Sutherland- Background Verification Form
Content
Background Verification Form
Personal Details Full Name
Former Name(s) / Maiden Name (if applicable) Father’s Name Mailing Address:
First
Middle
Last
Current:
Landline No:
Mobile No:
Mailing Address:
Permanent:
Landline No:
Mobile No:
Gender:
Date of Birth:
1. Please provide clear copy of the Ration card for Address Proof and Voter ID, Passport and Driving licenses any one for photo ID.
Page 1 of 6
Education History
Highest Degree:
Educational Details (Highest Degree)
Specialization:
Exam Passed
Complete name and address of the college / institute from where qualification attained
Course start date
Course end date
% Achieved
2. Please mention if the candidate has attained qualification with correspondence
studies and also enclose copy of mark sheet and degree Certificate with roll no. clearly indicated. 3. Please provide clear copy of the Degree Certificate for the education qualification mentioned above
Page 2 of 6
Employment History 1
Details of Previous Employer Company Name :
Address (main office and branch where worked):
Company Board Line Numbers (No Cell Phone numbers accepted) If Deputed by Agency - Agency name and address
Tel no of the Agency Employee Code Designation and Dept Date of Joining Date of Leaving Monthly Gross Salary Reason For leaving Supervisor’s Name and Designation
Supervisor's direct line number and Mobile no. Any other information you would like to provide:
Page 3 of 6
Employment History 2
Details of Previous Employer Company Name :
Address (main office and branch where worked):
Company Board Line Numbers (No Cell Phone numbers accepted) If Deputed by Agency - Agency name and address
Tel no of the Agency Employee Code Designation and Dept Date of Joining Date of Leaving Monthly Gross Salary Reason For leaving Supervisor’s Name and Designation
Supervisor's direct line number and Mobile no. Any other information you would like to provide:
Page 4 of 6
Employment History 3
Details of Previous Employer Company Name :
Address (main office and branch where worked):
Company Board Line Numbers (No Cell Phone numbers accepted) If Deputed by Agency - Agency name and address Tel no of the Agency Employee Code Designation and Dept Date of Joining Date of Leaving Monthly Gross Salary Reason For leaving Supervisor’s Name and Designation Supervisor's direct line number and Mobile no. Any other information you would like to provide:
Candidate Name: ___________________ Date: ________________
Signature: _______________ Location: ________________
Page 5 of 6
Letter of Authorization
To whom it may concern
I hereby authorize Sutherland Global Services Pvt. Ltd. and its representative to verify information provided in my resume and application of employment, and to conduct enquiries as may be necessary, at the company’s discretion. I authorize all persons who may have information relevant to this enquiry to disclose it to Sutherland Global Services Pvt. Ltd. or its representative. I release all persons from liability on account of such disclosure Signed: ______________________
Name in capitals:_________________
Page 6 of 6
Personal Details Full Name
Former Name(s) / Maiden Name (if applicable) Father’s Name Mailing Address:
First
Middle
Last
Current:
Landline No:
Mobile No:
Mailing Address:
Permanent:
Landline No:
Mobile No:
Gender:
Date of Birth:
1. Please provide clear copy of the Ration card for Address Proof and Voter ID, Passport and Driving licenses any one for photo ID.
Page 1 of 6
Education History
Highest Degree:
Educational Details (Highest Degree)
Specialization:
Exam Passed
Complete name and address of the college / institute from where qualification attained
Course start date
Course end date
% Achieved
2. Please mention if the candidate has attained qualification with correspondence
studies and also enclose copy of mark sheet and degree Certificate with roll no. clearly indicated. 3. Please provide clear copy of the Degree Certificate for the education qualification mentioned above
Page 2 of 6
Employment History 1
Details of Previous Employer Company Name :
Address (main office and branch where worked):
Company Board Line Numbers (No Cell Phone numbers accepted) If Deputed by Agency - Agency name and address
Tel no of the Agency Employee Code Designation and Dept Date of Joining Date of Leaving Monthly Gross Salary Reason For leaving Supervisor’s Name and Designation
Supervisor's direct line number and Mobile no. Any other information you would like to provide:
Page 3 of 6
Employment History 2
Details of Previous Employer Company Name :
Address (main office and branch where worked):
Company Board Line Numbers (No Cell Phone numbers accepted) If Deputed by Agency - Agency name and address
Tel no of the Agency Employee Code Designation and Dept Date of Joining Date of Leaving Monthly Gross Salary Reason For leaving Supervisor’s Name and Designation
Supervisor's direct line number and Mobile no. Any other information you would like to provide:
Page 4 of 6
Employment History 3
Details of Previous Employer Company Name :
Address (main office and branch where worked):
Company Board Line Numbers (No Cell Phone numbers accepted) If Deputed by Agency - Agency name and address Tel no of the Agency Employee Code Designation and Dept Date of Joining Date of Leaving Monthly Gross Salary Reason For leaving Supervisor’s Name and Designation Supervisor's direct line number and Mobile no. Any other information you would like to provide:
Candidate Name: ___________________ Date: ________________
Signature: _______________ Location: ________________
Page 5 of 6
Letter of Authorization
To whom it may concern
I hereby authorize Sutherland Global Services Pvt. Ltd. and its representative to verify information provided in my resume and application of employment, and to conduct enquiries as may be necessary, at the company’s discretion. I authorize all persons who may have information relevant to this enquiry to disclose it to Sutherland Global Services Pvt. Ltd. or its representative. I release all persons from liability on account of such disclosure Signed: ______________________
Name in capitals:_________________
Page 6 of 6
