You are on page 1of 1

Reference Details

Name Destination

Organization Email ID

Phone No. Cell No.

Declaration

I hereby declare that I am a relative of the following Director / Executive Director in PricewaterhouseCoopers Pvt. Ltd. or
relative of a Partner in Price Waterhouse/ Lovelock and Lewis

Name of the Director/ED/Partner Relationship

If not applicable check this box ☐

I declare that the information given above is true to the best of my knowledge. I acknowledge that any false or incorrect
information given by me may result in termination of my service with the Company and imposition of penalties as my may
be thought fit by the management.

Date

Place Signature

You might also like