APPLICATION FOR EMPLOYMENT
INFOSYS CLIENT PROJECT
LEADER
INSTRUCTIONS:
The information you provide must be
It is mandatory for you to complete the fom in all respects.
conhidence.
complete and corect and he same shall be treated sthict
in
The details on this form will be used for all official requiremenis should you join the organization
APPLICATION FOR EMPLOYMENT
Client
Location
Date of Joining/Interview
ID
Applicant No / Employee 4 21/2021
Oshore
146084
Personal Information
Former Name/Ma den Name (f applicable
(irst Miodie Last)
FuR Name
Abhishek Mohanty
ALIAS NAME/NICK NAME(F ANY)
Date of Birth (dd/mm/y
Sather't Name
14/11/1998
Samach andra Mohanty Number (if applicabie) Nationality Marital Status
Gender Social Securty
Male indian Single
Fema'e
To Immiyy) stay Residence Number
Period of From (mm/yy)
Current Address
11/1998 Tl Date 350/450
|Tamandc350 Mobile number
Prom inent Landmark
7008758130
a9annath Temple To (mmyy) stay Residence Number
Permanent Address Pericd of From imm/y)
350/450 Nuasahi. Tamando.Khurdha Odisha 11/1998 Till Date 350/450
|Prominent Landmark
agannath Temple
Address History (List most recent first)- Please provide
addresses for the last Seven years
Period of Stay
ss p Code Contact Number
Nuasahi amando ESR.Khurdha 0aisha|Odisha india 75 2054 7008758130
11/1998Till Date 350/450
Education Qualification - which Falls in last7 years
College NameAddresversily Name Oualitication
ed
D /Rol No
CV.Raman élobal University CVRaman Glooal University
B13yanagar Nanua Jania.
mm/yy mm/yy e Full Time 1601227254
Eidyanagar Mahura, Janla.
Odisha, in0 a Odigha ndia 08/2016 7/2020 Part Tam
|Please tick mark the documents submitted for this qualification dong with this form
Degree Certihcate None
fMarksheet Provisiona! Certifca:e
College Name &Address D /Roll No
Council of Higher Secondary
B N internationl College of Science
and Commerce
EDUCEion
Prainapitha, Samantapur,
mm/yy Imm/yy Full Tim 333MZ001
Tamando.Khurdha,Odisha Bhucaneshwar Odisha. india05/2014 8/2016 Part Time
Please tick mark the documents subrmitted for this qualification along with this form
a Markcheet CProvisional Certificate Degrae Certificate None
Education Qualification- Highest Qualification in case there is no education in last 7 years
college Nme Address Universi NmeAddrn
mm/yy mm/yy FullTime
PatTim
for this qualification along with this form
documents submitted
Please tick mark the
DegreeCertificate None
Marksheet
ProvisionalCertificate
Employment History (Llist most
recent first for last 7 years)
if Co. do mention
is closed, it. Employee Code ID/ Number is mandatory. if
descriptive wherever necessary-e.g.
Note: Ensure that you aredid and state reasons for the same.
not provide one, p'ease mention
your previous empkoyer Address of Current Employer
Name of Current Empioyer Pliot No-PE-1, NE-1& NP-1, info valy DCO TATES SEZ Gaudakashipur
Odisha 752054 India
Infcsys Limited & Arisail, Ehubanaswar
Telephone No
Employee Code/No Designation Department
|1146084 |Sy stems Engineer MSWTPU
Can a reference taken
Manager's Name Manager's Contact No
Employment Period now?
From Managers Email iD Yes
Deepak Kumar Mchanty
|062021 TTil Date
deepak.mohanty01@infosys.com No
Reasons for leaving
Duties & Responsibilities
First Salary drawn Was this Position Agency Details [if temporary or contractual). provide details
Permanent
Last Saiary crawn
Temporary
Lontactual
Dlease tick mark the documents submitted for this emplayment
Service Certificate Releving letter Offer latter D Any Cther iplease spedty
None
Documents Required
Education:
Photocopy of degrèe certificate and final mark sheet
For identity verification
Kindly upload a photo copy of passport
. f passport not available kindly uplcad copy of your pan card.
Employment
PhotocoPy ofrelieving/experience letter.
Letter of Authoization
concern
To whom it may
Infosys Limited infosys
anas epresenaE EdEny to
vey all the information provided in m
hereby authorize
s DE
TEui y hrosysMTed to veriy facts of all such infcrmaticos
acplication of emplcymant and to
conduct suc Enui E
authorcaion srall be vaid i l suC ime rmain an emplcyee Infosys Limited. I hereby authcwire
of
lerovided bv me l hereby declare that this es e3ucational insitutions who may have information relevant tntthi
government estabishmens agnc
al individuals, private establishments. SUcn iniormaricn as may be required. I hereby release Infosys Limited
anauiry to co-operate and disciose to Infosys
mited
and or ts 3gEns
could erther directy or indirecty. Tom he disclosure of informadion by a thira
ird
iabity which resur,
and all its personnel and agants rom any Limited's enquiries
in response to infosys
party to another party
sgrenrs phishek Mohonhy
MOHANTY
ABHISHEK
NameinBlockCapitalis
Date
Employee D. 111G081
