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PERSONAL INFORMATION

Employee Name RATNA RAI Date of Birth 23/08/1997


(DD/MM/YYYY)

RANJIT RAI
Father’s Name Mobile # 6363340292

Residential Details
Permanent Address
10TH TINKSUKI
MILE,BISHNUPURE,JAGUN,ASSAM City
Address - 786188
ASSAM
State
78
Nearest
Pin Code 61
Landmark 88
Residing Fro 6001 To
(Years) m 5631
8

Current Address
BANGALORE
City
Address
KARNATAKA
State
5
6
Nearest 0
Pin Code 0
Landmark
6
6
Residing Fro To
(Years) m
ACADEMICS
Education Records
Roll # /
Name of Name of Cours Dates
Registratio
Degree College/ Universit e Stream Attended
n# Exam
Institute y Name
From To Seat#
Highest
Qualification

Other
Qualification
, if required

Reference Check
Reference Details – 1
Referee Name
Company Name
Designation
Contact Number
Email ID

Reference Details – 2
Referee Name
Company Name
Designation
Contact Number
Email ID
EMPLOYMENT RECORDS

Employer 1 | Company Closed Operations : Currently Employed :

Full Name of the Organization Employee ID From To

City State Country Postal Code

Company Phone# 1: Company Phone# 2 (Optional):

Job Title: Reason for Leaving:

Designation: Final Salary (Annual CTC):

Supervisor Name &Contact Info: HR Manager Name & Contact Info:

Employer 2| Company Closed Operations : Currently Employed :

Full Name of the Organization Employee ID From To

City State Country Postal Code

Company Phone# 1: Company Phone# 2 (Optional):

Job Title: Reason for Leaving:

Designation: Final Salary (Annual CTC):

Supervisor Name &Contact Info: HR Manager Name & Contact Info:


AUTHORIZATION FORM

To Whom It May Concern

___________ _______________ _______________


Last Name Middle Name First Name

I hereby authorize Aegis Customer Support Services Pvt. Ltd. or their representatives to verify
information presented on my Background Verification Form / resume and to procure an investigative
report or consumer report for that purpose.

I certify that the information furnished in this form filled-in by me in conjunction with my
Addresses, details are true to the best of my knowledge.

I hereby grant authority to the bearer of this letter to access or to be provided with full details.

Signature Date :

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