Verification Form
Content
YASH TECHNOLOGIES
Background Verification Form
YASH-TAC-001-T002
Please do spare time & read these instructions before you start filling the form.
Guidelines to Your Background Verification Form
General Instructions:
PLEASE USE THIS FONT WHILE FILLING THE ENTIRE FORM THROUGH DESKTOP SYSTEMS –
CALIBRI; FONT SIZE 11
Please sign all the pages of this Form including the last one during Joining Formalities.
Please do mention the contact numbers wherever asked.
Kindly mention the updated contact numbers & email ids as applicable wherever asked.
Category Specific Instructions:
Personal Details:
Kindly mention your Full Name in CAPITAL Letters.
Address:
All the categories are MANDATORY to be filled. Do not leave any category blank.
Please make sure your complete address with proper landmark is mentioned in permanent as
well as current address blocks.
Education:
Kindly mention all the details of education including the roll numbers/seat numbers/etc.
Please mention the exact & Full Name & Address of school/college/Institution/organization you
have studied in.
Employment Records:
All the categories are MANDATORY to be filled. Do not leave any category blank.
Kindly mention the Employment Records in Descending Order – Latest Employment is to be
mentioned first.
Kindly mention “NA” wherever information is absolutely Unavailable / Non-applicable.
Kindly mentioned the full date of Employment duration & do not leave any of them blank.
If you were deployed / deputed to other company, then kindly mention the details of only
your Parent company on whose payrolls you were employed.
Please ensure all the contact numbers of Company/Supervisor/HR Manager are updated ones
& functional.
Kindly mention the updated & functional Email Ids wherever asked.
Please mention the document/documents submitted by you during the Joining Formalities at
YASH for the particular Employment as asked.
Please do mention the current status of the company for the particular employment record.
Reference Verification:
Kindly make sure that the references are Professional & not Personal/Relatives.
Information Release Form:
Please write your full name as asked.
Kindly Sign the form & mention the date on which you are signing it during Joining Formalities.
YASH TECHNOLOGIES
Background Verification Form
Employee Code
Employee Location
(To be filled in by HR on Joining)
(To be filled in by HR on Joining)
YASH-TAC-001-T002
PERSONAL DETAILS
Full Name of Candidate:
First
RIYAZ
Middle
Surname
HASSAN
Maiden Name :
Have you ever been known by another name?
YES
NO
If Yes, please write the other name:
Place of Birth: Kanpur
Date of Birth (dd/mm/yy): 20-JAN-1983
Gender: Male
Nationality: Indian
Father’s Name: S.K.Hassan
Passport No:
SSN No.
L1664459
(Mandatory for US address)
.
Home Phone: +91 9319816234
Office Phone
Mobile: 9742117021
YASH TECHNOLOGIES
Background Verification Form
YASH-TAC-001-T002
RESIDENTIAL ADDRESS
Permanent Address: 130 / 318 B, Ajeet Ganj, T.P.Nagar
City : Kanpur
State : Uttar Pradesh
Pin Code : 208023
Nearest Landmark : Shakawat Deen Gas Agency
Name of the contact person at the address : Mr. Kamrul Hassan
Relationship of contact person : Father
Landline No.
Mobile No. +91 9319816234
Nature Of Location: Rented/Owned/Others
Preferred time of the day for conducting the verification, if
any : 8:00 AM to 6:00 PM
Owned
Residing Since (Mandatory): 19
Residing Till ( Mandatory): 20
(Year)
(Year)
Current Address: Hoppers Stop service apartment, #14/9, Jayram Nagar, Jakkur Main Road, (Guest House)
City : Bangalore
State : Karnataka
Pin : 560064
Nearest Landmark : Near smart super market, Opp.
Corporation Bank ATM
Contact Person at the address : Mr. Ravi
Relationship of contact person : Guest House care taker
Landline No.
Mobile No. +099001 60344 (P.Sathya – owner)
Nature Of Location: Rented/Owned/Others
Preferred time of the day for conducting the verification, if
any : 9:00 AM to 5:00 PM
Guest house provided by company
Residing Since (Mandatory): 8 Months
Residing Till ( Mandatory): 4 Months
(Year)
(Year)
YASH TECHNOLOGIES
YASH-TAC-001-T002
Background Verification Form
EDUCATION RECORD
EDUCATION RECORD (Start with the latest / highest qualification; please attach photocopies of the
documents) All fields are mandatory
Name & Address of
School/College/Institute
Meerut Institute of
Engineering &
Technology
Dr. Soney Lal Patel
Public School
Dr. Soney Lal Patel
Public School
Name & Address of
University its affiliated
Type of
Degree/Diploma
obtained. State
“F” for fulltime
and “P” for parttime within
brackets
Dates Attended
U.P.T.U (current
name G.B.T.U)
B.Tech
2004
2008
0406854031
C.B.S.E
12th
2000
2001
5651326
C.B.S.E
10th
1998
1999
5166973
From
To
Roll
Number/Registration
Number/Exam Seat
number
PROFESSIONAL EDUCATION RECORD
PROFESSIONAL EDUCATION RECORD
(Start with the latest/ highest qualification; please attach photocopies of the documents) All fields are
mandatory
Name & Address of
School/College/Institute
Name & Address of
University its affiliated
(Mandatory)
(Mandatory)
Meerut Institute of
Engineering &
Technology
U.P.T.U (current
name G.B.T.U)
Type of
Degree/Diploma
obtained. State
“F” for fulltime
and “P” for parttime within
brackets
Dates Attended
B.Tech
2004
From
To
2008
Roll
Number/Registration
Number/Exam Seat
number
0406854031
YASH TECHNOLOGIES
YASH-TAC-001-T002
Background Verification Form
EMPLOYMENT RECORDS
PLEASE MENTION THE RECORDS IN DESCENDING ORDER (LATEST EMPLOYMENT TO BE MENTIONED FIRST)
ALL THE FIELDS ARE MANDATORY TO BE FILLED
KINDLY MENTION ‘NA’ WHEREVER NO INFORMATION IS ABSOLTELY UNAVAILABLE/ NON-APPLICABLE
Employer 1
Employee ID
Full Name of the Company
51092
From
(dd/mm/yy)
SEAL INFOTECH PVT. LTD.
03-NOV2012
Address: Bascon IT Park 56L, Venkatnarayana Road,
Phone Number :
T.Nagar
City: Chennai
To (dd/mm/yy)
Till Date
+91 44 6618 017
State: Tamil Nadu
Country
Postal Code: 600017
India
Job Title: PP AFS Consultant
Designation: Consultant
Reason of Leaving
Final Salary (Annual CTC):
Got married and wanted to relocate to
NCR region
Mode of Payment:
Direct Transfer
Cheque
Cash
Others (Please Specify Details)
Supervisor’s –
HR Manager’s –
Name: Mr. Suryanarayana Tata
Name: Karthik KK
Title: Project Manager
Contact Number: +91-44-66187000
Contact Number: +91 9866492929
Email ID: [email protected]
Email ID:
[email protected]
YASH TECHNOLOGIES
YASH-TAC-001-T002
Background Verification Form
Tick Mark The Documents Submitted for this
Employment while Joining at YASH:
Current Status of the Company:
In Existence
Offer Letter
Closed
Resignation Letter
Not Known
Resignation Acceptance
Relieving Letter
Service Certificate
Experience Letter
Salary Slips
Full & Final Settlement Document
None
Employer 2
Employee ID
Full Name of the Company
8814
From
(dd/mm/yy)
To (dd/mm/yy)
23-OCT-2012
Sonata Software Ltd.
20-June2011
Address
Phone Number
APS Trust Building
Bull Temple Road, N. R. Colony
+91-80-3097 1999
City: Bangalore
State: Karnataka
Country:
Postal Code: 560 019
India
Job Title PP-QM consultant
Designation System Analyst
Reason of Leaving
Final Salary (Annual CTC):
Better career prospects
Mode of Payment:
Direct Transfer
Cheque
Cash
Others (Please Specify Details)
Supervisor’s -
HR Manager’s -
Name: Bhaskar Biswas
Name: Padmashree. SV
Title: Project Manager
Contact Number: +91 80-30971999
Contact Number: +91 9811815900
Email ID: padmashree.sv@sonata-
Email ID: [email protected]
software.com
YASH TECHNOLOGIES
YASH-TAC-001-T002
Background Verification Form
Tick Mark The Documents Submitted for this
Employment while Joining at YASH:
Current Status of the Company:
In Existence
Offer Letter
Closed
Resignation Letter
Not Known
Resignation Acceptance
Relieving Letter
Service Certificate
Experience Letter
Salary Slips
Full & Final Settlement Document
None
Employer 3
Employee ID
Full Name of the Company
From
(dd/mm/yy)
To (dd/mm/yy)
17-June-2011
4-Apr-2009
Rahman Industries Ltd.
Address
Phone Number
184/167, Wajidpur, Jajmau,
+91-512-3931400
City: Kanpur
State: Uttar Pradesh
Country
Postal Code: 208010
INDIA
Job Title SCM executive
Designation Executive
Reason of Leaving
Final Salary (Annual CTC):
To work in SAP implementation projects
Mode of Payment:
Direct Transfer
Cheque
Cash
Others (Please Specify Details)
Supervisor’s -
HR Manager’s -
Name: M. Ahmad
Name: Intikhab Alam
Title: SAP PP Lead Consultant
Contact Number: +91 512 3935441
Contact Number: +91 9984943777
Email ID: [email protected]
Email ID: [email protected]
YASH TECHNOLOGIES
YASH-TAC-001-T002
Background Verification Form
Tick Mark The Documents Submitted for this
Employment while Joining at YASH:
Current Status of the Company:
In Existence
Offer Letter
Closed
Resignation Letter
Not Known
Resignation Acceptance
Relieving Letter
Service Certificate
Experience Letter
Salary Slips
Full & Final Settlement Document
None
Employer 4
Employee ID
Full Name of the Company
From
(dd/mm/yy)
To (dd/mm/yy)
26- Feb-2009
13-Oct-2008
G.H.P PHARMA PVT. LTD.
Address
Phone Number
A1/265, Paschim Vihar, Delhi – 110063
City Delhi
State Delhi
Country
Postal Code 110063
India
Job Title
Designation
Reason of Leaving
Final Salary (Annual CTC):
Do not want to continue in sales
Mode of Payment:
Direct Transfer
Cheque
Cash
Others (Please Specify Details)
Supervisor’s -
HR Manager’s -
Name: Tarandeep Singh
Name: Ms. Mohini
Title: Sales Manager
Contact Number: +91 011 45683343
Contact Number:
Email ID: [email protected]
Email ID: [email protected]
YASH TECHNOLOGIES
Background Verification Form
Tick Mark The Documents Submitted for this
Employment while Joining at YASH:
YASH-TAC-001-T002
Current Status of the Company:
In Existence
Offer Letter
Closed
Resignation Letter
Not Known
Resignation Acceptance
Relieving Letter
Service Certificate
Experience Letter
Salary Slips
Full & Final Settlement Document
None
REFERENCE VERIFICATION
Note – The reference provided should be currently employed or engaged in a professional activity.
**Please ensure that the contact numbers of the References are active numbers and are reachable for verification.
Kindly provide with the Professional References & not Personal/of relatives.
REFERENCE (1)
Full name of the Reference
Rais Ahamad
(Professional)
Contact Number
+91 9611137917
Email ID
[email protected]
Organization
UST Global
Designation
Software Developer
Relationship with the candidate
Friend
REFERENCE (2)
Full name of the Reference
Fareed Ahamad Ansari
(Professional)
Contact Number
+91 7569619652
Email ID
[email protected]
Organization
Accenture
Designation
Senior SAP PP consultant
YASH TECHNOLOGIES
YASH-TAC-001-T002
Background Verification Form
Friend
Relationship with the candidate
REFERENCE (3)
Harshavardhan B Reddy
Full name of the Reference
(Professional)
Contact Number
+91 9663392922
Email ID
[email protected]
Organization
Sonata Software Ltd.
Designation
Senior SD consultant
Relationship with the candidate
Friend
OTHER INFORMATION
Marital Status: Married / Unmarried / Other
Family Background:
Single (Father, Mother & Sibling details):
Name
Relation
Occupation
Contact Number
Location
Married (Father, Mother, Wife & Children details):
Name
S.K.Hassan
Jabur Nisha
Mahmooda Fatima
Relation
Father
Mother
Wife
Occupation
Business
House Wife
Student
Contact Number
+91 9319816234
+91 9369313224
Location
Kanpur
Kanpur
Kanpur
Do you have a Bond with your current employer? If yes, please give details of
the time period, amount and any other relevant details.
If you have any relatives / friends / acquaintances in this company working at
present or in the past, please give details.
Name
Department/Tech
nology
Relationship
Contact Number
YASH TECHNOLOGIES
YASH-TAC-001-T002
Background Verification Form
Awards / Achievements or Special Comments:
Areas of Interest:
Do you posses any technical certification/ training? (Specify):
CURRENT EMOLUMENTS
Details
Annual
Basic
House Rent Allowance
Special Allowance
Conveyance
Leave Travel Assistance
Medical Reimbursement
Medical Insurance
Provident Fund
Superannuation
Gratuity
16000
6400
5630
800
4000
1250
1920
Any other Benefits/ Perks (Please Specify)
of
Elements Of Compensation
Please list out all the perquisites, which can be measured monetarily including those benefits that
may be once in 2-3 years also.
Performance Bonus
ion mpensat o c
3792
TOT
AL
39762
YASH TECHNOLOGIES
YASH-TAC-001-T002
Background Verification Form
Last Appraisal Month/Year
% Hike in present Company for last appraisal
April
5.4 %
INFORMATION RELEASE FORM
To Whom It May Concern:
Please print
I____Hassan_________________Riyaz______________________________________________
Last name
First name
Middle name
I hereby authorize KPMG or their representatives to verify information presented on my employment
application/resume and to procure an investigative report or consumer report for that purpose.
I hereby grant authority for the bearer of this letter to access or be provided with full details
n
of my previous employment record held by any company or business for whom I previously
worked. This information should include the dates of employment; the nature of the position
held, [details of my salary upon departure] and an appraisal of my performance, capabilities
and character. In addition, please provide any other pertinent information requested by the
individual presenting this authority. I hereby release from liability all persons or entities
requesting or supplying such information.
n
of my qualification/degree (copy of my certificates attached)
n
information in respect to my character from the records maintained by local authorities
Riyaz Hassan
28 / July / 2013
Signature:
Date: dd / mm / yyyy
YASH TECHNOLOGIES
Background Verification Form
YASH-TAC-001-T002
Background Verification Form
YASH-TAC-001-T002
Please do spare time & read these instructions before you start filling the form.
Guidelines to Your Background Verification Form
General Instructions:
PLEASE USE THIS FONT WHILE FILLING THE ENTIRE FORM THROUGH DESKTOP SYSTEMS –
CALIBRI; FONT SIZE 11
Please sign all the pages of this Form including the last one during Joining Formalities.
Please do mention the contact numbers wherever asked.
Kindly mention the updated contact numbers & email ids as applicable wherever asked.
Category Specific Instructions:
Personal Details:
Kindly mention your Full Name in CAPITAL Letters.
Address:
All the categories are MANDATORY to be filled. Do not leave any category blank.
Please make sure your complete address with proper landmark is mentioned in permanent as
well as current address blocks.
Education:
Kindly mention all the details of education including the roll numbers/seat numbers/etc.
Please mention the exact & Full Name & Address of school/college/Institution/organization you
have studied in.
Employment Records:
All the categories are MANDATORY to be filled. Do not leave any category blank.
Kindly mention the Employment Records in Descending Order – Latest Employment is to be
mentioned first.
Kindly mention “NA” wherever information is absolutely Unavailable / Non-applicable.
Kindly mentioned the full date of Employment duration & do not leave any of them blank.
If you were deployed / deputed to other company, then kindly mention the details of only
your Parent company on whose payrolls you were employed.
Please ensure all the contact numbers of Company/Supervisor/HR Manager are updated ones
& functional.
Kindly mention the updated & functional Email Ids wherever asked.
Please mention the document/documents submitted by you during the Joining Formalities at
YASH for the particular Employment as asked.
Please do mention the current status of the company for the particular employment record.
Reference Verification:
Kindly make sure that the references are Professional & not Personal/Relatives.
Information Release Form:
Please write your full name as asked.
Kindly Sign the form & mention the date on which you are signing it during Joining Formalities.
YASH TECHNOLOGIES
Background Verification Form
Employee Code
Employee Location
(To be filled in by HR on Joining)
(To be filled in by HR on Joining)
YASH-TAC-001-T002
PERSONAL DETAILS
Full Name of Candidate:
First
RIYAZ
Middle
Surname
HASSAN
Maiden Name :
Have you ever been known by another name?
YES
NO
If Yes, please write the other name:
Place of Birth: Kanpur
Date of Birth (dd/mm/yy): 20-JAN-1983
Gender: Male
Nationality: Indian
Father’s Name: S.K.Hassan
Passport No:
SSN No.
L1664459
(Mandatory for US address)
.
Home Phone: +91 9319816234
Office Phone
Mobile: 9742117021
YASH TECHNOLOGIES
Background Verification Form
YASH-TAC-001-T002
RESIDENTIAL ADDRESS
Permanent Address: 130 / 318 B, Ajeet Ganj, T.P.Nagar
City : Kanpur
State : Uttar Pradesh
Pin Code : 208023
Nearest Landmark : Shakawat Deen Gas Agency
Name of the contact person at the address : Mr. Kamrul Hassan
Relationship of contact person : Father
Landline No.
Mobile No. +91 9319816234
Nature Of Location: Rented/Owned/Others
Preferred time of the day for conducting the verification, if
any : 8:00 AM to 6:00 PM
Owned
Residing Since (Mandatory): 19
Residing Till ( Mandatory): 20
(Year)
(Year)
Current Address: Hoppers Stop service apartment, #14/9, Jayram Nagar, Jakkur Main Road, (Guest House)
City : Bangalore
State : Karnataka
Pin : 560064
Nearest Landmark : Near smart super market, Opp.
Corporation Bank ATM
Contact Person at the address : Mr. Ravi
Relationship of contact person : Guest House care taker
Landline No.
Mobile No. +099001 60344 (P.Sathya – owner)
Nature Of Location: Rented/Owned/Others
Preferred time of the day for conducting the verification, if
any : 9:00 AM to 5:00 PM
Guest house provided by company
Residing Since (Mandatory): 8 Months
Residing Till ( Mandatory): 4 Months
(Year)
(Year)
YASH TECHNOLOGIES
YASH-TAC-001-T002
Background Verification Form
EDUCATION RECORD
EDUCATION RECORD (Start with the latest / highest qualification; please attach photocopies of the
documents) All fields are mandatory
Name & Address of
School/College/Institute
Meerut Institute of
Engineering &
Technology
Dr. Soney Lal Patel
Public School
Dr. Soney Lal Patel
Public School
Name & Address of
University its affiliated
Type of
Degree/Diploma
obtained. State
“F” for fulltime
and “P” for parttime within
brackets
Dates Attended
U.P.T.U (current
name G.B.T.U)
B.Tech
2004
2008
0406854031
C.B.S.E
12th
2000
2001
5651326
C.B.S.E
10th
1998
1999
5166973
From
To
Roll
Number/Registration
Number/Exam Seat
number
PROFESSIONAL EDUCATION RECORD
PROFESSIONAL EDUCATION RECORD
(Start with the latest/ highest qualification; please attach photocopies of the documents) All fields are
mandatory
Name & Address of
School/College/Institute
Name & Address of
University its affiliated
(Mandatory)
(Mandatory)
Meerut Institute of
Engineering &
Technology
U.P.T.U (current
name G.B.T.U)
Type of
Degree/Diploma
obtained. State
“F” for fulltime
and “P” for parttime within
brackets
Dates Attended
B.Tech
2004
From
To
2008
Roll
Number/Registration
Number/Exam Seat
number
0406854031
YASH TECHNOLOGIES
YASH-TAC-001-T002
Background Verification Form
EMPLOYMENT RECORDS
PLEASE MENTION THE RECORDS IN DESCENDING ORDER (LATEST EMPLOYMENT TO BE MENTIONED FIRST)
ALL THE FIELDS ARE MANDATORY TO BE FILLED
KINDLY MENTION ‘NA’ WHEREVER NO INFORMATION IS ABSOLTELY UNAVAILABLE/ NON-APPLICABLE
Employer 1
Employee ID
Full Name of the Company
51092
From
(dd/mm/yy)
SEAL INFOTECH PVT. LTD.
03-NOV2012
Address: Bascon IT Park 56L, Venkatnarayana Road,
Phone Number :
T.Nagar
City: Chennai
To (dd/mm/yy)
Till Date
+91 44 6618 017
State: Tamil Nadu
Country
Postal Code: 600017
India
Job Title: PP AFS Consultant
Designation: Consultant
Reason of Leaving
Final Salary (Annual CTC):
Got married and wanted to relocate to
NCR region
Mode of Payment:
Direct Transfer
Cheque
Cash
Others (Please Specify Details)
Supervisor’s –
HR Manager’s –
Name: Mr. Suryanarayana Tata
Name: Karthik KK
Title: Project Manager
Contact Number: +91-44-66187000
Contact Number: +91 9866492929
Email ID: [email protected]
Email ID:
[email protected]
YASH TECHNOLOGIES
YASH-TAC-001-T002
Background Verification Form
Tick Mark The Documents Submitted for this
Employment while Joining at YASH:
Current Status of the Company:
In Existence
Offer Letter
Closed
Resignation Letter
Not Known
Resignation Acceptance
Relieving Letter
Service Certificate
Experience Letter
Salary Slips
Full & Final Settlement Document
None
Employer 2
Employee ID
Full Name of the Company
8814
From
(dd/mm/yy)
To (dd/mm/yy)
23-OCT-2012
Sonata Software Ltd.
20-June2011
Address
Phone Number
APS Trust Building
Bull Temple Road, N. R. Colony
+91-80-3097 1999
City: Bangalore
State: Karnataka
Country:
Postal Code: 560 019
India
Job Title PP-QM consultant
Designation System Analyst
Reason of Leaving
Final Salary (Annual CTC):
Better career prospects
Mode of Payment:
Direct Transfer
Cheque
Cash
Others (Please Specify Details)
Supervisor’s -
HR Manager’s -
Name: Bhaskar Biswas
Name: Padmashree. SV
Title: Project Manager
Contact Number: +91 80-30971999
Contact Number: +91 9811815900
Email ID: padmashree.sv@sonata-
Email ID: [email protected]
software.com
YASH TECHNOLOGIES
YASH-TAC-001-T002
Background Verification Form
Tick Mark The Documents Submitted for this
Employment while Joining at YASH:
Current Status of the Company:
In Existence
Offer Letter
Closed
Resignation Letter
Not Known
Resignation Acceptance
Relieving Letter
Service Certificate
Experience Letter
Salary Slips
Full & Final Settlement Document
None
Employer 3
Employee ID
Full Name of the Company
From
(dd/mm/yy)
To (dd/mm/yy)
17-June-2011
4-Apr-2009
Rahman Industries Ltd.
Address
Phone Number
184/167, Wajidpur, Jajmau,
+91-512-3931400
City: Kanpur
State: Uttar Pradesh
Country
Postal Code: 208010
INDIA
Job Title SCM executive
Designation Executive
Reason of Leaving
Final Salary (Annual CTC):
To work in SAP implementation projects
Mode of Payment:
Direct Transfer
Cheque
Cash
Others (Please Specify Details)
Supervisor’s -
HR Manager’s -
Name: M. Ahmad
Name: Intikhab Alam
Title: SAP PP Lead Consultant
Contact Number: +91 512 3935441
Contact Number: +91 9984943777
Email ID: [email protected]
Email ID: [email protected]
YASH TECHNOLOGIES
YASH-TAC-001-T002
Background Verification Form
Tick Mark The Documents Submitted for this
Employment while Joining at YASH:
Current Status of the Company:
In Existence
Offer Letter
Closed
Resignation Letter
Not Known
Resignation Acceptance
Relieving Letter
Service Certificate
Experience Letter
Salary Slips
Full & Final Settlement Document
None
Employer 4
Employee ID
Full Name of the Company
From
(dd/mm/yy)
To (dd/mm/yy)
26- Feb-2009
13-Oct-2008
G.H.P PHARMA PVT. LTD.
Address
Phone Number
A1/265, Paschim Vihar, Delhi – 110063
City Delhi
State Delhi
Country
Postal Code 110063
India
Job Title
Designation
Reason of Leaving
Final Salary (Annual CTC):
Do not want to continue in sales
Mode of Payment:
Direct Transfer
Cheque
Cash
Others (Please Specify Details)
Supervisor’s -
HR Manager’s -
Name: Tarandeep Singh
Name: Ms. Mohini
Title: Sales Manager
Contact Number: +91 011 45683343
Contact Number:
Email ID: [email protected]
Email ID: [email protected]
YASH TECHNOLOGIES
Background Verification Form
Tick Mark The Documents Submitted for this
Employment while Joining at YASH:
YASH-TAC-001-T002
Current Status of the Company:
In Existence
Offer Letter
Closed
Resignation Letter
Not Known
Resignation Acceptance
Relieving Letter
Service Certificate
Experience Letter
Salary Slips
Full & Final Settlement Document
None
REFERENCE VERIFICATION
Note – The reference provided should be currently employed or engaged in a professional activity.
**Please ensure that the contact numbers of the References are active numbers and are reachable for verification.
Kindly provide with the Professional References & not Personal/of relatives.
REFERENCE (1)
Full name of the Reference
Rais Ahamad
(Professional)
Contact Number
+91 9611137917
Email ID
[email protected]
Organization
UST Global
Designation
Software Developer
Relationship with the candidate
Friend
REFERENCE (2)
Full name of the Reference
Fareed Ahamad Ansari
(Professional)
Contact Number
+91 7569619652
Email ID
[email protected]
Organization
Accenture
Designation
Senior SAP PP consultant
YASH TECHNOLOGIES
YASH-TAC-001-T002
Background Verification Form
Friend
Relationship with the candidate
REFERENCE (3)
Harshavardhan B Reddy
Full name of the Reference
(Professional)
Contact Number
+91 9663392922
Email ID
[email protected]
Organization
Sonata Software Ltd.
Designation
Senior SD consultant
Relationship with the candidate
Friend
OTHER INFORMATION
Marital Status: Married / Unmarried / Other
Family Background:
Single (Father, Mother & Sibling details):
Name
Relation
Occupation
Contact Number
Location
Married (Father, Mother, Wife & Children details):
Name
S.K.Hassan
Jabur Nisha
Mahmooda Fatima
Relation
Father
Mother
Wife
Occupation
Business
House Wife
Student
Contact Number
+91 9319816234
+91 9369313224
Location
Kanpur
Kanpur
Kanpur
Do you have a Bond with your current employer? If yes, please give details of
the time period, amount and any other relevant details.
If you have any relatives / friends / acquaintances in this company working at
present or in the past, please give details.
Name
Department/Tech
nology
Relationship
Contact Number
YASH TECHNOLOGIES
YASH-TAC-001-T002
Background Verification Form
Awards / Achievements or Special Comments:
Areas of Interest:
Do you posses any technical certification/ training? (Specify):
CURRENT EMOLUMENTS
Details
Annual
Basic
House Rent Allowance
Special Allowance
Conveyance
Leave Travel Assistance
Medical Reimbursement
Medical Insurance
Provident Fund
Superannuation
Gratuity
16000
6400
5630
800
4000
1250
1920
Any other Benefits/ Perks (Please Specify)
of
Elements Of Compensation
Please list out all the perquisites, which can be measured monetarily including those benefits that
may be once in 2-3 years also.
Performance Bonus
ion mpensat o c
3792
TOT
AL
39762
YASH TECHNOLOGIES
YASH-TAC-001-T002
Background Verification Form
Last Appraisal Month/Year
% Hike in present Company for last appraisal
April
5.4 %
INFORMATION RELEASE FORM
To Whom It May Concern:
Please print
I____Hassan_________________Riyaz______________________________________________
Last name
First name
Middle name
I hereby authorize KPMG or their representatives to verify information presented on my employment
application/resume and to procure an investigative report or consumer report for that purpose.
I hereby grant authority for the bearer of this letter to access or be provided with full details
n
of my previous employment record held by any company or business for whom I previously
worked. This information should include the dates of employment; the nature of the position
held, [details of my salary upon departure] and an appraisal of my performance, capabilities
and character. In addition, please provide any other pertinent information requested by the
individual presenting this authority. I hereby release from liability all persons or entities
requesting or supplying such information.
n
of my qualification/degree (copy of my certificates attached)
n
information in respect to my character from the records maintained by local authorities
Riyaz Hassan
28 / July / 2013
Signature:
Date: dd / mm / yyyy
YASH TECHNOLOGIES
Background Verification Form
YASH-TAC-001-T002
