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JOINING KIT

Statutory Compliance

Welcome Onboard!

We look forward to have a fruitful association with you

Employee ID: 50080848 Employee Name: Eram Shaikh

Process/Division: TSS Date of Joining (DD/MM/YYYY): 23/05/2022


New Form No.-11 – Declaration Form
(To be retained by the employer for future reference)

EMPLOYEES’ PROVIDENT FUND ORGANIZATION


Employees’ Provident Funds Scheme, 1952(Paragraph 32 & 57) &

Employees’ Pension Scheme, 1995(Paragraph 24)

(Declaration by a person taking up employment in any establishment on which EPF Scheme, 1952 and for EPS, 1995 is applicable)

1 Name of the member (Name as per Pan Card) Eram Shaikh

2 Father’s Name Spouse’s Name Umer Shaikh

(Please tick whichever is applicable)

3 Date of Birth: (DD/MM/YYYY) 21/09/1996

4 Gender: (Male/Female/Transgender) Female

5 Marital Status: (Married/Unmarried/Widow/Widower/Divorcee) Married

6 (a) Email ID: erum1996.21@gmail.com

(b) Mobile No. : 8805250339


7 Whether earlier a member of Employees’ Provident Scheme, Yes
1952
8 Whether earlier a member of Employees’ Pension Scheme, 1995 No

9 Previous Employment details:[If Yes to 7 AND/OR 8 above]


(a) Universal Account Number:
(b) Previous PF Account Number:
(c) Date of exit from previous employment: (DD/MM/YYY)

(d) Scheme Certificate Number(If Issued)

(e) Pension Payment Order (PPO) No. (If Issued)


10 (a) International worker: ( will be NO for all employees) No

(b) If Yes, State Country of origin(India/Name of the


Country)

(c) Passport No. TO

(d) Validity of Passport [(DD/MM/YYYY) to (DD/MM/YYYY)]


11 KYC Details: (attach self-attested copies of following KYCs)
(a) Bank Account No. & IFS code 50100315309646 & HDFC0000029

(b) AADHAR Number 4547 7619 0507


GIMPS3744F
(c) Permanent Account Number (PAN), if available
UNDERTAKING

1) Certified that the particulars are true to the best of my knowledge.


2) I authorize EPFO to use my Aadhar for verification/authentication/eKYC purpose for service delivery.
3) Kindly transfer the funds and service details, if applicable, from the previous PF account as declared above to the
present P.F. Account(The transfer would be possible only if the identified KYC detail approved by previous employer
has been verified by present employer using his Digital signature Certificate)
4) In case of changes in above details, the same will be intimated to employer at the earliest.

Date of Joining (DD/MM/YYYY): 23/05/2022

Place: Pune-CZ Signature of Member

DECLARATION BY PRESENT EMPLOYER

A. The member Mr./Mrs./Ms has joined on and has been allotted PF


Number
B. In case the person was earlier not a member of EPF Scheme, 1952 and EPS, 1995:
 (Post allotment of UAN) The UAN allotted number for the member is
 Please Tick the Appropriate option:-
The KYC details of the above member in the UAN database
� Have not been uploaded
� Have been uploaded but not approved
� Have been uploaded and approved with DSC
C. In case the person was earlier a member of EPF Scheme, 1952 and EPS, 1995:
 The above PF Account Number/UAN of the member as mentioned in (A) above has been tagged with
his/her UAN/Previous Member ID as declared by member.
 Please Tick the Appropriate option:-
� The KYC details of the above member in the UAN database have been approved with Digital
Signature Certificate and transfer request has been generated on portal.
� As the DSC of establishment are not registered with EPFO, the member has been informed to
file physical claim (Form-13) for transfer of funds from his previous establishment.

Date of Joining (DD/MM/YYYY): 23/05/2022 Signature of Employer with Seal of Establishment


For Office use only

Inward No.

FORM 2(REVISED) Group No.


Nomination and Declaration Form for Unexempted /
Exempted Establishment Office At

Declaration and Nomination form under the Employee’s


Provident Funds & Employees’ Pension Scheme
(Paragraphs 33 & 61(1) of the Employees Provident Funds Scheme, 1952 and
Paragraph 18 of the Employees’ Pension Scheme, 1995)

1 Name(in block letters): Eram Shaikh


2 Father’s / Husband’s Name: Umer Shaikh
3 Date of Birth (DD/MM/YYYY): 21/09/1996

4 Sex (Male/Female): Female


5 Marital Status(Married/Unmarried/Widow/Widower): married
6 Account No. PU/PUN/121598
7 Address :
Permanent: 350 Ghorpade peth near Arabia tours and travels mohammadiya apartment, Pune -42
Temporary:
Part A (EPF)
I hereby nominate the person(s)/cancel the nomination made by me previously and nominate the person(s),
mentioned below to receive the amount standing to my credit in the Employees’ Provident Fund, in the
event of my death:
Name of the Address Nominee’s Date of Total amount If the Nominee is a
nominee relationship Birth or share of minor, name &
with the accumulation relationship & address
member s in Provident of the guardian who
Fund to be may receive the
paid to each amount during the
nominee minority of nominee

1 2 3 4 5 6
Umer Shaikh 350 Spouse 01/12/1995
Ghorpade
peth near
Arabia tours
and travels
mohammadiya
apartment,
Pune -42
1. *Certified that I have no family as defined in Para 2(g) of the Employees’ Provident Funds Scheme,
1952 and should I acquire a family hereafter the above nomination should be deemed as cancelled.
2. *Certified that my father/mother is / are dependent upon me.
Signature or thumb impression of the subscriber
Part-B (EPS)
Part 18
I hereby furnish below particulars of the members of my family who would be eligible to receive
Widow/Children Pension in the event of my death.
Sr. Name & Address of the family Date of Birth Relationship with
No. member the member
Name Address
1 2 3 4 5
Ayzal Shaikh 350 Ghorpade 27/06/2021 Child
peth near Arabia
tours and travels
mohammadiya
apartment, Pune
-42
* Certified that I have no family as defined in Para 2 (vii) of the Employees’ Pension Scheme, 1971 and
should acquire a family hereafter I shall furnish particulars thereon in the above form.
I hereby nominate the following person for receiving the monthly window pension(admissible under para
16(2) (a) (i) & (ii) in the event of my death without leaving any eligible family member for receiving pension
Name & Address of the family member Date of Birth Relationship with the
member

Date of Joining (DD/MM/YYYY):23/05/2022


Signature of thumb impression of the subscriber
Certificate by employer
Certified that the above declaration and nomination has been signed/thumb impressed before me by
Shri/Smt/Km employed in my establishment after he/she has read
the entries. The entries have been read over to him/her by me and got confirmed by him/her.

Signature of the employer or other Authorized


Officer of the establishment
Place Pune-CZ Designation
Date of Joining (DD/MM/YYYY): Name & Address of the Factory / Establishment or rubber stamp thereof
Ventura (India) Private Limited
Upper Ground Level, Level 1, Level 2 & Level 3,
Tower B1, Magarpatta City SEZ,
Magarpatta City, Hadapsar, For Office use only
Pune – 411013, Maharashtra, India
Inward No.

FORM 2(REVISED) Group No.


NOMINATION AND DECLARATION FORM FOR UNEXEMPTED /
EXEMPTED ESTABLISHMENT Office At
Declaration and Nomination form under the Employee’s
Provident Funds & Employees’ Pension Scheme
(Paragraphs 33 & 61(1) of the Employees Provident Funds Scheme, 1952 and
Paragraph 18 of the Employees’ Pension Scheme, 1995)

1. Name(in block letters): Eram Shaikh


2. Father’s / Husband’s Name: Umer Shaikh
3. Date of Birth (DD/MM/YYYY): 21/09/1996

4. Sex (Male/Female): female


5. Marital Status(Married/Unmarried/Widow/Widower): married
6. Account No. PU/PUN/121598

7. Permanent: 350 Ghorpade peth near Arabia tours and travels mohammadiya apartment, Pune
-42
8. Temporary:
Part A (EPF)
I hereby nominate the person(s)/cancel the nomination made by me previously and nominate the person(s),
mentioned below to receive the amount standing to my credit in the Employees’ Provident Fund, in the
event of my death:
Name of the Address Nominee’s Date of Total amount If the Nominee is a
nominee relationship Birth or share of minor, name &
with the accumulation relationship & address
member s in Provident of the guardian who
Fund to be may receive the
paid to each amount during the
nominee minority of nominee

1 2 3 4 5 6
Umer Shaikh 350 Ghorpade Spouse 01/12/1995
peth near
Arabia tours
and travels
mohammadiya
apartment,
Pune -42
3. *Certified that I have no family as defined in Para 2(g) of the Employees’ Provident Funds Scheme,
1952 and should I acquire a family hereafter the above nomination should be deemed as cancelled.
4. *Certified that my father/mother is / are dependent upon me.
Signature or thumb impression of the subscriber

Part-B (EPS)
Part 18
I hereby furnish below particulars of the members of my family who would be eligible to receive
Widow/Children Pension in the event of my death.
Sr. Name & Address of the family member Date of Birth Relationship with
No. the member
Name Address
1 2 3 4 5

* Certified that I have no family as defined in Para 2 (vii) of the Employees’ Pension Scheme, 1971 and
should acquire a family hereafter I shall furnish particulars thereon in the above form.
I hereby nominate the following person for receiving the monthly window pension(admissible under para
16(2) (a) (i) & (ii) in the event of my death without leaving any eligible family member for receiving pension
Name & Address of the family member Date of Birth Relationship with the
member

Date of Joining (DD/MM/YYYY): 23/05/2022


Signature of thumb impression of the subscriber
Certificate by employer
Certified that the above declaration and nomination has been signed/thumb impressed before me by
Shri/Smt/Km employed in my establishment after he/she has read
the entries. The entries have been read over to him/her by me and got confirmed by him/her.

Signature of the employer or other Authorized


officer of the establishment
Place Pune-CZ Designation
Date of Joining (DD/MM/YYYY):
Name & Address of the Factory / Establishment or rubber stamp thereof
Ventura (India) Private Limited
Upper Ground Level, Level 1, Level 2 & Level 3,
Tower B1, Magarpatta City SEZ,
Magarpatta City, Hadapsar,
Pune – 411013, Maharashtra, India.
FORM 'F'
THE PAYMENT OF GRATUITY ACT
(See sub-rule (1) of Rule 6)

NOMINATION

To, Ventura (India) Private Limited


Upper Ground Level, Level 1, Level 2 & Level 3 Tower B1, Magarpatta City SEZ,Magarpatta
City, Hadapsar,Pune – 411013, Maharashtra, India

1. I, Shri / Smt. / Kum. Eram Shaikh

(Name in full here)


whose particulars are given in the statement below, hereby nominate the person(s) mentioned below to receive
the gratuity payable after my death as also the gratuity standing to my credit in the event of my death before that
amount has become payable, or having become payable has not been paid and direct that the said amount of
gratuity shall be paid in proportion indicated against the name(s) of the nominee(s).

2. I hereby certify that the person(s) mentioned is/are a member(s) of my family within the meaning of clause (h)
of Section 2 of the Payment of Gratuity Act, 1972.
3. I hereby declare that I have no family within the meaning of clause (h) of Section 2 of the said Act.

4 (a) My father/mother/parents is/are not dependent on me.


(b) My husband's father/mother/parents is/are not dependent on my husband.
5. I have excluded my husband from my family by a notice dated the to controlling authority in terms of
the proviso to clause (h) of Section 2 of the said Act.
6. Nomination made herein invalidates my previous nomination.

NOMINEE(S)

Name in full with full Relationship with Age of Proportion by which


address of nominee(s) the employee nominee the gratuity will be
shared

(1) (2) (3) (4)

1. Umer Shaikh Spouse 26


2.
3.
4
STATEMENT
1. Name of employee in full: Eram Shaikh
2. Sex: female
3. Religion: Islam
4. Whether unmarried/married/widow/widower: Married
5. Department/Branch/Section where employed: TSS
6. Post held with Ticket No. or Serial No., if any: Analyst - Service Desk
7. Date of appointment (DD/MM/YYYY): 23/05/2022
8. Permanent address:
350 Ghorpade peth near Arabia tours and travels mohammadiya apartment, Pune -42
Place: Pune

Date of Joining (DD/MM/YYYY): 23/05/2022 Signature/Thumb-impression of the


Employee

DECLARATION BY WITNESS
Nomination signed/thumb-impressed before me
Name in full and full address of witnesses. Signature of Witnesses.
1. 1.

2. 2.

Place: Pune-CZ Date of Joining (DD/MM/YYYY):

CERTIFICATE BY THE EMPLOYER


Certified that the particulars of the above nomination have been verified and recorded in this
establishment.
Employer's Reference No., if any

Ventura (India) Private Limited


Upper Ground Level, Level1, Level 2&Level 3,
Tower B1, Magarpatta City SEZ,
Magarpatta City, Hadapsar, Signature of the Employer/Authorized Office
Pune – 411013, Maharashtra, India Designation Date:
Name and address of the establishment or rubber stamp thereof
ACKNOWLEDGEMENT BY THE EMPLOYEE
Received the duplicate copy of nomination in Form 'F' filed by me and duly certified by the employer.

Date of Joining (DD/MM/YYYY):23/05/2022 Signature of the Employee


Note.—Strike out the words/paragraphs not applicable.
JOINT DECLARATION UNDER PARA 26(6) OF THE EPF SCHEME, 1952
To,
Regional EPF Commissioner(Maharashtra Region)
Employees’ PF Organization
2nd & 3rd Floor,Pune Cantontment Board Building,
Golibar Maidan, Camp, Pune-411001

Sub: Application for regularising membership/Provident Fund Contributions deducted on Salaries over & above Rs.
6500/- per month or at higher rate.

Sir,
I the undersigned Shri/Smt. Eram Shaikh bearing Account Number
PU/PUN/121598/ , employee of M/s Ventura(India) Private Limited hereby declare that I
have been contributing Provident Fund on my entire salary @ 12% with effect from (DOJ). 23/05/2022
I am/am not an `EXCLUDED EMPLOYEE’ within the meaning of para 2(f) of the EPF Scheme, 1952
I request that;
1. I may be enrolled as member of the Employees’ Provident Fund voluntarily with effect from (DOJ). 23/05/2022
2. I may be permitted to contribute voluntarily on my entire salary exceeding Rs. 6500/- per month w.e.f. (DOJ)
3. I may be permitted to contribute @ __nil______% instead of the statutory rate of 12% with effect from
(DOJ). 23/05/2022

Yours Faithfully,
________________________________
(Member’s signature)

We M/s Ventura(India) Private Limited, bearing Employer’s Code No. PU/PUN/121598_______ hereby
declare that;
1. We have voluntarily enrolled Shri/Smt. Eram Shaikh as member of the EPF Scheme, 1952, w.e.f. (DOJ) and
his/her Account Number is ____________.
2. We have been deducting contribution on his/her entire pay w.e.f. ______________________
3. We have been making matching contribution on pay upto Rs. 6500/- per month / on entire pay w.e.f.
______________.
4. We have been deducting Provident Fund contribution voluntarily @ 12% of pay and making matching
contribution @ 12% of pay.
5. We have paid Administrative Charges and submitted all the Returns in respect of the above Member accordingly
and will continue to do so.

We request that this case be regularised by permitting voluntary membership and contribute on entire salary @ 12%
of pay as stated above.

Yours Faithfully,

For Ventura(India) Private Limited

Authorized Signatory
CAPITA

Affix passport Size


Photograph
PERSONNEL INVENTORY RECORD
(Please fill details in block letters)

Date of Joining
Employee No : 50080848 (dd/mm/yyyy) 23/05/2022

Name : Eram Shaikh

Gender : Location : Pune-CZ

Designation : Analyst - Service Desk Division/Project name : TSS

Date of birth : (DD/MM/YYYY) 21/09/1996 Pan No : GIMPS3744F

Father /Husband’s Name Umer Shaikh


Permanent Address Present Address :

350 Ghorpade peth near


Arabia tours and travels
mohammadiya apartment,
Pune -42

Pin : 411042 Pin :


Mob: Mobile 8805250339
Resi: Mobile 8805250339

Email ID : erum1996.21@gmail.com
Undergraduate Graduate Post graduate Diploma

Qualification : BCA graduate


Qualification : (Mention the highest Qualification)

Total Work Exp. Mths. 3.5 years approx


Relevant Work Exp. : Mths
Work Experience
Passport :
Blood Group : B+
Driving License :
CAPITA
Particulars of other family members (Parents ,Spouse, Children)
Sr. No Name Relationship Date of Birth State whether employed,
studying etc
1 Umer Shaikh Spouse 01/12/1995 Employed
2 Ayzal Shaikh Child 27/06/2021

If married and spouse is employed give his/her Employer Name, Office Address and telephone numbers

Capita (Ventura) commerce zone, yerawadaPune.e


TlephoneNo (s) _____________________________________ Mobile No.7757953589

Academic /Profession Qualification : (To be given in revers chronological order) (10th till highest qualification)
Degree Branch of College/Institute University Start Date End Date Percentage/Class
study /Grade
SSC Crescent High Pune 28/05/2011 13/06/2012 63.80
school
HSC Poona college Pune 27/07/2013 14/02/2014 63.85

BCA Abeda Inamdar Pune 26/03/2016 05/06/2017 Second class


senior college

Professional Training programs/ Courses Attended / Professional Certification (Give this in reverse Chronological order).

Diploma/Certificate Branch Institution Start Date End Date


of Study
CAPITA

Details of previous employment : (To be given in reverse Chronological order)

Name of Organization Designation held Start Date End date Exp. in Last Salary Reason
Yrs. Drawn for
leaving
Concentrix Representative, 29/08/2017 10/12/2018 1year 2 11000 as a Was
operations months part timer getting
married
Capita Senior customer 10/10/2019 21/04/2022 2years 6 31000 Process
care executive months ramp
down

Languages Known: (Also state whether fluent, written, spoken or both).

Language Known Read Write Speak


1) _______English
2) Hindi
3) Marathi______________
4) _____________________
5) _____________________
6) _____________________
7) _____________________
8) _____________________

_______Eram 23/05/2022___________________________
Employee’s Signature & Date of Joining (DD/MM/YYYY):
CAPITA

Personal Accident and Term Life Insurance Nomination Form

Employee Number 50080848 Name Eram Shaikh


Date of Joining Umer Shaikh
(DD/MM/YYYY) 23/05/2022 Father’s /Husband’s Name
Married
DOB(DD/MM/YYYY) 21/09/1996 Marital Status

I hereby nominate person/s mentioned below to receive the amount, in the event of my death and direct the said amount shall be
distributed among the said person/s in the manner shown below against their name.

Share to be paid to
Nominee/s Relation with the Age of each nominee/s (%)
Name and Address of the Nominee employee Nominee (*)

(*) This column should be filled so as to cover the whole amount that may stand to the credit of the member
(Total of all should be 100%)

In case the nominee is minor then provide guardian details.


Name and Address of the guardian Guardian’s Relation with the Age of Share to be paid to
employee Guardian each nominee/s (%)
(*)

______________________________________
Signature of Employee & Date of Joining (DD/MM/YYYY):
Declaration of Resignation

Date of Joining (DD/MM/YYYY):23/05/2022

To,
Manager - Human Resource
Ventura (India) Pvt Ltd
Commerzone, Yerwada, Pune – 411006.

Sub : Declaration of Resignation

I the undersigned hereby confirm that I have resigned from my previous


employment at (Previous Company Name) and last working
Day was 21/04/2022 .
Since my resignation acceptance / relieving letter is currently being processed, I
shall be Forwarding the same to the Human Resource Department within a
period of 45 days. Any concern w.r.t dual employment, Capita is
authorized to take action against me.

(Reliving letter – mention “0” days and resignation acceptance letter – mention
no.of days when reliving letter will be received)

Signature : Eram

Name : Eram Shaikh

Date of Joining (DD/MM/YYYY): : 23/05/2022


Declaration – Non submission of Pan Card details

I EMPNAME hereby declare that

I am working with NAMEOFCOMPANY (Name of our establishment). As per the employment


contract it is mandatory to have the PAN CARD number for statutory purpose.

Currently I do not have PAN CARD and therefore I am not able to provide the PAN CARD Number to
complete my on-boarding requirement.

Tick the applicable option:

I will immediately apply for a PAN CARD by -------------and will submit the details before -------
(Not later than one month from my date of joining)

I have applied for a PAN CARD and will submit the details on or before ------------

(Not later than one month from my date of joining)

Reference No. of PAN CARD application: -------------------------

On receipt of my PAN CARD I will submit a copy to HR and will update the details on the system
accordingly.

I acknowledge that I will be responsible for the consequences of any tax computation and/or my
salary being kept on hold, in case I do not submit & update PAN CARD Number on the system by
the above mentioned dates.

Employees Name:

Employee ID:

Date of Joining (DD/MM/YYYY):


Date of Joining (DD/MM/YYYY):

TO WHOMSOEVER IT MAY CONCERN

This is to confirm that I have not completed my Aadhaar Card registration; therefore I am unable to
provide my Aadhaar Card number.

Herewith, I am giving my assurance that I will complete the Aadhaar Card registration at the earliest
possible or whenever EPFO will arrange a camp for Aadhaar Card Registration, I will participate in the
same as per the schedule provided by the Regional PF Commissioner.

Thanking you.

Yours Sincerely,

(Employee’s Signature)

Employee’s Name:

Emp. No.

PF A/c No. ________________________________________________________

Mobile No.

Email Id.
AUTHORISATION
Human Resource Dept.

Dear Sir,

I Ms./Mr Eram Shaikh Designation Analyst - Service DeskDepartment TSS Hereby


authorize the company that in the event of my death, the balance of my salary
due for the period of leave and all other dues availed of shall be paid to
Umer Shaikh
Who is my (specify relationship) husband

and resides at 350 ghorpade peth near Arabia tours and travels,
mohammadiya apartment, pune-42

The nomination shall remain in force until it is cancelled or revised by another


nomination(s).

(Emergency contact person details)

Signature of the Employee :Eram

Date of Joining (DD/MM/YYYY): : 23/05/2022

Private & Confidential


Code of Conduct

Employee Acknowledgement and Certification of Compliance

I hereby confirm that on receiving, reading and fully understanding the standards
expected of me by Capita Code of conduct, I will observe and abide by the ethical
standards, policies, rule and procedures contained within it.

 Employee Acknowledgement and Certification of Compliance


 Confidential and Sensitive Information
 Conflict of Interest
 Use of Electronic Facilities
 Third Party Intellectual Property Rights
 Data Security Complaince
 Professional Behaviour
 Abusive Substances
 Reports of Complaints, Litigation and Regulatory Inquiries
 Legal/ Regulatory Compliance
 Anti- Bribery
 Communication
 Harassment
 Acceptable Usage Policy & E-mail, Internet Guidelines

I understand that any breach of the above may lead to disciplinary action,
including dismissal.

Signature : Eram

Employee Name : Eram Shaikh

Date of Joining (DD/MM/YYYY): :


USER DECLARATION ON INFORMATION SECURITY INCIDENT MANAGEMENT
POLICY
What is An Incident?

A violation or imminent threat of violation of computer security policies, acceptable use policy,
or standard Security policies.

Incident is classified as

Severity Classification Actionable


Misconduct Misconduct is a term used to describe behavior that
warrants disciplinary action.
Gross misconduct Gross Misconduct describes that strikes at the root of the
contract between Capita and an employee : where an
individual has forfeited that trust we placed in them and is
liable to be terminated.

Please note that should any Capita employee be proved to be actively involved in the
occurrence of any security incident, then disciplinary procedures shall be initiated against the
employee.
For reference, we have categorized the scenarios under ‘Misconduct’ or ‘Gross Misconduct’.

Some of the common information security threat scenarios, which give rise to security
incidents, are mentioned below but not limited to :

Sr. No. Threat/ Incident scenario Disciplinary


category
1 Being an accessory to a disciplinary offence such as failing to Misconduct
report an incident of gross misconduct you observed
2 Any attempt at logging onto systems without proper Misconduct
authorization
3 Any attempt to deliberately infect any device with viruses. Misconduct
4 Sharing of User ID, passwords and/ or personal swipe / access Misconduct
cards
5 Tail gating Misconduct
6 Attempt to access restriction areas (server room & Electrical Misconduct
Rooms)
7 Using Capita network to make unauthorized entry into other Misconduct
networks.
8 Take and / or send any Capita confidential and proprietary Misconduct
information including any client’s or third party information,
outside the office without proper authorization.
9 Installation of unlicensed software on any Capita IT device Group
Misconduct
10 Attempt to intrude any system, network and /or company folder Group
without authorization Misconduct
11 Rendering any infrastructure support device (AC, DGs, UPS, Fire Group
Alarm System, Physical Access System, CCTV), Unavailable or non- Misconduct
operational
12 Forge documents, conceal and/ or provide misleading, inaccurate Group
information at the time of recruitment Misconduct
13 Attempt to change the configuration or setting of Firewall, ACL, Group
Router IP Route, Switch ACL, Windows 2000 Group Policy and / or Misconduct
IP Addressing scheme
14 Attempt at email id impersonation Group
Misconduct
15 Deliberate sharing of Capita confidential and proprietary Group
information including any client’s information Misconduct
16 Rendering any network device and / or critical servers, non- Group
available or not-operational Misconduct
17 Any browsing, accessing and / or downloading of any Group
pornographic content Misconduct
18 Inappropriate email message such as pornographic or offensive Group
emails Misconduct
19 Corrupt or improper practice such as committing or assisting in Group
fraudulent practices Misconduct
20 Misconduct in relation to company documents such as defacing Group
or amending company policies Misconduct
21 Installation of unlicensed software on an Capita IT device. Group
Misconduct

I declare that I have read and understood various misconduct and gross misconduct and if I
fail to follow mandatory requirements outlined in the policy, I may be subject to disciplinary
action, dismissal/termination of contracts.

Employee Name : Eram Shaikh Employee ID : 50080848

Signature : Eram Date of Joining (23/05/2022):


User Declaration On Information Security

I declare that I have read and understood Capita Information Security Policy relevant to my
job profile. Furthermore, I undertake that I shall:

 Use Passwords and keep them secret.


 Create passwords that are at least ten characters long, have both letters and numbers
as well as special characters, that do not spell a word or a name, and do not contain
personal data.
 Protect sensitive data / information by following applicable policies and procedures.
 Protect the confidentiality of information, both during and after contractual relations
with Capita
 Protect my computer by logging off when I am gone for the day or leave it for 5minutes
or more.
 Do not bring personal bags, mobile phone and pager, blackberry etc. in the shop floor
area or its vicinity unless authorized by your immediate Manager.
 Protect equipment assigned to me by keeping it safe from any harm / damage.
 Scan all discs from external sources for viruses before using them on any computer.
 Not install any software unless authorized to do so.
 Use only authorized hardware and software.
 Protect my work area, media, and files, against all threats and report any incidents that
occur to the Security Administrator.
 Not download software from the Internet unless Specifically Authorized to do so by the
Management.
 Comply with all applicable laws and Capita policies and procedures.

I agree that by signing this document I am declaring that I have read and understood the
relevant Information Security Policy and that if I fail to follow mandatory requirement outlined
in the policy, I may be subject to disciplinary action / dismissal /termination of contracts.

Signature : Eram

Employee Name : Eram Shaikh

Date of Joining (DD/MM/YYYY): :


JOINING KIT
Statutory Compliance

Welcome Onboard!

We look forward to have a fruitful association with you

Employee ID: 50080956 Employee Name: Yagamurthy Thoomati

Process/Division: TSS Date of Joining (DD/MM/YYYY): 23/05/2022


New Form No.-11 – Declaration Form
(To be retained by the employer for future reference)

EMPLOYEES’ PROVIDENT FUND ORGANIZATION


Employees’ Provident Funds Scheme, 1952(Paragraph 32 & 57) &

Employees’ Pension Scheme, 1995(Paragraph 24)

(Declaration by a person taking up employment in any establishment on which EPF Scheme, 1952 and for EPS, 1995 is applicable)

1 Name of the member (Name as per Pan Card) Yagamurthy Thoomati

2 Father’s Name Spouse’s Name

(Please tick whichever is applicable)

3 Date of Birth: (DD/MM/YYYY)

4 Gender: (Male/Female/Transgender)

5 Marital Status: (Married/Unmarried/Widow/Widower/Divorcee)

6 (a) Email ID: y.thoomati@gmail.com

(b) Mobile No. : 8125345589


7 Whether earlier a member of Employees’ Provident Scheme, Yes/No
1952
8 Whether earlier a member of Employees’ Pension Scheme, 1995 Yes/No

9 Previous Employment details:[If Yes to 7 AND/OR 8 above]


(a) Universal Account Number:
(b) Previous PF Account Number:
(c) Date of exit from previous employment: (DD/MM/YYY)

(d) Scheme Certificate Number(If Issued)

(e) Pension Payment Order (PPO) No. (If Issued)


10 (a) International worker: ( will be NO for all employees) No

(b) If Yes, State Country of origin(India/Name of the


Country)

(c) Passport No. TO

(d) Validity of Passport [(DD/MM/YYYY) to (DD/MM/YYYY)]


11 KYC Details: (attach self-attested copies of following KYCs)
(a) Bank Account No. & IFS code

(b) AADHAR Number

(c) Permanent Account Number (PAN), if available


UNDERTAKING

1) Certified that the particulars are true to the best of my knowledge.


2) I authorize EPFO to use my Aadhar for verification/authentication/eKYC purpose for service delivery.
3) Kindly transfer the funds and service details, if applicable, from the previous PF account as declared above to the
present P.F. Account(The transfer would be possible only if the identified KYC detail approved by previous employer
has been verified by present employer using his Digital signature Certificate)
4) In case of changes in above details, the same will be intimated to employer at the earliest.

Date of Joining (DD/MM/YYYY):

Place: Remote - Pune-CZ Signature of Member

DECLARATION BY PRESENT EMPLOYER

A. The member Mr./Mrs./Ms has joined on and has been allotted PF


Number
B. In case the person was earlier not a member of EPF Scheme, 1952 and EPS, 1995:
 (Post allotment of UAN) The UAN allotted number for the member is
 Please Tick the Appropriate option:-
The KYC details of the above member in the UAN database
� Have not been uploaded
� Have been uploaded but not approved
� Have been uploaded and approved with DSC
C. In case the person was earlier a member of EPF Scheme, 1952 and EPS, 1995:
 The above PF Account Number/UAN of the member as mentioned in (A) above has been tagged with
his/her UAN/Previous Member ID as declared by member.
 Please Tick the Appropriate option:-
� The KYC details of the above member in the UAN database have been approved with Digital
Signature Certificate and transfer request has been generated on portal.
� As the DSC of establishment are not registered with EPFO, the member has been informed to
file physical claim (Form-13) for transfer of funds from his previous establishment.

Date of Joining (DD/MM/YYYY): Signature of Employer with Seal of Establishment


For Office use only

Inward No.

FORM 2(REVISED) Group No.


Nomination and Declaration Form for Unexempted /
Exempted Establishment Office At

Declaration and Nomination form under the Employee’s


Provident Funds & Employees’ Pension Scheme
(Paragraphs 33 & 61(1) of the Employees Provident Funds Scheme, 1952 and
Paragraph 18 of the Employees’ Pension Scheme, 1995)

1 Name(in block letters): Yagamurthy Thoomati


2 Father’s / Husband’s Name:
3 Date of Birth (DD/MM/YYYY):

4 Sex (Male/Female):
5 Marital Status(Married/Unmarried/Widow/Widower):
6 Account No. PU/PUN/121598
7 Address :
Permanent:
Temporary:
Part A (EPF)
I hereby nominate the person(s)/cancel the nomination made by me previously and nominate the person(s),
mentioned below to receive the amount standing to my credit in the Employees’ Provident Fund, in the
event of my death:
Name of the Address Nominee’s Date of Total amount If the Nominee is a
nominee relationship Birth or share of minor, name &
with the accumulation relationship & address
member s in Provident of the guardian who
Fund to be may receive the
paid to each amount during the
nominee minority of nominee

1 2 3 4 5 6

1. *Certified that I have no family as defined in Para 2(g) of the Employees’ Provident Funds Scheme,
1952 and should I acquire a family hereafter the above nomination should be deemed as cancelled.
2. *Certified that my father/mother is / are dependent upon me.
Signature or thumb impression of the subscriber
Part-B (EPS)
Part 18
I hereby furnish below particulars of the members of my family who would be eligible to receive
Widow/Children Pension in the event of my death.
Sr. Name & Address of the family member Date of Birth Relationship with
No. the member
Name Address
1 2 3 4 5

* Certified that I have no family as defined in Para 2 (vii) of the Employees’ Pension Scheme, 1971 and
should acquire a family hereafter I shall furnish particulars thereon in the above form.
I hereby nominate the following person for receiving the monthly window pension(admissible under para
16(2) (a) (i) & (ii) in the event of my death without leaving any eligible family member for receiving pension
Name & Address of the family member Date of Birth Relationship with the
member

Date of Joining (DD/MM/YYYY):


Signature of thumb impression of the subscriber
Certificate by employer
Certified that the above declaration and nomination has been signed/thumb impressed before me by
Shri/Smt/Km employed in my establishment after he/she has read
the entries. The entries have been read over to him/her by me and got confirmed by him/her.

Signature of the employer or other Authorized


Officer of the establishment
Place Remote - Pune-CZ Designation
Date of Joining (DD/MM/YYYY): Name & Address of the Factory / Establishment or rubber stamp thereof
Ventura (India) Private Limited
Upper Ground Level, Level 1, Level 2 & Level 3,
Tower B1, Magarpatta City SEZ,
Magarpatta City, Hadapsar,
Pune – 411013, Maharashtra, India
For Office use only

Inward No.

FORM 2(REVISED) Group No.


NOMINATION AND DECLARATION FORM FOR UNEXEMPTED /
EXEMPTED ESTABLISHMENT Office At
Declaration and Nomination form under the Employee’s
Provident Funds & Employees’ Pension Scheme
(Paragraphs 33 & 61(1) of the Employees Provident Funds Scheme, 1952 and
Paragraph 18 of the Employees’ Pension Scheme, 1995)

1. Name(in block letters): Yagamurthy Thoomati


2. Father’s / Husband’s Name:
3. Date of Birth (DD/MM/YYYY):

4. Sex (Male/Female):
5. Marital Status(Married/Unmarried/Widow/Widower):
6. Account No. PU/PUN/121598
7. Address :
8. Permanent:
9. Temporary:
Part A (EPF)
I hereby nominate the person(s)/cancel the nomination made by me previously and nominate the person(s),
mentioned below to receive the amount standing to my credit in the Employees’ Provident Fund, in the
event of my death:
Name of the Address Nominee’s Date of Total amount If the Nominee is a
nominee relationship Birth or share of minor, name &
with the accumulation relationship & address
member s in Provident of the guardian who
Fund to be may receive the
paid to each amount during the
nominee minority of nominee

1 2 3 4 5 6

3. *Certified that I have no family as defined in Para 2(g) of the Employees’ Provident Funds Scheme,
1952 and should I acquire a family hereafter the above nomination should be deemed as cancelled.
4. *Certified that my father/mother is / are dependent upon me.
Signature or thumb impression of the subscriber
Part-B (EPS)
Part 18
I hereby furnish below particulars of the members of my family who would be eligible to receive
Widow/Children Pension in the event of my death.
Sr. Name & Address of the family member Date of Birth Relationship with
No. the member
Name Address
1 2 3 4 5

* Certified that I have no family as defined in Para 2 (vii) of the Employees’ Pension Scheme, 1971 and
should acquire a family hereafter I shall furnish particulars thereon in the above form.
I hereby nominate the following person for receiving the monthly window pension(admissible under para
16(2) (a) (i) & (ii) in the event of my death without leaving any eligible family member for receiving pension
Name & Address of the family member Date of Birth Relationship with the
member

Date of Joining (DD/MM/YYYY):


Signature of thumb impression of the subscriber
Certificate by employer
Certified that the above declaration and nomination has been signed/thumb impressed before me by
Shri/Smt/Km employed in my establishment after he/she has read
the entries. The entries have been read over to him/her by me and got confirmed by him/her.

Signature of the employer or other Authorized


officer of the establishment
Place Remote - Pune-CZ Designation
Date of Joining (DD/MM/YYYY):
Name & Address of the Factory / Establishment or rubber stamp thereof
Ventura (India) Private Limited
Upper Ground Level, Level 1, Level 2 & Level 3,
Tower B1, Magarpatta City SEZ,
Magarpatta City, Hadapsar,
Pune – 411013, Maharashtra, India.
FORM 'F'
THE PAYMENT OF GRATUITY ACT
(See sub-rule (1) of Rule 6)

NOMINATION

To, Ventura (India) Private Limited


Upper Ground Level, Level 1, Level 2 & Level 3 Tower B1, Magarpatta City SEZ,Magarpatta
City, Hadapsar,Pune – 411013, Maharashtra, India

1. I, Shri / Smt. / Kum. Yagamurthy Thoomati

(Name in full here)


whose particulars are given in the statement below, hereby nominate the person(s) mentioned below to receive
the gratuity payable after my death as also the gratuity standing to my credit in the event of my death before that
amount has become payable, or having become payable has not been paid and direct that the said amount of
gratuity shall be paid in proportion indicated against the name(s) of the nominee(s).

2. I hereby certify that the person(s) mentioned is/are a member(s) of my family within the meaning of clause (h)
of Section 2 of the Payment of Gratuity Act, 1972.
3. I hereby declare that I have no family within the meaning of clause (h) of Section 2 of the said Act.

4 (a) My father/mother/parents is/are not dependent on me.


(b) My husband's father/mother/parents is/are not dependent on my husband.
5. I have excluded my husband from my family by a notice dated the to controlling authority in terms of
the proviso to clause (h) of Section 2 of the said Act.
6. Nomination made herein invalidates my previous nomination.

NOMINEE(S)

Name in full with full Relationship with Age of Proportion by which


address of nominee(s) the employee nominee the gratuity will be
shared

(1) (2) (3) (4)

1.
2.
3.
4
STATEMENT
1. Name of employee in full: Yagamurthy Thoomati
2. Sex:
3. Religion:
4. Whether unmarried/married/widow/widower:
5. Department/Branch/Section where employed: TSS
6. Post held with Ticket No. or Serial No., if any: Software Consultant
7. Date of appointment (DD/MM/YYYY):
8. Permanent address:

Place:
Date of Joining (DD/MM/YYYY): Signature/Thumb-impression of the Employee

DECLARATION BY WITNESS
Nomination signed/thumb-impressed before me
Name in full and full address of witnesses. Signature of Witnesses.
1. 1.

2. 2.

Place: Remote - Pune-CZ Date of Joining (DD/MM/YYYY):

CERTIFICATE BY THE EMPLOYER


Certified that the particulars of the above nomination have been verified and recorded in this
establishment.
Employer's Reference No., if any

Ventura (India) Private Limited


Upper Ground Level, Level1, Level 2&Level 3,
Tower B1, Magarpatta City SEZ,
Magarpatta City, Hadapsar, Signature of the Employer/Authorized Office
Pune – 411013, Maharashtra, India Designation Date:
Name and address of the establishment or rubber stamp thereof
ACKNOWLEDGEMENT BY THE EMPLOYEE
Received the duplicate copy of nomination in Form 'F' filed by me and duly certified by the employer.

Date of Joining (DD/MM/YYYY): Signature of the Employee


Note.—Strike out the words/paragraphs not applicable.
JOINT DECLARATION UNDER PARA 26(6) OF THE EPF SCHEME, 1952
To,
Regional EPF Commissioner(Maharashtra Region)
Employees’ PF Organization
2nd & 3rd Floor,Pune Cantontment Board Building,
Golibar Maidan, Camp, Pune-411001

Sub: Application for regularising membership/Provident Fund Contributions deducted on Salaries over & above Rs.
6500/- per month or at higher rate.

Sir,
I the undersigned Shri/Smt. Yagamurthy Thoomati bearing Account Number
PU/PUN/121598/ , employee of M/s Ventura(India) Private Limited hereby declare that I
have been contributing Provident Fund on my entire salary @ 12% with effect from (DOJ).
I am/am not an `EXCLUDED EMPLOYEE’ within the meaning of para 2(f) of the EPF Scheme, 1952
I request that;
1. I may be enrolled as member of the Employees’ Provident Fund voluntarily with effect from (DOJ).
2. I may be permitted to contribute voluntarily on my entire salary exceeding Rs. 6500/- per month w.e.f. (DOJ)
3. I may be permitted to contribute @ __nil______% instead of the statutory rate of 12% with effect from
(DOJ).

Yours Faithfully,
________________________________
(Member’s signature)

We M/s Ventura(India) Private Limited, bearing Employer’s Code No. PU/PUN/121598_______ hereby
declare that;
1. We have voluntarily enrolled Shri/Smt. Yagamurthy Thoomati as member of the EPF Scheme, 1952, w.e.f.
(DOJ) and his/her Account Number is ____________.
2. We have been deducting contribution on his/her entire pay w.e.f. ______________________
3. We have been making matching contribution on pay upto Rs. 6500/- per month / on entire pay w.e.f.
______________.
4. We have been deducting Provident Fund contribution voluntarily @ 12% of pay and making matching
contribution @ 12% of pay.
5. We have paid Administrative Charges and submitted all the Returns in respect of the above Member accordingly
and will continue to do so.

We request that this case be regularised by permitting voluntary membership and contribute on entire salary @ 12%
of pay as stated above.

Yours Faithfully,

For Ventura(India) Private Limited

Authorized Signatory
CAPITA

Affix passport Size


Photograph
PERSONNEL INVENTORY RECORD
(Please fill details in block letters)

Date of Joining
Employee No : 50080956 (dd/mm/yyyy)

Name : Yagamurthy Thoomati

Gender : Location : Remote - Pune-CZ

Designation : Software Consultant Division/Project name : TSS

Date of birth : (DD/MM/YYYY) Pan No :

Father /Husband’s Name


Permanent Address Present Address :

Pin : Pin :
Mob: Mobile 8125345589
Resi: Mobile 8125345589

Email ID : y.thoomati@gmail.com
Undergraduate Graduate Post graduate Diploma

Qualification :
Qualification : (Mention the highest Qualification)

Total Work Exp. Mths.


Relevant Work Exp. : Mths
Work Experience
Passport :
Blood Group :
Driving License :
CAPITA
Particulars of other family members (Parents ,Spouse, Children)
Sr. No Name Relationship Date of Birth State whether employed,
studying etc

If married and spouse is employed give his/her Employer Name, Office Address and telephone numbers

Tel: No (s) _____________________________________ Mobile No.

Academic /Profession Qualification : (To be given in revers chronological order) (10th till highest qualification)
Degree Branch of College/Institute University Start Date End Date Percentage/Class
study /Grade

Professional Training programs/ Courses Attended / Professional Certification (Give this in reverse Chronological order).

Diploma/Certificate Branch Institution Start Date End Date


of Study
CAPITA

Details of previous employment : (To be given in reverse Chronological order)

Name of Organization Designation held Start Date End date Exp. in Last Salary Reason
Yrs. Drawn for
leaving

Languages Known: (Also state whether fluent, written, spoken or both).

Language Known Read Write Speak


1) _____________________
2) _____________________
3) _____________________
4) _____________________
5) _____________________
6) _____________________

__________________________________
Employee’s Signature & Date of Joining (DD/MM/YYYY):
CAPITA

Personal Accident and Term Life Insurance Nomination Form

Employee Number 50080956 Name Yagamurthy Thoomati


Date of Joining
(DD/MM/YYYY) Father’s /Husband’s Name

DOB(DD/MM/YYYY) Marital Status

I hereby nominate person/s mentioned below to receive the amount, in the event of my death and direct the said amount shall be
distributed among the said person/s in the manner shown below against their name.

Share to be paid to
Nominee/s Relation with the Age of each nominee/s (%)
Name and Address of the Nominee employee Nominee (*)

(*) This column should be filled so as to cover the whole amount that may stand to the credit of the member
(Total of all should be 100%)

In case the nominee is minor then provide guardian details.


Name and Address of the guardian Guardian’s Relation with the Age of Share to be paid to
employee Guardian each nominee/s (%)
(*)

______________________________________
Signature of Employee & Date of Joining (DD/MM/YYYY):
Declaration of Resignation

Date of Joining (DD/MM/YYYY):

To,
Manager - Human Resource
Ventura (India) Pvt Ltd
Commerzone, Yerwada, Pune – 411006.

Sub : Declaration of Resignation

I the undersigned hereby confirm that I have resigned from my previous


employment at (Previous Company Name) and last working
Day was .
Since my resignation acceptance / relieving letter is currently being processed, I
shall be Forwarding the same to the Human Resource Department within a
period of days. Any concern w.r.t dual employment, Capita is
authorized to take action against me.

(Reliving letter – mention “0” days and resignation acceptance letter – mention
no.of days when reliving letter will be received)

Signature :

Name : Yagamurthy Thoomati

Date of Joining (DD/MM/YYYY): :


Declaration – Non submission of Pan Card details

I EMPNAME hereby declare that

I am working with NAMEOFCOMPANY (Name of our establishment). As per the employment


contract it is mandatory to have the PAN CARD number for statutory purpose.

Currently I do not have PAN CARD and therefore I am not able to provide the PAN CARD Number to
complete my on-boarding requirement.

Tick the applicable option:

I will immediately apply for a PAN CARD by -------------and will submit the details before -------
(Not later than one month from my date of joining)

I have applied for a PAN CARD and will submit the details on or before ------------

(Not later than one month from my date of joining)

Reference No. of PAN CARD application: -------------------------

On receipt of my PAN CARD I will submit a copy to HR and will update the details on the system
accordingly.

I acknowledge that I will be responsible for the consequences of any tax computation and/or my
salary being kept on hold, in case I do not submit & update PAN CARD Number on the system by
the above mentioned dates.

Employees Name:

Employee ID:

Date of Joining (DD/MM/YYYY):


Date of Joining (DD/MM/YYYY):

TO WHOMSOEVER IT MAY CONCERN

This is to confirm that I have not completed my Aadhaar Card registration; therefore I am unable to
provide my Aadhaar Card number.

Herewith, I am giving my assurance that I will complete the Aadhaar Card registration at the earliest
possible or whenever EPFO will arrange a camp for Aadhaar Card Registration, I will participate in the
same as per the schedule provided by the Regional PF Commissioner.

Thanking you.

Yours Sincerely,

(Employee’s Signature)

Employee’s Name:

Emp. No.

PF A/c No. ________________________________________________________

Mobile No.

Email Id.
AUTHORISATION
Human Resource Dept.

Dear Sir,

I Ms./Mr Yagamurthy Thoomati Designation Software ConsultantDepartment TSS


Hereby authorize the company that in the event of my death, the balance of my
salary due for the period of leave and all other dues availed of shall be paid to
Who
is my (specify relationship)

and resides at

The nomination shall remain in force until it is cancelled or revised by another


nomination(s).

(Emergency contact person details)

Signature of the Employee :

Date of Joining (DD/MM/YYYY): :

Private & Confidential


Code of Conduct

Employee Acknowledgement and Certification of Compliance

I hereby confirm that on receiving, reading and fully understanding the standards
expected of me by Capita Code of conduct, I will observe and abide by the ethical
standards, policies, rule and procedures contained within it.

 Employee Acknowledgement and Certification of Compliance


 Confidential and Sensitive Information
 Conflict of Interest
 Use of Electronic Facilities
 Third Party Intellectual Property Rights
 Data Security Complaince
 Professional Behaviour
 Abusive Substances
 Reports of Complaints, Litigation and Regulatory Inquiries
 Legal/ Regulatory Compliance
 Anti- Bribery
 Communication
 Harassment
 Acceptable Usage Policy & E-mail, Internet Guidelines

I understand that any breach of the above may lead to disciplinary action,
including dismissal.

Signature :

Employee Name : Yagamurthy Thoomati

Date of Joining (DD/MM/YYYY): :


USER DECLARATION ON INFORMATION SECURITY INCIDENT MANAGEMENT
POLICY
What is An Incident?

A violation or imminent threat of violation of computer security policies, acceptable use policy,
or standard Security policies.

Incident is classified as

Severity Classification Actionable


Misconduct Misconduct is a term used to describe behavior that
warrants disciplinary action.
Gross misconduct Gross Misconduct describes that strikes at the root of the
contract between Capita and an employee : where an
individual has forfeited that trust we placed in them and is
liable to be terminated.

Please note that should any Capita employee be proved to be actively involved in the
occurrence of any security incident, then disciplinary procedures shall be initiated against the
employee.
For reference, we have categorized the scenarios under ‘Misconduct’ or ‘Gross Misconduct’.

Some of the common information security threat scenarios, which give rise to security
incidents, are mentioned below but not limited to :

Sr. No. Threat/ Incident scenario Disciplinary


category
1 Being an accessory to a disciplinary offence such as failing to Misconduct
report an incident of gross misconduct you observed
2 Any attempt at logging onto systems without proper Misconduct
authorization
3 Any attempt to deliberately infect any device with viruses. Misconduct
4 Sharing of User ID, passwords and/ or personal swipe / access Misconduct
cards
5 Tail gating Misconduct
6 Attempt to access restriction areas (server room & Electrical Misconduct
Rooms)
7 Using Capita network to make unauthorized entry into other Misconduct
networks.
8 Take and / or send any Capita confidential and proprietary Misconduct
information including any client’s or third party information,
outside the office without proper authorization.
9 Installation of unlicensed software on any Capita IT device Group
Misconduct
10 Attempt to intrude any system, network and /or company folder Group
without authorization Misconduct
11 Rendering any infrastructure support device (AC, DGs, UPS, Fire Group
Alarm System, Physical Access System, CCTV), Unavailable or non- Misconduct
operational
12 Forge documents, conceal and/ or provide misleading, inaccurate Group
information at the time of recruitment Misconduct
13 Attempt to change the configuration or setting of Firewall, ACL, Group
Router IP Route, Switch ACL, Windows 2000 Group Policy and / or Misconduct
IP Addressing scheme
14 Attempt at email id impersonation Group
Misconduct
15 Deliberate sharing of Capita confidential and proprietary Group
information including any client’s information Misconduct
16 Rendering any network device and / or critical servers, non- Group
available or not-operational Misconduct
17 Any browsing, accessing and / or downloading of any Group
pornographic content Misconduct
18 Inappropriate email message such as pornographic or offensive Group
emails Misconduct
19 Corrupt or improper practice such as committing or assisting in Group
fraudulent practices Misconduct
20 Misconduct in relation to company documents such as defacing Group
or amending company policies Misconduct
21 Installation of unlicensed software on an Capita IT device. Group
Misconduct

I declare that I have read and understood various misconduct and gross misconduct and if I
fail to follow mandatory requirements outlined in the policy, I may be subject to disciplinary
action, dismissal/termination of contracts.

Employee Name : Yagamurthy Thoomati Employee ID : 50080956

Signature : Date of Joining (DD/MM/YYYY):


User Declaration On Information Security

I declare that I have read and understood Capita Information Security Policy relevant to my
job profile. Furthermore, I undertake that I shall:

 Use Passwords and keep them secret.


 Create passwords that are at least ten characters long, have both letters and numbers
as well as special characters, that do not spell a word or a name, and do not contain
personal data.
 Protect sensitive data / information by following applicable policies and procedures.
 Protect the confidentiality of information, both during and after contractual relations
with Capita
 Protect my computer by logging off when I am gone for the day or leave it for 5minutes
or more.
 Do not bring personal bags, mobile phone and pager, blackberry etc. in the shop floor
area or its vicinity unless authorized by your immediate Manager.
 Protect equipment assigned to me by keeping it safe from any harm / damage.
 Scan all discs from external sources for viruses before using them on any computer.
 Not install any software unless authorized to do so.
 Use only authorized hardware and software.
 Protect my work area, media, and files, against all threats and report any incidents that
occur to the Security Administrator.
 Not download software from the Internet unless Specifically Authorized to do so by the
Management.
 Comply with all applicable laws and Capita policies and procedures.

I agree that by signing this document I am declaring that I have read and understood the
relevant Information Security Policy and that if I fail to follow mandatory requirement outlined
in the policy, I may be subject to disciplinary action / dismissal /termination of contracts.

Signature :

Employee Name : Yagamurthy Thoomati

Date of Joining (DD/MM/YYYY): :


JOINING KIT
Statutory Compliance

Welcome Onboard!

We look forward to have a fruitful association with you

Employee ID: 50080951 Employee Name: MD Ghulam Nabi Ansari

Process/Division: TSS Date of Joining (DD/MM/YYYY): 23/05/2022


New Form No.-11 – Declaration Form
(To be retained by the employer for future reference)

EMPLOYEES’ PROVIDENT FUND ORGANIZATION


Employees’ Provident Funds Scheme, 1952(Paragraph 32 & 57) &

Employees’ Pension Scheme, 1995(Paragraph 24)

(Declaration by a person taking up employment in any establishment on which EPF Scheme, 1952 and for EPS, 1995 is applicable)

1 Name of the member (Name as per Pan Card) MD Ghulam Nabi Ansari

2 Father’s Name Spouse’s Name

(Please tick whichever is applicable)

3 Date of Birth: (DD/MM/YYYY)

4 Gender: (Male/Female/Transgender)

5 Marital Status: (Married/Unmarried/Widow/Widower/Divorcee)

6 (a) Email ID: ANSARINABI05@GMAIL.COM

(b) Mobile No. : 8928125528


7 Whether earlier a member of Employees’ Provident Scheme, Yes/No
1952
8 Whether earlier a member of Employees’ Pension Scheme, 1995 Yes/No

9 Previous Employment details:[If Yes to 7 AND/OR 8 above]


(a) Universal Account Number:
(b) Previous PF Account Number:
(c) Date of exit from previous employment: (DD/MM/YYY)

(d) Scheme Certificate Number(If Issued)

(e) Pension Payment Order (PPO) No. (If Issued)


10 (a) International worker: ( will be NO for all employees) No

(b) If Yes, State Country of origin(India/Name of the


Country)

(c) Passport No. TO

(d) Validity of Passport [(DD/MM/YYYY) to (DD/MM/YYYY)]


11 KYC Details: (attach self-attested copies of following KYCs)
(a) Bank Account No. & IFS code

(b) AADHAR Number

(c) Permanent Account Number (PAN), if available


UNDERTAKING

1) Certified that the particulars are true to the best of my knowledge.


2) I authorize EPFO to use my Aadhar for verification/authentication/eKYC purpose for service delivery.
3) Kindly transfer the funds and service details, if applicable, from the previous PF account as declared above to the
present P.F. Account(The transfer would be possible only if the identified KYC detail approved by previous employer
has been verified by present employer using his Digital signature Certificate)
4) In case of changes in above details, the same will be intimated to employer at the earliest.

Date of Joining (DD/MM/YYYY):

Place: Remote - Pune-CZ Signature of Member

DECLARATION BY PRESENT EMPLOYER

A. The member Mr./Mrs./Ms has joined on and has been allotted PF


Number
B. In case the person was earlier not a member of EPF Scheme, 1952 and EPS, 1995:
 (Post allotment of UAN) The UAN allotted number for the member is
 Please Tick the Appropriate option:-
The KYC details of the above member in the UAN database
� Have not been uploaded
� Have been uploaded but not approved
� Have been uploaded and approved with DSC
C. In case the person was earlier a member of EPF Scheme, 1952 and EPS, 1995:
 The above PF Account Number/UAN of the member as mentioned in (A) above has been tagged with
his/her UAN/Previous Member ID as declared by member.
 Please Tick the Appropriate option:-
� The KYC details of the above member in the UAN database have been approved with Digital
Signature Certificate and transfer request has been generated on portal.
� As the DSC of establishment are not registered with EPFO, the member has been informed to
file physical claim (Form-13) for transfer of funds from his previous establishment.

Date of Joining (DD/MM/YYYY): Signature of Employer with Seal of Establishment


For Office use only

Inward No.

FORM 2(REVISED) Group No.


Nomination and Declaration Form for Unexempted /
Exempted Establishment Office At

Declaration and Nomination form under the Employee’s


Provident Funds & Employees’ Pension Scheme
(Paragraphs 33 & 61(1) of the Employees Provident Funds Scheme, 1952 and
Paragraph 18 of the Employees’ Pension Scheme, 1995)

1 Name(in block letters): MD Ghulam Nabi Ansari


2 Father’s / Husband’s Name:
3 Date of Birth (DD/MM/YYYY):

4 Sex (Male/Female):
5 Marital Status(Married/Unmarried/Widow/Widower):
6 Account No. PU/PUN/121598
7 Address :
Permanent:
Temporary:
Part A (EPF)
I hereby nominate the person(s)/cancel the nomination made by me previously and nominate the person(s),
mentioned below to receive the amount standing to my credit in the Employees’ Provident Fund, in the
event of my death:
Name of the Address Nominee’s Date of Total amount If the Nominee is a
nominee relationship Birth or share of minor, name &
with the accumulation relationship & address
member s in Provident of the guardian who
Fund to be may receive the
paid to each amount during the
nominee minority of nominee

1 2 3 4 5 6

1. *Certified that I have no family as defined in Para 2(g) of the Employees’ Provident Funds Scheme,
1952 and should I acquire a family hereafter the above nomination should be deemed as cancelled.
2. *Certified that my father/mother is / are dependent upon me.
Signature or thumb impression of the subscriber
Part-B (EPS)
Part 18
I hereby furnish below particulars of the members of my family who would be eligible to receive
Widow/Children Pension in the event of my death.
Sr. Name & Address of the family member Date of Birth Relationship with
No. the member
Name Address
1 2 3 4 5

* Certified that I have no family as defined in Para 2 (vii) of the Employees’ Pension Scheme, 1971 and
should acquire a family hereafter I shall furnish particulars thereon in the above form.
I hereby nominate the following person for receiving the monthly window pension(admissible under para
16(2) (a) (i) & (ii) in the event of my death without leaving any eligible family member for receiving pension
Name & Address of the family member Date of Birth Relationship with the
member

Date of Joining (DD/MM/YYYY):


Signature of thumb impression of the subscriber
Certificate by employer
Certified that the above declaration and nomination has been signed/thumb impressed before me by
Shri/Smt/Km employed in my establishment after he/she has read
the entries. The entries have been read over to him/her by me and got confirmed by him/her.

Signature of the employer or other Authorized


Officer of the establishment
Place Remote - Pune-CZ Designation
Date of Joining (DD/MM/YYYY): Name & Address of the Factory / Establishment or rubber stamp thereof
Ventura (India) Private Limited
Upper Ground Level, Level 1, Level 2 & Level 3,
Tower B1, Magarpatta City SEZ,
Magarpatta City, Hadapsar,
Pune – 411013, Maharashtra, India
For Office use only

Inward No.

FORM 2(REVISED) Group No.


NOMINATION AND DECLARATION FORM FOR UNEXEMPTED /
EXEMPTED ESTABLISHMENT Office At
Declaration and Nomination form under the Employee’s
Provident Funds & Employees’ Pension Scheme
(Paragraphs 33 & 61(1) of the Employees Provident Funds Scheme, 1952 and
Paragraph 18 of the Employees’ Pension Scheme, 1995)

1. Name(in block letters): MD Ghulam Nabi Ansari


2. Father’s / Husband’s Name:
3. Date of Birth (DD/MM/YYYY):

4. Sex (Male/Female):
5. Marital Status(Married/Unmarried/Widow/Widower):
6. Account No. PU/PUN/121598
7. Address :
8. Permanent:
9. Temporary:
Part A (EPF)
I hereby nominate the person(s)/cancel the nomination made by me previously and nominate the person(s),
mentioned below to receive the amount standing to my credit in the Employees’ Provident Fund, in the
event of my death:
Name of the Address Nominee’s Date of Total amount If the Nominee is a
nominee relationship Birth or share of minor, name &
with the accumulation relationship & address
member s in Provident of the guardian who
Fund to be may receive the
paid to each amount during the
nominee minority of nominee

1 2 3 4 5 6

3. *Certified that I have no family as defined in Para 2(g) of the Employees’ Provident Funds Scheme,
1952 and should I acquire a family hereafter the above nomination should be deemed as cancelled.
4. *Certified that my father/mother is / are dependent upon me.
Signature or thumb impression of the subscriber
Part-B (EPS)
Part 18
I hereby furnish below particulars of the members of my family who would be eligible to receive
Widow/Children Pension in the event of my death.
Sr. Name & Address of the family member Date of Birth Relationship with
No. the member
Name Address
1 2 3 4 5

* Certified that I have no family as defined in Para 2 (vii) of the Employees’ Pension Scheme, 1971 and
should acquire a family hereafter I shall furnish particulars thereon in the above form.
I hereby nominate the following person for receiving the monthly window pension(admissible under para
16(2) (a) (i) & (ii) in the event of my death without leaving any eligible family member for receiving pension
Name & Address of the family member Date of Birth Relationship with the
member

Date of Joining (DD/MM/YYYY):


Signature of thumb impression of the subscriber
Certificate by employer
Certified that the above declaration and nomination has been signed/thumb impressed before me by
Shri/Smt/Km employed in my establishment after he/she has read
the entries. The entries have been read over to him/her by me and got confirmed by him/her.

Signature of the employer or other Authorized


officer of the establishment
Place Remote - Pune-CZ Designation
Date of Joining (DD/MM/YYYY):
Name & Address of the Factory / Establishment or rubber stamp thereof
Ventura (India) Private Limited
Upper Ground Level, Level 1, Level 2 & Level 3,
Tower B1, Magarpatta City SEZ,
Magarpatta City, Hadapsar,
Pune – 411013, Maharashtra, India.
FORM 'F'
THE PAYMENT OF GRATUITY ACT
(See sub-rule (1) of Rule 6)

NOMINATION

To, Ventura (India) Private Limited


Upper Ground Level, Level 1, Level 2 & Level 3 Tower B1, Magarpatta City SEZ,Magarpatta
City, Hadapsar,Pune – 411013, Maharashtra, India

1. I, Shri / Smt. / Kum. MD Ghulam Nabi Ansari

(Name in full here)


whose particulars are given in the statement below, hereby nominate the person(s) mentioned below to receive
the gratuity payable after my death as also the gratuity standing to my credit in the event of my death before that
amount has become payable, or having become payable has not been paid and direct that the said amount of
gratuity shall be paid in proportion indicated against the name(s) of the nominee(s).

2. I hereby certify that the person(s) mentioned is/are a member(s) of my family within the meaning of clause (h)
of Section 2 of the Payment of Gratuity Act, 1972.
3. I hereby declare that I have no family within the meaning of clause (h) of Section 2 of the said Act.

4 (a) My father/mother/parents is/are not dependent on me.


(b) My husband's father/mother/parents is/are not dependent on my husband.
5. I have excluded my husband from my family by a notice dated the to controlling authority in terms of
the proviso to clause (h) of Section 2 of the said Act.
6. Nomination made herein invalidates my previous nomination.

NOMINEE(S)

Name in full with full Relationship with Age of Proportion by which


address of nominee(s) the employee nominee the gratuity will be
shared

(1) (2) (3) (4)

1.
2.
3.
4
STATEMENT
1. Name of employee in full: MD Ghulam Nabi Ansari
2. Sex:
3. Religion:
4. Whether unmarried/married/widow/widower:
5. Department/Branch/Section where employed: TSS
6. Post held with Ticket No. or Serial No., if any: Senior Software Consultant
7. Date of appointment (DD/MM/YYYY):
8. Permanent address:

Place:
Date of Joining (DD/MM/YYYY): Signature/Thumb-impression of the Employee

DECLARATION BY WITNESS
Nomination signed/thumb-impressed before me
Name in full and full address of witnesses. Signature of Witnesses.
1. 1.

2. 2.

Place: Remote - Pune-CZ Date of Joining (DD/MM/YYYY):

CERTIFICATE BY THE EMPLOYER


Certified that the particulars of the above nomination have been verified and recorded in this
establishment.
Employer's Reference No., if any

Ventura (India) Private Limited


Upper Ground Level, Level1, Level 2&Level 3,
Tower B1, Magarpatta City SEZ,
Magarpatta City, Hadapsar, Signature of the Employer/Authorized Office
Pune – 411013, Maharashtra, India Designation Date:
Name and address of the establishment or rubber stamp thereof
ACKNOWLEDGEMENT BY THE EMPLOYEE
Received the duplicate copy of nomination in Form 'F' filed by me and duly certified by the employer.

Date of Joining (DD/MM/YYYY): Signature of the Employee


Note.—Strike out the words/paragraphs not applicable.
JOINT DECLARATION UNDER PARA 26(6) OF THE EPF SCHEME, 1952
To,
Regional EPF Commissioner(Maharashtra Region)
Employees’ PF Organization
2nd & 3rd Floor,Pune Cantontment Board Building,
Golibar Maidan, Camp, Pune-411001

Sub: Application for regularising membership/Provident Fund Contributions deducted on Salaries over & above Rs.
6500/- per month or at higher rate.

Sir,
I the undersigned Shri/Smt. MD Ghulam Nabi Ansari bearing Account Number
PU/PUN/121598/ , employee of M/s Ventura(India) Private Limited hereby declare that I
have been contributing Provident Fund on my entire salary @ 12% with effect from (DOJ).
I am/am not an `EXCLUDED EMPLOYEE’ within the meaning of para 2(f) of the EPF Scheme, 1952
I request that;
1. I may be enrolled as member of the Employees’ Provident Fund voluntarily with effect from (DOJ).
2. I may be permitted to contribute voluntarily on my entire salary exceeding Rs. 6500/- per month w.e.f. (DOJ)
3. I may be permitted to contribute @ __nil______% instead of the statutory rate of 12% with effect from
(DOJ).

Yours Faithfully,
________________________________
(Member’s signature)

We M/s Ventura(India) Private Limited, bearing Employer’s Code No. PU/PUN/121598_______ hereby
declare that;
1. We have voluntarily enrolled Shri/Smt. MD Ghulam Nabi Ansari as member of the EPF Scheme, 1952, w.e.f.
(DOJ) and his/her Account Number is ____________.
2. We have been deducting contribution on his/her entire pay w.e.f. ______________________
3. We have been making matching contribution on pay upto Rs. 6500/- per month / on entire pay w.e.f.
______________.
4. We have been deducting Provident Fund contribution voluntarily @ 12% of pay and making matching
contribution @ 12% of pay.
5. We have paid Administrative Charges and submitted all the Returns in respect of the above Member accordingly
and will continue to do so.

We request that this case be regularised by permitting voluntary membership and contribute on entire salary @ 12%
of pay as stated above.

Yours Faithfully,

For Ventura(India) Private Limited

Authorized Signatory
CAPITA

Affix passport Size


Photograph
PERSONNEL INVENTORY RECORD
(Please fill details in block letters)

Date of Joining
Employee No : 50080951 (dd/mm/yyyy)

Name : MD Ghulam Nabi Ansari

Gender : Location : Remote - Pune-CZ

Designation : Senior Software Consultant Division/Project name : TSS

Date of birth : (DD/MM/YYYY) Pan No :

Father /Husband’s Name


Permanent Address Present Address :

Pin : Pin :
Mob: Mobile 8928125528
Resi: Mobile 8928125528

Email ID : ANSARINABI05@GMAIL.COM
Undergraduate Graduate Post graduate Diploma

Qualification :
Qualification : (Mention the highest Qualification)

Total Work Exp. Mths.


Relevant Work Exp. : Mths
Work Experience
Passport :
Blood Group :
Driving License :
CAPITA
Particulars of other family members (Parents ,Spouse, Children)
Sr. No Name Relationship Date of Birth State whether employed,
studying etc

If married and spouse is employed give his/her Employer Name, Office Address and telephone numbers

Tel: No (s) _____________________________________ Mobile No.

Academic /Profession Qualification : (To be given in revers chronological order) (10th till highest qualification)
Degree Branch of College/Institute University Start Date End Date Percentage/Class
study /Grade

Professional Training programs/ Courses Attended / Professional Certification (Give this in reverse Chronological order).

Diploma/Certificate Branch Institution Start Date End Date


of Study
CAPITA

Details of previous employment : (To be given in reverse Chronological order)

Name of Organization Designation held Start Date End date Exp. in Last Salary Reason
Yrs. Drawn for
leaving

Languages Known: (Also state whether fluent, written, spoken or both).

Language Known Read Write Speak


1) _____________________
2) _____________________
3) _____________________
4) _____________________
5) _____________________
6) _____________________

__________________________________
Employee’s Signature & Date of Joining (DD/MM/YYYY):
CAPITA

Personal Accident and Term Life Insurance Nomination Form

Employee Number 50080951 Name MD Ghulam Nabi Ansari


Date of Joining
(DD/MM/YYYY) Father’s /Husband’s Name

DOB(DD/MM/YYYY) Marital Status

I hereby nominate person/s mentioned below to receive the amount, in the event of my death and direct the said amount shall be
distributed among the said person/s in the manner shown below against their name.

Share to be paid to
Nominee/s Relation with the Age of each nominee/s (%)
Name and Address of the Nominee employee Nominee (*)

(*) This column should be filled so as to cover the whole amount that may stand to the credit of the member
(Total of all should be 100%)

In case the nominee is minor then provide guardian details.


Name and Address of the guardian Guardian’s Relation with the Age of Share to be paid to
employee Guardian each nominee/s (%)
(*)

______________________________________
Signature of Employee & Date of Joining (DD/MM/YYYY):
Declaration of Resignation

Date of Joining (DD/MM/YYYY):

To,
Manager - Human Resource
Ventura (India) Pvt Ltd
Commerzone, Yerwada, Pune – 411006.

Sub : Declaration of Resignation

I the undersigned hereby confirm that I have resigned from my previous


employment at (Previous Company Name) and last working
Day was .
Since my resignation acceptance / relieving letter is currently being processed, I
shall be Forwarding the same to the Human Resource Department within a
period of days. Any concern w.r.t dual employment, Capita is
authorized to take action against me.

(Reliving letter – mention “0” days and resignation acceptance letter – mention
no.of days when reliving letter will be received)

Signature :

Name : MD Ghulam Nabi Ansari

Date of Joining (DD/MM/YYYY): :


Declaration – Non submission of Pan Card details

I EMPNAME hereby declare that

I am working with NAMEOFCOMPANY (Name of our establishment). As per the employment


contract it is mandatory to have the PAN CARD number for statutory purpose.

Currently I do not have PAN CARD and therefore I am not able to provide the PAN CARD Number to
complete my on-boarding requirement.

Tick the applicable option:

I will immediately apply for a PAN CARD by -------------and will submit the details before -------
(Not later than one month from my date of joining)

I have applied for a PAN CARD and will submit the details on or before ------------

(Not later than one month from my date of joining)

Reference No. of PAN CARD application: -------------------------

On receipt of my PAN CARD I will submit a copy to HR and will update the details on the system
accordingly.

I acknowledge that I will be responsible for the consequences of any tax computation and/or my
salary being kept on hold, in case I do not submit & update PAN CARD Number on the system by
the above mentioned dates.

Employees Name:

Employee ID:

Date of Joining (DD/MM/YYYY):


Date of Joining (DD/MM/YYYY):

TO WHOMSOEVER IT MAY CONCERN

This is to confirm that I have not completed my Aadhaar Card registration; therefore I am unable to
provide my Aadhaar Card number.

Herewith, I am giving my assurance that I will complete the Aadhaar Card registration at the earliest
possible or whenever EPFO will arrange a camp for Aadhaar Card Registration, I will participate in the
same as per the schedule provided by the Regional PF Commissioner.

Thanking you.

Yours Sincerely,

(Employee’s Signature)

Employee’s Name:

Emp. No.

PF A/c No. ________________________________________________________

Mobile No.

Email Id.
AUTHORISATION
Human Resource Dept.

Dear Sir,

I Ms./Mr MD Ghulam Nabi Ansari Designation Senior Software ConsultantDepartment


TSS Hereby authorize the company that in the event of my death, the balance of
my salary due for the period of leave and all other dues availed of shall be paid to
Who
is my (specify relationship)

and resides at

The nomination shall remain in force until it is cancelled or revised by another


nomination(s).

(Emergency contact person details)

Signature of the Employee :

Date of Joining (DD/MM/YYYY): :

Private & Confidential


Code of Conduct

Employee Acknowledgement and Certification of Compliance

I hereby confirm that on receiving, reading and fully understanding the standards
expected of me by Capita Code of conduct, I will observe and abide by the ethical
standards, policies, rule and procedures contained within it.

 Employee Acknowledgement and Certification of Compliance


 Confidential and Sensitive Information
 Conflict of Interest
 Use of Electronic Facilities
 Third Party Intellectual Property Rights
 Data Security Complaince
 Professional Behaviour
 Abusive Substances
 Reports of Complaints, Litigation and Regulatory Inquiries
 Legal/ Regulatory Compliance
 Anti- Bribery
 Communication
 Harassment
 Acceptable Usage Policy & E-mail, Internet Guidelines

I understand that any breach of the above may lead to disciplinary action,
including dismissal.

Signature :

Employee Name : MD Ghulam Nabi Ansari

Date of Joining (DD/MM/YYYY): :


USER DECLARATION ON INFORMATION SECURITY INCIDENT MANAGEMENT
POLICY
What is An Incident?

A violation or imminent threat of violation of computer security policies, acceptable use policy,
or standard Security policies.

Incident is classified as

Severity Classification Actionable


Misconduct Misconduct is a term used to describe behavior that
warrants disciplinary action.
Gross misconduct Gross Misconduct describes that strikes at the root of the
contract between Capita and an employee : where an
individual has forfeited that trust we placed in them and is
liable to be terminated.

Please note that should any Capita employee be proved to be actively involved in the
occurrence of any security incident, then disciplinary procedures shall be initiated against the
employee.
For reference, we have categorized the scenarios under ‘Misconduct’ or ‘Gross Misconduct’.

Some of the common information security threat scenarios, which give rise to security
incidents, are mentioned below but not limited to :

Sr. No. Threat/ Incident scenario Disciplinary


category
1 Being an accessory to a disciplinary offence such as failing to Misconduct
report an incident of gross misconduct you observed
2 Any attempt at logging onto systems without proper Misconduct
authorization
3 Any attempt to deliberately infect any device with viruses. Misconduct
4 Sharing of User ID, passwords and/ or personal swipe / access Misconduct
cards
5 Tail gating Misconduct
6 Attempt to access restriction areas (server room & Electrical Misconduct
Rooms)
7 Using Capita network to make unauthorized entry into other Misconduct
networks.
8 Take and / or send any Capita confidential and proprietary Misconduct
information including any client’s or third party information,
outside the office without proper authorization.
9 Installation of unlicensed software on any Capita IT device Group
Misconduct
10 Attempt to intrude any system, network and /or company folder Group
without authorization Misconduct
11 Rendering any infrastructure support device (AC, DGs, UPS, Fire Group
Alarm System, Physical Access System, CCTV), Unavailable or non- Misconduct
operational
12 Forge documents, conceal and/ or provide misleading, inaccurate Group
information at the time of recruitment Misconduct
13 Attempt to change the configuration or setting of Firewall, ACL, Group
Router IP Route, Switch ACL, Windows 2000 Group Policy and / or Misconduct
IP Addressing scheme
14 Attempt at email id impersonation Group
Misconduct
15 Deliberate sharing of Capita confidential and proprietary Group
information including any client’s information Misconduct
16 Rendering any network device and / or critical servers, non- Group
available or not-operational Misconduct
17 Any browsing, accessing and / or downloading of any Group
pornographic content Misconduct
18 Inappropriate email message such as pornographic or offensive Group
emails Misconduct
19 Corrupt or improper practice such as committing or assisting in Group
fraudulent practices Misconduct
20 Misconduct in relation to company documents such as defacing Group
or amending company policies Misconduct
21 Installation of unlicensed software on an Capita IT device. Group
Misconduct

I declare that I have read and understood various misconduct and gross misconduct and if I
fail to follow mandatory requirements outlined in the policy, I may be subject to disciplinary
action, dismissal/termination of contracts.

Employee Name : MD Ghulam Nabi Ansari Employee ID : 50080951

Signature : Date of Joining (DD/MM/YYYY):


User Declaration On Information Security

I declare that I have read and understood Capita Information Security Policy relevant to my
job profile. Furthermore, I undertake that I shall:

 Use Passwords and keep them secret.


 Create passwords that are at least ten characters long, have both letters and numbers
as well as special characters, that do not spell a word or a name, and do not contain
personal data.
 Protect sensitive data / information by following applicable policies and procedures.
 Protect the confidentiality of information, both during and after contractual relations
with Capita
 Protect my computer by logging off when I am gone for the day or leave it for 5minutes
or more.
 Do not bring personal bags, mobile phone and pager, blackberry etc. in the shop floor
area or its vicinity unless authorized by your immediate Manager.
 Protect equipment assigned to me by keeping it safe from any harm / damage.
 Scan all discs from external sources for viruses before using them on any computer.
 Not install any software unless authorized to do so.
 Use only authorized hardware and software.
 Protect my work area, media, and files, against all threats and report any incidents that
occur to the Security Administrator.
 Not download software from the Internet unless Specifically Authorized to do so by the
Management.
 Comply with all applicable laws and Capita policies and procedures.

I agree that by signing this document I am declaring that I have read and understood the
relevant Information Security Policy and that if I fail to follow mandatory requirement outlined
in the policy, I may be subject to disciplinary action / dismissal /termination of contracts.

Signature :

Employee Name : MD Ghulam Nabi Ansari

Date of Joining (DD/MM/YYYY): :


JOINING KIT
Statutory Compliance

Welcome Onboard!

We look forward to have a fruitful association with you

Employee ID: 0 Employee Name: Dipesh Kumar

Process/Division: TSS Date of Joining (DD/MM/YYYY): 23/05/2022


New Form No.-11 – Declaration Form
(To be retained by the employer for future reference)

EMPLOYEES’ PROVIDENT FUND ORGANIZATION


Employees’ Provident Funds Scheme, 1952(Paragraph 32 & 57) &

Employees’ Pension Scheme, 1995(Paragraph 24)

(Declaration by a person taking up employment in any establishment on which EPF Scheme, 1952 and for EPS, 1995 is applicable)

1 Name of the member (Name as per Pan Card) Dipesh Kumar

2 Father’s Name Spouse’s Name

(Please tick whichever is applicable)

3 Date of Birth: (DD/MM/YYYY)

4 Gender: (Male/Female/Transgender)

5 Marital Status: (Married/Unmarried/Widow/Widower/Divorcee)

6 (a) Email ID: kumardipesh@hotmail.com

(b) Mobile No. : 9970650638


7 Whether earlier a member of Employees’ Provident Scheme, Yes/No
1952
8 Whether earlier a member of Employees’ Pension Scheme, 1995 Yes/No

9 Previous Employment details:[If Yes to 7 AND/OR 8 above]


(a) Universal Account Number:
(b) Previous PF Account Number:
(c) Date of exit from previous employment: (DD/MM/YYY)

(d) Scheme Certificate Number(If Issued)

(e) Pension Payment Order (PPO) No. (If Issued)


10 (a) International worker: ( will be NO for all employees) No

(b) If Yes, State Country of origin(India/Name of the


Country)

(c) Passport No. TO

(d) Validity of Passport [(DD/MM/YYYY) to (DD/MM/YYYY)]


11 KYC Details: (attach self-attested copies of following KYCs)
(a) Bank Account No. & IFS code

(b) AADHAR Number

(c) Permanent Account Number (PAN), if available


UNDERTAKING

1) Certified that the particulars are true to the best of my knowledge.


2) I authorize EPFO to use my Aadhar for verification/authentication/eKYC purpose for service delivery.
3) Kindly transfer the funds and service details, if applicable, from the previous PF account as declared above to the
present P.F. Account(The transfer would be possible only if the identified KYC detail approved by previous employer
has been verified by present employer using his Digital signature Certificate)
4) In case of changes in above details, the same will be intimated to employer at the earliest.

Date of Joining (DD/MM/YYYY):

Place: Pune-CZ Signature of Member

DECLARATION BY PRESENT EMPLOYER

A. The member Mr./Mrs./Ms has joined on and has been allotted PF


Number
B. In case the person was earlier not a member of EPF Scheme, 1952 and EPS, 1995:
 (Post allotment of UAN) The UAN allotted number for the member is
 Please Tick the Appropriate option:-
The KYC details of the above member in the UAN database
� Have not been uploaded
� Have been uploaded but not approved
� Have been uploaded and approved with DSC
C. In case the person was earlier a member of EPF Scheme, 1952 and EPS, 1995:
 The above PF Account Number/UAN of the member as mentioned in (A) above has been tagged with
his/her UAN/Previous Member ID as declared by member.
 Please Tick the Appropriate option:-
� The KYC details of the above member in the UAN database have been approved with Digital
Signature Certificate and transfer request has been generated on portal.
� As the DSC of establishment are not registered with EPFO, the member has been informed to
file physical claim (Form-13) for transfer of funds from his previous establishment.

Date of Joining (DD/MM/YYYY): Signature of Employer with Seal of Establishment


For Office use only

Inward No.

FORM 2(REVISED) Group No.


Nomination and Declaration Form for Unexempted /
Exempted Establishment Office At

Declaration and Nomination form under the Employee’s


Provident Funds & Employees’ Pension Scheme
(Paragraphs 33 & 61(1) of the Employees Provident Funds Scheme, 1952 and
Paragraph 18 of the Employees’ Pension Scheme, 1995)

1 Name(in block letters): Dipesh Kumar


2 Father’s / Husband’s Name:
3 Date of Birth (DD/MM/YYYY):

4 Sex (Male/Female):
5 Marital Status(Married/Unmarried/Widow/Widower):
6 Account No. PU/PUN/121598
7 Address :
Permanent:
Temporary:
Part A (EPF)
I hereby nominate the person(s)/cancel the nomination made by me previously and nominate the person(s),
mentioned below to receive the amount standing to my credit in the Employees’ Provident Fund, in the
event of my death:
Name of the Address Nominee’s Date of Total amount If the Nominee is a
nominee relationship Birth or share of minor, name &
with the accumulation relationship & address
member s in Provident of the guardian who
Fund to be may receive the
paid to each amount during the
nominee minority of nominee

1 2 3 4 5 6

1. *Certified that I have no family as defined in Para 2(g) of the Employees’ Provident Funds Scheme,
1952 and should I acquire a family hereafter the above nomination should be deemed as cancelled.
2. *Certified that my father/mother is / are dependent upon me.
Signature or thumb impression of the subscriber
Part-B (EPS)
Part 18
I hereby furnish below particulars of the members of my family who would be eligible to receive
Widow/Children Pension in the event of my death.
Sr. Name & Address of the family member Date of Birth Relationship with
No. the member
Name Address
1 2 3 4 5

* Certified that I have no family as defined in Para 2 (vii) of the Employees’ Pension Scheme, 1971 and
should acquire a family hereafter I shall furnish particulars thereon in the above form.
I hereby nominate the following person for receiving the monthly window pension(admissible under para
16(2) (a) (i) & (ii) in the event of my death without leaving any eligible family member for receiving pension
Name & Address of the family member Date of Birth Relationship with the
member

Date of Joining (DD/MM/YYYY):


Signature of thumb impression of the subscriber
Certificate by employer
Certified that the above declaration and nomination has been signed/thumb impressed before me by
Shri/Smt/Km employed in my establishment after he/she has read
the entries. The entries have been read over to him/her by me and got confirmed by him/her.

Signature of the employer or other Authorized


Officer of the establishment
Place Pune-CZ Designation
Date of Joining (DD/MM/YYYY): Name & Address of the Factory / Establishment or rubber stamp thereof
Ventura (India) Private Limited
Upper Ground Level, Level 1, Level 2 & Level 3,
Tower B1, Magarpatta City SEZ,
Magarpatta City, Hadapsar,
Pune – 411013, Maharashtra, India
For Office use only

Inward No.

FORM 2(REVISED) Group No.


NOMINATION AND DECLARATION FORM FOR UNEXEMPTED /
EXEMPTED ESTABLISHMENT Office At
Declaration and Nomination form under the Employee’s
Provident Funds & Employees’ Pension Scheme
(Paragraphs 33 & 61(1) of the Employees Provident Funds Scheme, 1952 and
Paragraph 18 of the Employees’ Pension Scheme, 1995)

1. Name(in block letters): Dipesh Kumar


2. Father’s / Husband’s Name:
3. Date of Birth (DD/MM/YYYY):

4. Sex (Male/Female):
5. Marital Status(Married/Unmarried/Widow/Widower):
6. Account No. PU/PUN/121598
7. Address :
8. Permanent:
9. Temporary:
Part A (EPF)
I hereby nominate the person(s)/cancel the nomination made by me previously and nominate the person(s),
mentioned below to receive the amount standing to my credit in the Employees’ Provident Fund, in the
event of my death:
Name of the Address Nominee’s Date of Total amount If the Nominee is a
nominee relationship Birth or share of minor, name &
with the accumulation relationship & address
member s in Provident of the guardian who
Fund to be may receive the
paid to each amount during the
nominee minority of nominee

1 2 3 4 5 6

3. *Certified that I have no family as defined in Para 2(g) of the Employees’ Provident Funds Scheme,
1952 and should I acquire a family hereafter the above nomination should be deemed as cancelled.
4. *Certified that my father/mother is / are dependent upon me.
Signature or thumb impression of the subscriber
Part-B (EPS)
Part 18
I hereby furnish below particulars of the members of my family who would be eligible to receive
Widow/Children Pension in the event of my death.
Sr. Name & Address of the family member Date of Birth Relationship with
No. the member
Name Address
1 2 3 4 5

* Certified that I have no family as defined in Para 2 (vii) of the Employees’ Pension Scheme, 1971 and
should acquire a family hereafter I shall furnish particulars thereon in the above form.
I hereby nominate the following person for receiving the monthly window pension(admissible under para
16(2) (a) (i) & (ii) in the event of my death without leaving any eligible family member for receiving pension
Name & Address of the family member Date of Birth Relationship with the
member

Date of Joining (DD/MM/YYYY):


Signature of thumb impression of the subscriber
Certificate by employer
Certified that the above declaration and nomination has been signed/thumb impressed before me by
Shri/Smt/Km employed in my establishment after he/she has read
the entries. The entries have been read over to him/her by me and got confirmed by him/her.

Signature of the employer or other Authorized


officer of the establishment
Place Pune-CZ Designation
Date of Joining (DD/MM/YYYY):
Name & Address of the Factory / Establishment or rubber stamp thereof
Ventura (India) Private Limited
Upper Ground Level, Level 1, Level 2 & Level 3,
Tower B1, Magarpatta City SEZ,
Magarpatta City, Hadapsar,
Pune – 411013, Maharashtra, India.
FORM 'F'
THE PAYMENT OF GRATUITY ACT
(See sub-rule (1) of Rule 6)

NOMINATION

To, Ventura (India) Private Limited


Upper Ground Level, Level 1, Level 2 & Level 3 Tower B1, Magarpatta City SEZ,Magarpatta
City, Hadapsar,Pune – 411013, Maharashtra, India

1. I, Shri / Smt. / Kum. Dipesh Kumar

(Name in full here)


whose particulars are given in the statement below, hereby nominate the person(s) mentioned below to receive
the gratuity payable after my death as also the gratuity standing to my credit in the event of my death before that
amount has become payable, or having become payable has not been paid and direct that the said amount of
gratuity shall be paid in proportion indicated against the name(s) of the nominee(s).

2. I hereby certify that the person(s) mentioned is/are a member(s) of my family within the meaning of clause (h)
of Section 2 of the Payment of Gratuity Act, 1972.
3. I hereby declare that I have no family within the meaning of clause (h) of Section 2 of the said Act.

4 (a) My father/mother/parents is/are not dependent on me.


(b) My husband's father/mother/parents is/are not dependent on my husband.
5. I have excluded my husband from my family by a notice dated the to controlling authority in terms of
the proviso to clause (h) of Section 2 of the said Act.
6. Nomination made herein invalidates my previous nomination.

NOMINEE(S)

Name in full with full Relationship with Age of Proportion by which


address of nominee(s) the employee nominee the gratuity will be
shared

(1) (2) (3) (4)

1.
2.
3.
4
STATEMENT
1. Name of employee in full: Dipesh Kumar
2. Sex:
3. Religion:
4. Whether unmarried/married/widow/widower:
5. Department/Branch/Section where employed: TSS
6. Post held with Ticket No. or Serial No., if any: Assistant Technical Manager
7. Date of appointment (DD/MM/YYYY):
8. Permanent address:

Place:
Date of Joining (DD/MM/YYYY): Signature/Thumb-impression of the Employee

DECLARATION BY WITNESS
Nomination signed/thumb-impressed before me
Name in full and full address of witnesses. Signature of Witnesses.
1. 1.

2. 2.

Place: Pune-CZ Date of Joining (DD/MM/YYYY):

CERTIFICATE BY THE EMPLOYER


Certified that the particulars of the above nomination have been verified and recorded in this
establishment.
Employer's Reference No., if any

Ventura (India) Private Limited


Upper Ground Level, Level1, Level 2&Level 3,
Tower B1, Magarpatta City SEZ,
Magarpatta City, Hadapsar, Signature of the Employer/Authorized Office
Pune – 411013, Maharashtra, India Designation Date:
Name and address of the establishment or rubber stamp thereof
ACKNOWLEDGEMENT BY THE EMPLOYEE
Received the duplicate copy of nomination in Form 'F' filed by me and duly certified by the employer.

Date of Joining (DD/MM/YYYY): Signature of the Employee


Note.—Strike out the words/paragraphs not applicable.
JOINT DECLARATION UNDER PARA 26(6) OF THE EPF SCHEME, 1952
To,
Regional EPF Commissioner(Maharashtra Region)
Employees’ PF Organization
2nd & 3rd Floor,Pune Cantontment Board Building,
Golibar Maidan, Camp, Pune-411001

Sub: Application for regularising membership/Provident Fund Contributions deducted on Salaries over & above Rs.
6500/- per month or at higher rate.

Sir,
I the undersigned Shri/Smt. Dipesh Kumar bearing Account Number
PU/PUN/121598/ , employee of M/s Ventura(India) Private Limited hereby declare that I
have been contributing Provident Fund on my entire salary @ 12% with effect from (DOJ).
I am/am not an `EXCLUDED EMPLOYEE’ within the meaning of para 2(f) of the EPF Scheme, 1952
I request that;
1. I may be enrolled as member of the Employees’ Provident Fund voluntarily with effect from (DOJ).
2. I may be permitted to contribute voluntarily on my entire salary exceeding Rs. 6500/- per month w.e.f. (DOJ)
3. I may be permitted to contribute @ __nil______% instead of the statutory rate of 12% with effect from
(DOJ).

Yours Faithfully,
________________________________
(Member’s signature)

We M/s Ventura(India) Private Limited, bearing Employer’s Code No. PU/PUN/121598_______ hereby
declare that;
1. We have voluntarily enrolled Shri/Smt. Dipesh Kumar as member of the EPF Scheme, 1952, w.e.f. (DOJ) and
his/her Account Number is ____________.
2. We have been deducting contribution on his/her entire pay w.e.f. ______________________
3. We have been making matching contribution on pay upto Rs. 6500/- per month / on entire pay w.e.f.
______________.
4. We have been deducting Provident Fund contribution voluntarily @ 12% of pay and making matching
contribution @ 12% of pay.
5. We have paid Administrative Charges and submitted all the Returns in respect of the above Member accordingly
and will continue to do so.

We request that this case be regularised by permitting voluntary membership and contribute on entire salary @ 12%
of pay as stated above.

Yours Faithfully,

For Ventura(India) Private Limited

Authorized Signatory
CAPITA

Affix passport Size


Photograph
PERSONNEL INVENTORY RECORD
(Please fill details in block letters)

Date of Joining
Employee No : 0 (dd/mm/yyyy)

Name : Dipesh Kumar

Gender : Location : Pune-CZ


Assistant Technical
Designation : Manager Division/Project name : TSS

Date of birth : (DD/MM/YYYY) Pan No :

Father /Husband’s Name


Permanent Address Present Address :

Pin : Pin :
Mob: Mobile 9970650638
Resi: Mobile 9970650638

Email ID : kumardipesh@hotmail.com
Undergraduate Graduate Post graduate Diploma

Qualification :
Qualification : (Mention the highest Qualification)

Total Work Exp. Mths.


Relevant Work Exp. : Mths
Work Experience
Passport :
Blood Group :
Driving License :
CAPITA
Particulars of other family members (Parents ,Spouse, Children)
Sr. No Name Relationship Date of Birth State whether employed,
studying etc

If married and spouse is employed give his/her Employer Name, Office Address and telephone numbers

Tel: No (s) _____________________________________ Mobile No.

Academic /Profession Qualification : (To be given in revers chronological order) (10th till highest qualification)
Degree Branch of College/Institute University Start Date End Date Percentage/Class
study /Grade

Professional Training programs/ Courses Attended / Professional Certification (Give this in reverse Chronological order).

Diploma/Certificate Branch Institution Start Date End Date


of Study
CAPITA

Details of previous employment : (To be given in reverse Chronological order)

Name of Organization Designation held Start Date End date Exp. in Last Salary Reason
Yrs. Drawn for
leaving

Languages Known: (Also state whether fluent, written, spoken or both).

Language Known Read Write Speak


1) _____________________
2) _____________________
3) _____________________
4) _____________________
5) _____________________
6) _____________________

__________________________________
Employee’s Signature & Date of Joining (DD/MM/YYYY):
CAPITA

Personal Accident and Term Life Insurance Nomination Form

Employee Number 0 Name Dipesh Kumar


Date of Joining
(DD/MM/YYYY) Father’s /Husband’s Name

DOB(DD/MM/YYYY) Marital Status

I hereby nominate person/s mentioned below to receive the amount, in the event of my death and direct the said amount shall be
distributed among the said person/s in the manner shown below against their name.

Share to be paid to
Nominee/s Relation with the Age of each nominee/s (%)
Name and Address of the Nominee employee Nominee (*)

(*) This column should be filled so as to cover the whole amount that may stand to the credit of the member
(Total of all should be 100%)

In case the nominee is minor then provide guardian details.


Name and Address of the guardian Guardian’s Relation with the Age of Share to be paid to
employee Guardian each nominee/s (%)
(*)

______________________________________
Signature of Employee & Date of Joining (DD/MM/YYYY):
Declaration of Resignation

Date of Joining (DD/MM/YYYY):

To,
Manager - Human Resource
Ventura (India) Pvt Ltd
Commerzone, Yerwada, Pune – 411006.

Sub : Declaration of Resignation

I the undersigned hereby confirm that I have resigned from my previous


employment at (Previous Company Name) and last working
Day was .
Since my resignation acceptance / relieving letter is currently being processed, I
shall be Forwarding the same to the Human Resource Department within a
period of days. Any concern w.r.t dual employment, Capita is
authorized to take action against me.

(Reliving letter – mention “0” days and resignation acceptance letter – mention
no.of days when reliving letter will be received)

Signature :

Name : Dipesh Kumar

Date of Joining (DD/MM/YYYY): :


Declaration – Non submission of Pan Card details

I EMPNAME hereby declare that

I am working with NAMEOFCOMPANY (Name of our establishment). As per the employment


contract it is mandatory to have the PAN CARD number for statutory purpose.

Currently I do not have PAN CARD and therefore I am not able to provide the PAN CARD Number to
complete my on-boarding requirement.

Tick the applicable option:

I will immediately apply for a PAN CARD by -------------and will submit the details before -------
(Not later than one month from my date of joining)

I have applied for a PAN CARD and will submit the details on or before ------------

(Not later than one month from my date of joining)

Reference No. of PAN CARD application: -------------------------

On receipt of my PAN CARD I will submit a copy to HR and will update the details on the system
accordingly.

I acknowledge that I will be responsible for the consequences of any tax computation and/or my
salary being kept on hold, in case I do not submit & update PAN CARD Number on the system by
the above mentioned dates.

Employees Name:

Employee ID:

Date of Joining (DD/MM/YYYY):


Date of Joining (DD/MM/YYYY):

TO WHOMSOEVER IT MAY CONCERN

This is to confirm that I have not completed my Aadhaar Card registration; therefore I am unable to
provide my Aadhaar Card number.

Herewith, I am giving my assurance that I will complete the Aadhaar Card registration at the earliest
possible or whenever EPFO will arrange a camp for Aadhaar Card Registration, I will participate in the
same as per the schedule provided by the Regional PF Commissioner.

Thanking you.

Yours Sincerely,

(Employee’s Signature)

Employee’s Name:

Emp. No.

PF A/c No. ________________________________________________________

Mobile No.

Email Id.
AUTHORISATION
Human Resource Dept.

Dear Sir,

I Ms./Mr Dipesh Kumar Designation Assistant Technical ManagerDepartment TSS


Hereby authorize the company that in the event of my death, the balance of my
salary due for the period of leave and all other dues availed of shall be paid to
Who
is my (specify relationship)

and resides at

The nomination shall remain in force until it is cancelled or revised by another


nomination(s).

(Emergency contact person details)

Signature of the Employee :

Date of Joining (DD/MM/YYYY): :

Private & Confidential


Code of Conduct

Employee Acknowledgement and Certification of Compliance

I hereby confirm that on receiving, reading and fully understanding the standards
expected of me by Capita Code of conduct, I will observe and abide by the ethical
standards, policies, rule and procedures contained within it.

 Employee Acknowledgement and Certification of Compliance


 Confidential and Sensitive Information
 Conflict of Interest
 Use of Electronic Facilities
 Third Party Intellectual Property Rights
 Data Security Complaince
 Professional Behaviour
 Abusive Substances
 Reports of Complaints, Litigation and Regulatory Inquiries
 Legal/ Regulatory Compliance
 Anti- Bribery
 Communication
 Harassment
 Acceptable Usage Policy & E-mail, Internet Guidelines

I understand that any breach of the above may lead to disciplinary action,
including dismissal.

Signature :

Employee Name : Dipesh Kumar

Date of Joining (DD/MM/YYYY): :


USER DECLARATION ON INFORMATION SECURITY INCIDENT MANAGEMENT
POLICY
What is An Incident?

A violation or imminent threat of violation of computer security policies, acceptable use policy,
or standard Security policies.

Incident is classified as

Severity Classification Actionable


Misconduct Misconduct is a term used to describe behavior that
warrants disciplinary action.
Gross misconduct Gross Misconduct describes that strikes at the root of the
contract between Capita and an employee : where an
individual has forfeited that trust we placed in them and is
liable to be terminated.

Please note that should any Capita employee be proved to be actively involved in the
occurrence of any security incident, then disciplinary procedures shall be initiated against the
employee.
For reference, we have categorized the scenarios under ‘Misconduct’ or ‘Gross Misconduct’.

Some of the common information security threat scenarios, which give rise to security
incidents, are mentioned below but not limited to :

Sr. No. Threat/ Incident scenario Disciplinary


category
1 Being an accessory to a disciplinary offence such as failing to Misconduct
report an incident of gross misconduct you observed
2 Any attempt at logging onto systems without proper Misconduct
authorization
3 Any attempt to deliberately infect any device with viruses. Misconduct
4 Sharing of User ID, passwords and/ or personal swipe / access Misconduct
cards
5 Tail gating Misconduct
6 Attempt to access restriction areas (server room & Electrical Misconduct
Rooms)
7 Using Capita network to make unauthorized entry into other Misconduct
networks.
8 Take and / or send any Capita confidential and proprietary Misconduct
information including any client’s or third party information,
outside the office without proper authorization.
9 Installation of unlicensed software on any Capita IT device Group
Misconduct
10 Attempt to intrude any system, network and /or company folder Group
without authorization Misconduct
11 Rendering any infrastructure support device (AC, DGs, UPS, Fire Group
Alarm System, Physical Access System, CCTV), Unavailable or non- Misconduct
operational
12 Forge documents, conceal and/ or provide misleading, inaccurate Group
information at the time of recruitment Misconduct
13 Attempt to change the configuration or setting of Firewall, ACL, Group
Router IP Route, Switch ACL, Windows 2000 Group Policy and / or Misconduct
IP Addressing scheme
14 Attempt at email id impersonation Group
Misconduct
15 Deliberate sharing of Capita confidential and proprietary Group
information including any client’s information Misconduct
16 Rendering any network device and / or critical servers, non- Group
available or not-operational Misconduct
17 Any browsing, accessing and / or downloading of any Group
pornographic content Misconduct
18 Inappropriate email message such as pornographic or offensive Group
emails Misconduct
19 Corrupt or improper practice such as committing or assisting in Group
fraudulent practices Misconduct
20 Misconduct in relation to company documents such as defacing Group
or amending company policies Misconduct
21 Installation of unlicensed software on an Capita IT device. Group
Misconduct

I declare that I have read and understood various misconduct and gross misconduct and if I
fail to follow mandatory requirements outlined in the policy, I may be subject to disciplinary
action, dismissal/termination of contracts.

Employee Name : Dipesh Kumar Employee ID : 0

Signature : Date of Joining (DD/MM/YYYY):


User Declaration On Information Security

I declare that I have read and understood Capita Information Security Policy relevant to my
job profile. Furthermore, I undertake that I shall:

 Use Passwords and keep them secret.


 Create passwords that are at least ten characters long, have both letters and numbers
as well as special characters, that do not spell a word or a name, and do not contain
personal data.
 Protect sensitive data / information by following applicable policies and procedures.
 Protect the confidentiality of information, both during and after contractual relations
with Capita
 Protect my computer by logging off when I am gone for the day or leave it for 5minutes
or more.
 Do not bring personal bags, mobile phone and pager, blackberry etc. in the shop floor
area or its vicinity unless authorized by your immediate Manager.
 Protect equipment assigned to me by keeping it safe from any harm / damage.
 Scan all discs from external sources for viruses before using them on any computer.
 Not install any software unless authorized to do so.
 Use only authorized hardware and software.
 Protect my work area, media, and files, against all threats and report any incidents that
occur to the Security Administrator.
 Not download software from the Internet unless Specifically Authorized to do so by the
Management.
 Comply with all applicable laws and Capita policies and procedures.

I agree that by signing this document I am declaring that I have read and understood the
relevant Information Security Policy and that if I fail to follow mandatory requirement outlined
in the policy, I may be subject to disciplinary action / dismissal /termination of contracts.

Signature :

Employee Name : Dipesh Kumar

Date of Joining (DD/MM/YYYY): :

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