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Background Verification Form Template

The document is a Background Verification Form that requires candidates to provide detailed personal, employment, educational, and address history information for verification purposes. It includes sections for mandatory fields, professional references, gaps in employment, and necessary enclosures for proof of identity, residence, and activity. The form emphasizes the importance of complete and accurate information to facilitate the verification process.

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Sachin Lohani
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0% found this document useful (0 votes)
25 views8 pages

Background Verification Form Template

The document is a Background Verification Form that requires candidates to provide detailed personal, employment, educational, and address history information for verification purposes. It includes sections for mandatory fields, professional references, gaps in employment, and necessary enclosures for proof of identity, residence, and activity. The form emphasizes the importance of complete and accurate information to facilitate the verification process.

Uploaded by

Sachin Lohani
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd

Background Verification Form

Note: Please Provide Complete and Accurate Information. Fields marked with an
astrics (*) are mandatory.

**COMPLETE NAME OF THE CANDIDATE:

Employment History:

If employment at current and previous employer does not equate to 5 Years then
provide details of all companies in last 5 years.

Details of Current or Last Employer (I):

* Employers Name & Branch:

* Address:

* Position Held & Department:

Office Telephone Land Line No:

* Employment Period: (date, month, year) From To

Employee Code (If Any):

Reporting Manager:

1.

(Please give Name & Department)

Details of Last Employer (II):

* Employers Name & Branch:

* Address:

Confidential Page 1
* Position Held & Department:

Office Telephone Land Line No:

* Employment Period: (date, month, year) From To

Employee Code (If Any):

Reporting Manager:

1.

(Please give Name & Department)

Details of Current or Last Employer (III):

* Employers Name & Branch:

* Address:

* Position Held & Department:

Office Telephone Land Line No:

* Employment Period: (date, month, year) From To

Employee Code (If Any):

Reporting Manager:

1.

(Please give Name & Department)

Confidential Page 2
Details of Current or Last Employer (IV):

* Employers Name & Branch:

* Address:

* Position Held & Department:

Office Telephone Land Line No:

* Employment Period: (date, month, year) From To

Employee Code (If Any):

Reporting Manager:

1.

(Please give Name & Department)

Details of Current or Last Employer (V):

* Employers Name & Branch:

* Address:

* Position Held & Department:

Office Telephone Land Line No:

* Employment Period: (date, month, year) From To

Employee Code (If Any):

Confidential Page 3
Reporting Manager:

1.

(Please give Name & Department)

Details of Highest Qualifications

* Name of the University and College:

Location (town/city) with Complete Address:

* Degree/ Diploma/ Course completed:


(Specialization if any)

From ___________ To _________________


* Period of the course: (month, year)

 Roll/ Registration Number:

Details of last 7yrs Address for Address & Criminal Verification:

* Complete Current Address:

Town/ City Name:

* Phone Number:

Duration of Stay (month, year) From ___________ To _________________

* Complete Previous Address 1 :

Town/ City Name:

* Phone Number:

Duration of Stay: (month, year) From ___________ To _________________

Confidential Page 4
* Complete Previous Address 2:

Town/ City Name:

* Phone Number:

Duration of Stay: (month, year) From ___________ To _________________

* Complete Previous Address 3:

Town/ City Name:

* Phone Number:

Duration of Stay: (month, year) From ___________ To _________________

* Complete Previous Address 4 :

Town/ City Name:

* Phone Number:

Duration of Stay: (month, year) From ___________ To _________________

* Complete Previous Address 5 :

Town/ City Name:

* Phone Number:

Duration of Stay: (month, year) From ___________ To _________________

Confidential Page 5
* Complete Permanent Address
(MANDATORY):

Town/ City Name:

* Phone Number:

Duration of Stay: (month, year) From ___________ To _________________

**Details of Professional References: Only from Senior Management Level

Reference 1 : Details :
Name
Ph #
Designation
Reference 2 : Details :
Name
Ph #
Designation

**Details of GAP if Any:

Reason for GAP 1


Period of GAP
Address stayed during the GAP

Reason for GAP 2


Period of GAP
Address stayed during the GAP

Enclosures:

(Proof of Right to Work)


Individual to produce one of the following
For non Indian citizens; Passport (with embedded photograph) with valid Employment
Visa or PIO card;
For Indian citizens;
Passport (with embedded photograph);
Work Permit
PAN Card (Card with photograph)
Voters ID Card (with embedded photograph)
Birth Certificate
Ration Card / Family Card

Confidential Page 6
(Proof of Identity)
Individual to produce one of the following
Passport
Driving Licence (not provisional / temporary and with embedded photograph)
Ration / Family card
PAN Card (Card with Photograph)
Voters’ ID Card (with embedded photograph)
Marriage Certificate (with embedded photograph)

(Proof of Residence)
Individual to produce one of the following
Driving Licence
Passport
Valid Proof of Address Card issued by the Government of India, Department of Posts;
Ration / Family card
Voters’ ID Card
Insurance policy or related correspondence
Bank Loan Document (personal / housing / education / consumer durables only)
Utilities Bill e.g. gas/electricity, landline telephone (not mobile)/ fixed line broadband bill
that includes the person's name and address (must be less than three (3)
months old if used for current address)
Society Maintenance Bill or Confirmation letter
Vehicle Registration Document
Residence Declaration Form
Tenancy Agreement / Hostel Receipt

If employees are unable to present one of the above mentioned documents as they live
with their parents or husband/wife, the following evidence may obtained:

􀀀If living with parents; PORTW acceptable document that shows employees full name and
father’s/mother’s full name AND POR acceptable document in father’s/mother’s full name.

􀀀If living with husband/wife; Marriage certificate that shows employees full name and
husband/wife’s full name AND POR acceptable document in husband/wife’s
full name.

(Proof of Activity)
Individual to produce one of the following
Professional Reference Employment Check verified with current and/or previous
employer(s)
Experience/Service Certificate
Offer/Appointment Letter
Salary Revision Letter
Relieving Letter or Acceptance of Resignation Letter
Evidence of redundancy / retrenchment
Evidence of job applications and correspondence (including declines)
Formal registration with an employment agency
For childcare activity: child’s birth certificate
Confirmation of employment letter;
Marriage Certificate
Travel, Immigration stamp/s in the passport or formal documentation from a recognized
travel company/airline evidencing travel during the period in question
 For gaps in employment due to medical reasons: letter from recognized medical
practitioner / hospital

Education Check
Final Degree Certificate / Education Marksheet / Highest Education Certificate / Passing
Provisional Certificate

Confidential Page 7
Note:
Proof of Residence
Current - If only current address history is required and this is less than six (6) months old
then previous address history must also be obtained.

Proof of Activity
Current or Last - This must cover the three (3) month period immediately prior to the date
of commencement of the individual providing contractual services to RBS. Except for
those documents evidencing full time education, any document presented must be dated
within three (3) months of the proposed date of the commencement of the individual
providing contractual services to RBS.
Last 2 years - This must cover a period of two (2) continuous years immediately prior to
the date of commencement of the individual providing contractual services to RBS. The
Supplier does not need to obtain evidence in relation to any periods or gaps of under three
(3) months however any periods or gaps over three (3) months must be verified and any
document presented must be dated within the period in which it is verifying.

Personal Details:

Date of Birth:
Father’s Name (Complete):

Confidential Page 8

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