BACKGROUND VERIFICATION FORM (Annexure-II)
1. Full Name (In Capital Letters):Mr./Ms./Mrs
2. Date of Birth:
3. Gender: Male Female
4. Mobile No.
5. Current Address/Address for Communication:
6. Permanent Address ( As mentioned in the Aadhaar
Card)
7. Father ‘s Name:-
8. Highest Education Qualification
Degree/diploma Enrollment Number/ Roll Year of Passing University/institute Location
Number
9. Work Experience (Previous I):
Name of the Organization Address & Location Employee From TO Designation
Code (DD/MM/YYYY)
Immediate Reporting Manager HR Manager Last drawn Salary Reasons for Leaving
Name :- Name :-
Tel No.:--------------Extn.------- Tel No.:--------------Extn.-------
Mobile: Mobile:
10. Work Experience (Previous II):
Name of the Organization Address & Location Employee From TO Designation
Code (DD/MM/YYYY)
Immediate Reporting Manager HR Manager Last drawn Salary Reasons for Leaving
Name :- Name :-
Tel No.:--------------Extn:------- Tel No.:--------------Extn.:-------
Mobile: Mobile:
Letter of Authorization
I hereby declare that all the information provided in this form is true, complete and correct to the best of my knowledge.
I hereby authorize Foxivision Screening Services Private Limited to conduct a comprehensive review of my current &
Past Employment History and Educational background history records.
Name in Capital Letters Signature Date
Documents Checklist:-
Employment Check:- Any Document with Employee ID ( Preferable Pay slip or Relieving letter)
Criminal Records Check: - Any clear Photo ID with full Address, Father’s name and Date of Birth (Aadhaar Card)
Education Check: - Scanned copy for the Degree or Final year Mark sheet
Address Check:- Same as Criminal Records check
Document Verification Any government approved document, Aadhaar Card, Pancard, Voter ID & Passport
Professional Reference:- Immediate Reporting Managers Phone number and Designation
