to perform a role for which I am interviewed by TCS.

Your Electronic Signature is below:

Name: Bharathi Baliboyina

Date: 23/06/2019

Place: Anaparthi

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