Candidate Information Sheet

Client Name: EMP ID: _ DOJ:

Instructions: Please fill the form in CAPITAL letters only and do not use any abbreviations
Personal Information
First Name
Gender ❑ Male ❑ Female Please affix
your most
Marital Status ❑ Single ❑ Married ❑ Widow recent photo
Mobile Numbers here
Email ID
Date of Birth & Age DD/MMM/YYYY Age
Father's Name DOB & Aadhar
Mother's Name DOB & Aadhar
Spouse's Name DOB & Aadhar
Current Address:
Flat/Door/Plot No.

Building/Street Name
City/Dist. Name: Pin code:
Permanent Address:
Same As Above (Tick) ❑ Yes ❑ No
Flat/Door/Plot No.

Building/Street Name
City/Dist. Name: Pin code:
Bank Account Details:
(Please attach a Cancel Cheque Leaf / Bank Pass Book Copy)
Bank Name:

Bank A/C Number:

Branch Name:

IFSC Code:
Previous Employment Details
Previous UAN/PF Member ID
Previous ESIC No
Date Of Exit for Member ID DD/MMM/YYYY

Please Check And Provide Your Details Here Mandatory:

Do you have any Relatives/Friends working for our Client: ❑ Yes ❑ No

Do you have any Relatives/Friends working under ❑ Yes ❑ No

BUZZWORKS Business Services Pvt. Ltd
Are you a Relative/Friend of the dealer: ❑ Yes ❑ No

1
 Educational Details
Graduation / Post Graduation
Qualification Obtained
Institution Name
(University/
College/Institution)
❑ ❑ ❑
Year of Passing Percentage _____ %
Yes No Pursuing

HSC / Pre - University

Qualification Obtained
Institution Name (School/
College/Institute)

Name of University / Board

Year of Passing Percentage _____ %

SSLC / 10th Equivalent

Qualification Obtained
Institution Name (School/
College/Institute)
Name of University / Board
Year of Passing Percentage _____ %

Reference Details
Reference 1 Reference 2 Reference 3
Name:
Contact Number:
Previous Employment History
Company Name:
From - To:
Last Position:
Previous PF/UAN Number
Previous ESIC Number
Submission of Proof
Type of Proof YES / NO Attached Proofs Document Number

Aadhar Card ❑ Yes ❑ No

PAN Card ❑ Yes ❑ No
Voter ID ❑ Yes ❑ No
Driving License ❑ Yes ❑ No
Passport ❑ Yes ❑ No
Ration Card ❑ Yes ❑ No
Educational Certificates ❑ Yes ❑ No
In Case the candidate have change the name or had involved in legal proceeding which can affect the status of the candidate.
Candidate must disclose such facts and shall submit the relevant Documents to the company.
Declaration:

I hereby declare that all the information given herein regarding the educational qualifications, personal/family profile are true
and to the best of my knowledge.
Place:
Date: Candidate's Signature