Reference Check Form
CSP Name: ‐
First Name: ‐…………………………. Middle Name:……………….…Last Name:……………….
Gender (M/F):…………………DOB:……………………………
Father Name:
First Name:………………………………Middle Name:…………………………..Last Name:……………………………
Mother Name:
First Name:…………………………………….Middle Name:…………………………….Last Name:………………………..
Accommodation: ‐ Own Rented
Permanent Address: ‐
Street/[Link]……………………………Landmark……………………. Village………………………………Po………………………………..
Tehsil………………………………………………District………………………State: ………………………………Pin Code………….………
Current Address: ‐
Street/[Link]……………………………Landmark……………………. Village………………………………Po………………………………..
Tehsil………………………………………………District………………………State: ………………………………Pin Code………….………
Communication Detail: ‐
Email ID: …………………………………………… Landline No:………………………………………Mobile No.:……………………………
Qualification:
Undergraduate/Graduate/Postgraduate……………………………………………………..
Reference detail other than relative:
Reference 1: Reference 2:
Name: ‐____________________ Name: ‐____________________
Address: ‐__________________ Address: ‐__________________
Contact: ‐__________________ Contact: ‐__________________
Job Experience: Yes /No
Last Employer name………………………………………………………. Designation:………………………………………..
From: ……………………………………. To:……………………. Reason of Leaving:…………………………………………
Relationship with Axis Bank: Yes/No
Bank A/c No.: ‐___________________________________
Loan A/c No.: ‐___________________________________
Credit Card No.: ‐_________________________________
Signature of Applicant
…………………………………………………………………………………………………………………………………………………………………………………….
For MBS Official use Only
MBS verifier must verify the below mentioned questions at the time of verification.
Company with which he/she was working before-
_______________________________________________________________________________________________
➢ Reason of leaving job-
________________________________________________________________________________________________________
➢ Any negative observation with organization-
_______________________________________________________________________________________________________
➢ How long does the reference person know the candidate?
________________________________________________________________________________________________________
➢ How was his/her conduct in the organization?
_________________________________________________________________________________________________________
➢ Was he/she ever suspended or terminated from service due to disciplinary action? If yes, why?
_________________________________________________________________________________________________
I hereby certify that I have done the verification of the candidate and the information furnished above by
the candidate are ______ (true / false) and therefore the candidate is _____________ (approved / rejected).
Reason for rejection- _______________________________
Verified by
Name of the Employee:
Emp Code:
Designation:
Date: Verifier Signature