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TATA
PRE-JOINING CHECKLIST
Read all instructions carefully before filling form
Fill in CAPITAL letters only
Details & Documents provided in this form will be subjected to verification as a process of
background check (BGC).
It primarily includes checking of Address (wherein our field executive will visit all addresses), Police
and Court Records, Reference, International Database, Identity, Education and Employment.
Additional checks if any may be conducted as per business requirement. e.g.: You may be advfsed
to undergo DRUG TEST (if and as applicable for process being hired), social media, credit rating etc.
Details provided in this form should match with:
1) Resume shared during interview
2) Information updated online @ https://grs.tcs.com/ep/index.jsp
3) Documents being submitted.
Please provide 2 photocopies of each document. Do Not Submit Any Originals.
However, refer original document to accurately capture all details.
This would help avoid your verification being reported negative post verification.
Be cautious while capturing details related to Employment (viz.Joining Date, Last Working
Date, Supervisor Names, Salary Details, Designation), Education (viz.dates, roll no, marks),
Address (viz. period of stay, pin code etc.) .
• Medicals: (Format/ Form available with recruiter)
• For age below 33 - Provide Medical Certificate from a Registered Doctor (MBBS/MD/MS)
• Forage 33 and above - Full Medical Check
ADDmONAL DOCUMENTS TO BE SUBMITTED (IF APPLICABLE)
• MARRIAGE REGISTRATION CERTIFICATE (gazette copy in case of name change post marriage)
• NAME CHANGE CERTIFICATE (gazette copy in case of name change in general)
• DUAL CITIZENSHIP DOCUMENT (if applicable)
• WORK PERMIT : Expatriates working in India should provide work permit, visa endorsements
• INTERNATIONAL: SSN #,IRS#, Taxation document/ Financials for past Experience
• DOCUMENTS PERTAINING TO CHANGE IN GENDER
For Experienced Candidates: UAN
Universal Account Number is a twelve digit number generated and allotted by EPFO (Employee Provident Fund
Organization, India) to employees who contributes in EPF (Employee Provident Fund) ·
Universal Account Number (UAN) 1. 0 1. 3 5 3 3 R. .6 Q, i '-I
Do connect with our RECRUITMENT OFFICER for any clarification
TCS Confidential Background Check Form Version 7
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TATA
DOCUMENT UST
1.Copy of Pan Card / Pan Card application number {Mandatory)
2. Proof of Citizenship (copy of Birth Certificate / Passport / School Leaving Certificate / Voters ID/Transfer Certificate)
(Mandatory)
3. Only one Copy of Aadhar card for Provident Fund {Mandatory)
Documents for Employment (please tick on submitted document) '
FOR CURRENT EMPLOYMENT:
: I 1. Appointment Or Offer Letter
2. Relieving / Experience / Resignation Acceptance Letter / Service Certificate
j If not available, Recruiter to sign on candidates declaration along with employee id
II 3. Salary Slips (Last 3 Months)/ Salary Certificate
If above documents are not available, please provide BANK STATEMENT copy for entire tenure
ALL PAST EMPLOYMENT {Post HSC /12tii For Under graduates)
1. Appointment Letter Or Offer Letter
2. Relieving Letter Or Service Certificate Or Experience Letter
Docli~ents for Education {Highest Q4~lifjcation) (plea"se tick mark on submitted document)
1. Passing Certificate / Convocation For Graduation & Post Graduation
2. All Semester Or Consolidated Mark Sheet For SSC, HSC, Graduation & Post Graduation
• (If Undergraduate Then Till 12th )
Documen1;s.for.pl'.Oof ,o f address:' ""' "' ' t ~- 'I'"> ..,.
1 each if resent current & er,nanent address-is .cliffere,:it. Please,;/ on suHmitted document .
1. Valid Passport (Also Valid For Id Proof)
2. Voter Id / Electors Photo ID (Also Valid For Id Proof)
3. Driving License With Address
4. Utility Bill With Address (Not More Than 3 Months Old From Date Of Submission)
(e.g.: Land Line/ Post-Paid Mobile Bill, Gas/ Electricity /Water Bill)
5. UC Policy Document With Address
6. Leave And License / Rental Agreement Copy (Registered) With Address
7. Valid Ration card With Address
8. Owners Letter Dedarin candidates Sta Alon With Owners Utili Bill With Address
NOTE:
Declaration templates are available at Document Collection Center to support Non availability of employment / education
documents
TCS Confidential Background Check Form Version 7
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TATA
BACKGROUND CHECK FORM
Please fill this form in BLOCK LETTERS
Are you relieved from the services of current Company at the time of submitting this form? YES / NO/ NA
N~me of the ApP-lican~: (Full name as per ID proof):
F1 ·" c 1, • Middle Name
Mobile No.: Alternate No: E-Mail
~f58~q~o~o4 ~qc{i).
Father's Name:
e e
Spouse Name:
First Name Middle Name Last Name
Date of birth Attach Proo
Present Residential Address : (Stated address cannot be temporarv or in transit mode)
\From: \ To: Landmark:
Period of Stay
MMMtYYYY MMM/YYYY
115~/1 N'frft[tlh~ .-- ioB:A"S'PYidE.i<tllHrl pM:tt~f,tt:tStaJ IJJ t~Jres~:)
I(-,
..
.~•... ,-t''.)'li'·i,,
,
''- . ;, . c• \i Ut ,.,J - ,,}J;l;-.. ~1;' P"'ctai
v.~ ::i-"'"'ir•:.,r····'
I QI•..". ,'·w,;_:;,;
City/Town: Ho11JRAJ.I State: W£ST 8fH"6JAI..- Pin Code: ""f II 1o /
Address of Longest Stav in. Last 7 Years: (Tick here If Same As Present Address)!
Period of Stay \From: \ To: Landmark: I
MMM/YYYY MMM/YYYY
115~/1- N°€.TA:JI. SuBA~1-1c··
• • - . \ RcAb'•1·•;
,·• • Ha·
... l'>.. 'F• -'..A• f11n,%HJ.D
•• • .4 \;,, • -· •,/
.. ,1,r{. ., ·.,r
1
.
., ., l - I ~1 ·l ;· .
~,j\,fvo) Ol ..:: ... ,,i.J , c:,::.>j
l, ,.,.. '> •
Pin Code: 1/ I /0 I
'
City/Town: HowRIIH State: we~1 0£N"Gtfl'--
Contact No: 9.68'R.qqo~04 .
P~rmanent AddJeS~t
Name of any family member residing at below address
(Tick here If Same As Present Address)
-
Iv I
Period of Stay From: To: ILandmark:
MMH/YYYY MMM/YY'f Y
- .. r' ..- -ir ,' i!,--•I
ti-.......,_i..,,.
f . ."' I
- ,· , : ... ' ...:::: ··•;
. .
.. ) t <..:,
,, , 1 t ,; 1-.,._
' ;
<>!. ·'<,'-... ,~ I
1:>:
, \.\..
. i ~:
,.,,
rj,
..,. ' . ...:
State: Pin Code:
City/Town:
Contact No:
l
TCS Confidential Background Check Form Version 7
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TATA
Edu~tional Qualifi~tioq~ {A~ch Proof) sGc UNIQUE m crinec1 by H~):....,== - - - - - - -
Ment,on qualifications completed & passed out from a recognized Institute/ University under UGC ACT_1956.
Name as in Certificat, -
,.
r,. . Qualification
Mode %f;ucation , -
Highest Qualification
(Considered for recruitment)
Select Mode
l Qualification
(Prior to Hiahest"O_ualification)
Select Mode
..I
_(Full ti e /Correspondence/ Part time):
BlA(_B~~ oJc?.0¥~
Name of Examination Pa~
(B.E, M.Tech, BCom, BSc, etc.):
Specialization / Main Subjects:
Name of Institute / College : µo~CJuli
University:
(ONLY RECOGNIZED)
.1t,c,k'V\19 _UC\.
Institute/
College/ Affiliated University Location: J<o.ihk
University
Date From : or&i-11vta-01 5
Details
Date To: 111~wv~e IB
Seat No / Roll No / Regn No Is 30 C\ I O I O O I ,1 o} ~or 15 • ~o I l,
Year Of Passing n YY ~otf
% of Marks / Grade G•l'lCl I
- J , / /
Please tick on pending semesters I ATKT / Backlog I II III IV V VI VII VIII
, ,
Please tick if Results / Mark sheet / Passing Certificate awaited for any semester I II III IV V VI VII VIII
Rstl'kPrnnnrl C:hP.«-k Fnrm VP.rdnn 7
,.-,,-,c r'nnfirli>nti!ll
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TATA
E_f!lpJoy_~~nt Q_etails ('lt:t;~ch Pro9f} ·
**For International Employment, please mention Work/ SSN / Unique number issued by country of work: _______________
Please declare gaps if any in Education or Employment or in between education & employment in the gap section
Previous Emplover's<Des~riotion ~:;_,.. ·Pr evious EmolQvment l (last befdre··TCSl,;-· ~" ·•· •·: ·. >,: Previous .Emi>lovinent 2 _'1/:;-J-·..
Employer Name: (~ ~e ~
..~ o) · - ~ ~ of.the ~
')II.ti..
= py T L, T..D
Employer
Details
(if deputed,
then please Address of the payroll DN Q ,AA,/ ...t; Y ~Y)t\Aq,t 100091 PiJtAf- fJ.o.,.,., N"~ {!.s,,,,mt,tc.M r.t ·; LD :1<1$. rt}l'O I::f
provide both company: Town/City: ko~ " Town/City: ko~
Parent and
Pin Code: -:/:0 oo 1-:f
Deputed
organization
Office Landline No.:
State: IA\olll- Yl • ..,,.I
Landline
Pin Code: 10oo~ I State: W.ul- ~,-,,. I
LandHne ,
names)
HR e-mail ID : ./ /
Company Status : Company functional? Yes / No Company functional? Yes / No / Don't Know
Date of Emp. From : 6''(;J'~5 /~'O Q 2 ·:r,,, ...._:,.-· ·" '. '/{'./
Period
Date of Emp. To: .p.;,1,
··- .·~.- ~.rYI-
t . : ci '\·' •::·..: f·t· 1'\.,
Designation : ~V(
Employee Code :/**
Employee
Details Annual Gross CTC : I · Lr ./ /
Remuneration Receivellllln Cash / CreditecfTo Bank Received In Cash/ Credited To Bank
Reason for Leaving :
Supervisor Name :
Supervisor Designation :
Supervisor LandHne
Landline
Details Supervisor Ph No.:
(Please provide official email id ) (Pl ea~ proviiie official email id)
Supervisor Email :
Yet To Resign I Resigned with notice I Resigned without notice Resigned with notice period I Resigned without notice period
Please On Exit Status oerlod oerlod
Ra«'kuronncl C'hP.«'k Form VP.r~ion 7
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TATA
Profession I R ·
- -~ , ."'""' . a
N eference Deta1·1 s:
OTE:
References of friends &. .
References of II relatives shall not be co "d
. . co eagues from previous org . n~, er~d. References of Professors/ Doctors/ Lawyers accepted.
anizations 1s acceptable Avoid ref f
' . ,,
Details
~.
erence ram current organization .
' """'
Reference Nam (M . · ·· l Reference 1
rob e • 0 ~~li~s/m~~ Reference 2
e Drov,ded as Reference)
G.~~
•,,
Organization name: ~\V(
Desicmation:
~).;~ l,,J.i~ J;~+J
ls the above mentioned Reference from
your current Organization :
Referee email ID:
11 NO YES El/ NO
Landline Telephone No.:
Mobile Phone No.:
~Gq"fO~t,002 lt Qo I I 00 .R.o
Period for which the Reference knows
the Aoolicant (minimum 6 Months)
Relationship with the Applicant
(No Relatives/Friends)
..
. ' "
. ...... Details
., "~,, • < ~--,~· ,,,_. .,j;;,;, ""'". . . ., ?\: 't Reference 4
s<· .. ,~ . ;:;," ., ·. . ,. ,._ 'i\.:
. - ' .'t.c •.
._, :· - :'·Reference'3"'¾>"'~
¢1;~~ ,. . ¥!!'., .~ . Y
t .,. ., , ...
'<h• ,
:~)l<,"
,
. _ ·. /~- ;1~. · " " ·•
'i'
• --t- •
Reference Name {No Relatives I Friends '
to be provided as Reference)
Organization name:
Desiqnation:
Is the above mentioned Reference from
your current Organization : YES / NO YES
Referee email ID:
Landline Telephone No.:
Mobile Phone No.:
Period for which t~e Reference knows
the App r,can t (minimum
. 6 . Months)
nt
Relationship with ~e Apphca
(No Relatives / Friends)
Background Check Form Version 7
TCS Confidential
~"' Ga~s during
· ·. Ed . TATA
Please mention deta· Utataon/1:rn I
(Gaps between ec1u:!~~ ~ny Qaps for a p!!!~ent (Attach Proof)
_
~- ernployment or b tw ore than 30 day.
,_ e een emplo
, Gap 1
,_
.,
- From To Yments or between educations)
-...;/~'.... .
I\.;,' ''( \'if"'
'"{''.'
' l,.
Reasons for gap (with supporti'!9 d~)
' .-~-.;'· Gap·2
I-'-
'
' Gap3
. ,; '
",
I
C
' -Gap,4_
\
I' "
''
Ga·p S ·1.,
- ',,
'
'•'
A) Is any case pending against you in an C . .
8) Is any case pending against ou in an Y o~rt ~f Law at the time of filling this Background Check Form? YES/NO
up this Background Check F:rm? YESY/U~rs1ty or any other educational authority/ institution at the time of filling
If the answer to any of the ab . . . ' , .
st
;~11·
conviction / sentence / punish~~et~ntion:~ que ions is Yes give full particulars of the case /arrest/ detention /fine
Educational Authority etc at th ~- e c. or the _nature of the case pending in the Court / University /
., e 1me o I mg up this form. (Attach additional sheet, if required)
Passport De~ils.,(. Attach,_ Prgef):;
(i) Name as in Passport:
(ii) Passport No.:
---------------------
(iii) Place oflssue:
(iv) Date oflssue:
---------- (v) Expiry Date :----------
----------
PAN Card Details °(Attach Proof}:1
Name on PAN Card: C. RN"'fK 301 eD PAN card Number: A~HIJ & _kfJR[IR
DECLARATION (To be signed by the Applicant)
I certify that the information furnished in this form is factually correct & complete in all respects to best of my knowledge & belief.
Name: ft/JrW.~ Jw.w,
Date
- ')./I.,/
,1-r,--------
f)..OQ2
This is an electronically captured form and hence does not capture manual signature.
.TCS Confidential Background Check Form Version 7
