CANDIDATE DECLARATION FORM

Note:
All * fields are Mandatory;
Applicant No / Employee ID (Office
For Official purpose Only Candidate Date of Joining: (DD/MM/YY)*
Use Only)

Candidate Personal Information* Please affix your recent photograph

Full Name (First, Middle, Last)*: Former Name / Maiden Name (if applicable)*:

Candidate Date of Birth (dd/mm/yy)*:

Father's Name*:

Social Security Number: Nationality*:

Photograph
Gender*:
(If Applicable)
Male
Female Marital Status*: Married Single

Mobile Number*: Home Landline Number*: Email id*:

Address Details*:
Candidate Current Street Address*:

City*: ____________________________ State*: _______________________ Pincode*: ________________ House Type*: Owned                   Rented 

Prominent Landmark*: _______________

Stay since when*: __________________ Alternate Contact No*: ___________________

(mm/yy)
Candidate Permanent Street Address*:

City*: ____________________________ State*: _______________________ Pin code*: ________________ House Type*: Owned                   Rented 

Prominent Landmark*:_______________

Period of Stay*: ___________________ --- ___________________ Alternate Contact No*: __________________

From (mm/yy) To (dd/mm/yy)

Address History*
Instructions:
1. We require your address history;
2. Kindly include all addresses that you have stayed at excluding current address & permanent Address as these details are provided above;

Period of stay* State* Country* Pin code* Premises Concern Person's

Street Address*
From (mm/yy) --- To (mm/yy) Contact number (if you have);
1

Educational Qualification*:
Instructions:
1. Please attach clear copies of the following documents relevant to your entries in the form;
2. Please furnish the Education Mark sheets/Certificates (wherever applicable):
a. 10th/Equivalent;
b. 12th/Equivalent;
c. UG/PG (All Graduates) mark sheets & Certificates;
d. Professional/Other degree/diploma certificates.
Education Details*:
Duration of Course*

Qualification* Degree* College/University name & Location*

From* To*
(mm/yy) mm/yy)

10th / Equivalent Yes † /No  †

12th / Equivalent Yes † /No  †

 CANDIDATE DECLARATION FORM
Note:
All * fields are Mandatory;

Under Graduate Yes † /No  †

(UG)

Post Graduate Yes † /No  †

(PG)

Other Yes † /No  †

Qualification
Other
Qualification Yes † /No  †
Professional Certification*
Duration of Course* Full Time (FT) or ID / Roll No.*
Qualification* Institute's Name & Address*
From (mm/yy) To (mm/yy) Part Time (PT)*

3
Employment History*
Instructions:
1. Verification for current employment will be carried out post joining a new company or once authorization is received from client/candidate to initiate verification;
2. Please provide past years experiences/previous employment details;
3. Please furnish relevant documents (Offer Letter, Appointment Letter, Experience Certificate, Pay slips, Relieving Letter) for all entries listed below;
4. Please provide agencies name^, in case temporary or contractual employment.

1 Permanent   
Yes  †
Temporary
No  †
Contractual

2 Permanent   
Yes  †
Temporary
Contractual No †
No  

3
Permanent   
Yes  †
Temporary
No  †
Contractual

4 Permanent   
Yes  †
Temporary
Contractual No  †

Permanent   
Yes  †
5 Temporary
Contractual No  †

Current CTC* Agency Name^ (if temporary or contractual)

1
2

3
Professional References*
Designation Held* Professional Contact Details*
Name* Organization Name*
Relationship* (Email Id & Contact No.)

Please account for all the gaps in education/ address or employment during your tenure
Gap type: Employment     † Education † Address    † From (DD/MM/YY) To (DD/MM/YY)

Reason for Gap :       
 CANDIDATE DECLARATION FORM
Note:
All * fields are Mandatory;

Gap type: Employment    † Education † Address    †

Reason for Gap :       

Gap type: Employment   † Education † Address    †

Reason for Gap :       

Criminal Details*:
Have you ever been charged or convicted for any criminal offence in India or abroad?* If yes, please provide details:

Yes † No †
Documentary Proof *:
Pan Card No*: Aadhaar No: Aadhaar Acknowledgement Slip Date & Time:

Passport No: Aadhaar Enrolment No: _ _ _ _ _ /_ _ _ _ _ / _ _ _ __ _ _ _ _ : _ _ _ _: _ _ _ _

DD/MM/YYYY HH:MM:SS

Authorization/ Declaration and Undertaking:

I hereby authorize ONICRA Credit Information Company Limited, and/or any of its subsidiaries or affiliates, and any persons or organization acting on its behalf to
verify the information presented on this application form and to procure an investigation report, Drug Test report or consumer report for that purpose.
I hereby grant authority for the bearer to access or to be provided with full details of my previous record. In addition, please provide any other pertinent information
requested by the individual presenting this authority.
I certify that the statements made in this application are valid and complete to the best of my knowledge. I understand that false or misleading information may result in
termination of employment.

If upon investigation, any of this information is found to be incomplete or inaccurate, I understand that I will be subject to dismissal at any time during my employment.

I hereby release all persons or entities requesting or supplying such information from all the liability.

I have read, understood, and consent to these statements listed above.

Full Name*: Signature*: Date*:

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