Background Verification Form
Note: Please Provide Complete and Accurate Information. Fields marked with an
astrics (*) are mandatory.
**COMPLETE NAME OF THE CANDIDATE: SACHIN LOHANI
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: Nerdapplabs Software Solutions Pvt. Ltd.
* Address: Sector 63, H-92, Noida
* Position Held & Department: Software Test Engineer
Office Telephone Land Line No: 01204221485
* Employment Period: (date, month, year) From 08th Feb 2016 To 20th May 2016
Employee Code (If Any): E055
Reporting Manager: Ashish Raina
1. (QA Lead in Nerdapplabs)
(Please give Name & Department)
Details of Last Employer (II):
* Employers Name & Branch: Thinksys Pvt. Ltd.
* Address: 1st Floor,Tower-C, Galaxy Business IT Park,
A-44/45, Sector 62, Noida, Uttar Pradesh
201309
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* Position Held & Department: Software Engineer(QA)
Office Telephone Land Line No: 0120 456 2034
* Employment Period: (date, month, year) From 13th October 2014 To 19th November
2015
Employee Code (If Any): 10176
Reporting Manager: Hemant Bhagwal
(Senior Software Engineer)
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
Uttrakhand Technical University
* Name of the University and College: Quantum School Of Technology, Roorkee
Location (town/city) with Complete Address: Quantum Global Campus
Mandawar (22 Km milestone)
Roorkee - Dehradun Highway (NH 73)
Roorkee # 247167
Uttarakhand India.
* Degree/ Diploma/ Course completed: [Link] with Computer Science Engineering
(Specialization if any)
From August 2010 To July 2014
* Period of the course: (month, year)
Roll/ Registration Number: 10430101055
Details of last 7yrs Address for Address & Criminal Verification:
* Complete Current Address: Sector 52, C-137, Noida (Rented)
Town/ City Name: Noida
* Phone Number: 9873321132
Duration of Stay (month, year) From 7th June 2015 To Currently living
* Complete Previous Address 1 : Sector 52, B-229, Noida
Town/ City Name: Noida
* Phone Number: 9643966273
Confidential Page 4
Duration of Stay: (month, year) From 13th August 2014 To 6th June 2015
* Complete Previous Address 2: Bharat Louge Hostel
Rampur Chungi
Roorkee
Town/ City Name: Roorkee
* Phone Number:
Duration of Stay: (month, year) From August 2011 To July 2014
* Complete Previous Address 3: Quantum School Of Technology,
College Hostel
Town/ City Name: Roorkee
* Phone Number: +91-9319909777
Duration of Stay: (month, year) From August 2010 To August 2011
* Complete Previous Address 4 : Corbett Tiger Reserve, Forest Compound,
Workshop Line, House No. 28
Town/ City Name: Ramnagar
* Phone Number: 9410335504
Duration of Stay: (month, year) From August 1994 To August 2010
* Complete Previous Address 5 :
Town/ City Name:
* Phone Number:
Duration of Stay: (month, year) From ___________ To _________________
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* Complete Permanent Address Corbett Tiger Reserve, Forest Compound,
(MANDATORY): Workshop Line, House No. 28
Town/ City Name: Ramnagar
* Phone Number: 9410335504
Duration of Stay: (month, year) From August 1994 To Currently Living
**Details of Professional References: Only from Senior Management Level
Reference 1 : Details :
Name Ashish Raina
Ph # 9911153431
Designation QA Lead at Nerdapplabs
Reference 2 : Details :
Name Shiraz Hoda
Ph # 9718476944
Designation Software Engineer at Thinksys
**Details of GAP if Any:
Reason for GAP 1 Personal Family Problems
Period of GAP 20th November 2015 to 7th February 2016
Address stayed during the GAP C-137, Sector 52, Noida
Reason for GAP 2 Did not find any new challenges to improve
my skills and learn something new.
Period of GAP 21st May 2016 to 10th June 2016
Address stayed during the GAP C-137, Sector 52, Noida
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
Confidential Page 6
Ration Card / Family Card
(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
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Final Degree Certificate / Education Marksheet / Highest Education Certificate / Passing
Provisional Certificate
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: 09 Jan 1994
Father’s Name (Complete): Janardan Lohani
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