Company Confidential Application Form-Offshore RMG-TAG-V.

DUMMY Application for Employment

Personal Information

TONY STARK
Name (as per Adhar Card): ____________________________________________________________________________
(First Name) (Middle Name) (Last Name)

HOWARD STARK
Father’s (Full name): ________________________________Mother’s MARIA STARK
(Full Name):________________________________

15-MAY-1995
DOB (DD/MM/YYYY): ___________________Place YOUR CITY OR STATE Nationality: ___________
& State of Birth: ________________________ YOUR CONTRY

GENDER
Male/Female/Transgender: _____________________ YOUR ADHAR NO. 1234 2356 4456
Aadhaar No: ______________________________________________

Marital Status: Single Married Separated, Widowed Spouse Name: ______________________________

YOUR PAN NO.

PAN NO: ___________________________________ PF ACOUNT NO. (OPTIONAL)
UAN Account NO: _________________________________________
Passport Details-
Passport No Pace of Issue Date of Issue (DD/MM/YY) Date of Expiry (DD/MM/YY)

If you don’t have valid Passport and have applied for passport application: -
Application No: ___________________________________ Date of Application: ________________________________

Present Address (PIN code Mandatory):

CURRENT ADDRESS
___________________________________________________________________________________________________
012345
__________________________________________________________________________PIN:______________________
0123456789
Landline: _______________________________________Mobile No: ___________________________________________
Email: Primary___________________________________Secondary:
TONYSTARK@GMAIL.COM ___________________________________________

Permanent Address (PIN code Mandatory):

ADDRES AS PER ADHAR
___________________________________________________________________________________________________
123456
__________________________________________________________________________PIN:______________________
1234567890
Landline: _______________________________________Mobile No: ___________________________________________
Email: Primary___________________________________Secondary: ___________________________________________

Emergency Contact Detail:

ANY ONE FAMILY & FRIENDS
Name: ____________________________________________Relationship: FATHER, MOTHER, BROTHER, FRIEND
_______________________________________
Address: ____________________________________________________________________________________________
HIM/HER ADDRESS
Landline: __________________________________________Mobile No: _______________________________________
CONTACT NO.

Do you have any relative(s) working with any of the Mahindra Group companies including Tech Mahindra? YES NO
If yes Please give details below:-
Name of Relative/s Relationship Mahindra Gp Company Emp ID Department

TONY
Signature of the Applicant: _______________________Date: CURRENT DATE
_______________________________
Education Details: (Only those done through Govt recognized Institute/Universities)

College/University Name of Duration (MM/YY)

Education Specialization Percentage
(With Location) Degree /Level from To
Matriculation/SSC/ START END - -
BOARD NAME 10TH
Equivalent YEAR YEAR
Intermediate/HSC/ EX:- CBSE, ICSE, WBBSE 12TH - -
Equivalent " "
Diploma/
DIPLOMA " " - -
Equivalent
Graduation/ BA. B.COM
UNIVERSITY B.TECH, OTHER " " - -
Equivalent
Post -Graduation/ NAME POST GRAD. " "
Equivalent - -

Employment History:

Present /Current Employment

Name of the Employer Industry Type:
Address:
Email and Ph No of Employer :
Period of Services : Current Designation:
Start Date (DD/MM/YY): Name of Reporting Manager:
End Date (DD/MM/YY): Designation of Reporting Manager:
Current CTC: Current Monthly In hand:
Variable/Incentive If any: Variable Payout frequency :

IF YOU FILL THIS SECTION MAKE SURE YOU HAVE

Previous Employment/ Jobs: (OFFER LETTER, EXPERIENCE LETTER AND LAST 3 MONTHS PAY SLIPS

Period (DD/MM/YYYY)
Name and Address of Employer Last Salary Drawn
Sr No Emp Id (Must fill) Designation

(Please also give Telephone Nos.) From To (Per Annum)

LAST
1234566 DATE OF YOUR DESG. 1234567
1 PREVIOUS ORGNIZATION JOINING
WORKING
DATE

TONY
Signature of the Applicant: _______________________ CURRENT DATE
Date: _______________________________
 IF YOU HAVE GAP THEN FILL OTHERWISE LEAVE

Gap Details- Gap Reasons in Education & Employments:

(Need to cover gaps of more than 1 month in employments & education)

Period (MM/YYYY)
Sr No Reason
From To
1 START DATE LAST DATE YOUR REASON
2

Professional References :( Please provide detail of three professional references who are known to you)

Details Reference No 1 Reference No 2 Reference No 3

Full Name CAPTAIN THOR HULK

Designation TEAM LEADER QUALITY TRAINIG

Email ID SDFSDF@GMAIL.COM 5654654@YAHOO.COM 87878@GMAIL.COM

Contact No 5444345353 2121212121 5454545454

Nature Of Association

General:
Have you ever applied for a job with any of the Mahindra Group Cos. in the last 6 months? YES NO

If yes, give details:

Name of Company Position Applied For Date of Application Reason for Not Joining

KYC Details: - Please provide bank KYC details in mentioned format.

A/C Number IFSC Code Bank Name Bank Branch Name

YOUR BANK ACCOUNT NO. IFSC CODE YOUR BANK NAME BANK BRANCH LOCATION

Any additional information you feel relevant to your candidature:

________________________________________________________________________________________________
_______________________________________________________________________________________________

Expected CTC :
Joining Time required :

I certify that:
1. The information furnished above is factually correct and subject to verification by Tech Mahindra Ltd.
2. All my education qualifications have been acquired from institutes duly recognized by Govt. established statutory
authorities.
3. I accept that an appointment given to me can be revoked; if any of above, information has been misstated or unstated.

Signature of the Applicant: _______________________Date:

TONY __________________________
CURRENT DATE
 General Declaration
READ AND TICK YES OR NO

Have you ever discharged, dismissed or terminated from your previous employment? YES NO

If yes, kindly furnish details ________________________________________________________________________

________________________________________________________________________________________________

Are you willing to work in shift timings as suggested by Management? YES NO

Have you signed an employment bond with previous employer (s)? YES NO

If yes, kindly furnish details ________________________________________________________________________

________________________________________________________________________________________________

Are you suffering from any handicap/s, ailments or are you under long-term medication? YES NO

If yes, kindly furnish details ________________________________________________________________________

________________________________________________________________________________________________

Are you under any service agreement or Bond? YES NO

If yes, kindly furnish details ________________________________________________________________________

________________________________________________________________________________________________

Do you have history of drug, alcohol abuse, depression, and /or any other psychological disorder? YES NO

If yes, kindly furnish details ________________________________________________________________________

________________________________________________________________________________________________

Have you ever been convicted by any court of law on grounds including civil, criminal, and socio-economic or
cybercrimes or other acts punishable under the Information Technology Act? YES NO

If yes, kindly furnish details ________________________________________________________________________

________________________________________________________________________________________________

Please details out if any Court order has been passed by the Court
________________________________________________________________________________________________
________________________________________________________________________________________________

I certify that

The information furnished above is factually correct and subject to verification by Tech Mahindra Ltd.

TONY
Signature of the Applicant: _______________________Date: CURRENT DATE
_______________________________