Employment application form

PwC SDC

Full name
(in block letter) (First name) (Middle name) (Surname)

Please mention your name as on Pan Card/ Passport.

Please read all instructions carefully and complete all sheets accurately.
Please mention dates in "DD/MM/YYYY" format only (for eg : 31/08/2010).

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Personal information

Name
(in block letters)

Gender

Father's name
(in block letters)

Date of Birth (DD / MM / YYYY)

Affix your
most recent photograph

Marital status

Date of marriage (DD / MM / YYYY)

Nationality

Birth location Birth country

(City/ State)

Languages spoken (mother tongue first):

Language 1 Language 2 Language 3 Language 4

Language

Speak

Read

Write

Current address

Address line 1 (house no.

/apartment name)
Address line 2 (street
name/area name/plot no.
/sector)

Address line 3 (location

name/landmark)

City State

Contact no.
Pincode
(home)

Contact no.
Email id
(mobile)

Emergency contact Relationship with

person employee

Emergency contact no.

Permanent Address

Address line 1 (House no.

/apartment name)
Address line 2 (Street
name/area name/ plot no.
/sector)

Address Line 3 (Location

name/landmark)

City State

Pincode

Name Signature

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Academic background

Upto Graduation
Dates (DD/MM/YYYY)
Examination passed School/ Institute Board Percentage of marks/CGPA
From To Part Time/Full Time
□

SSC / 10

HSC / 10+2

Graduation
Dates (DD/MM/YYYY)
Examination passed Institute/College University Percentage of marks/CGPA
From To Part Time/Full Time
□

Post Graduation only

Dates (DD/MM/YYYY)
Examination passed Institute/College University Percentage of marks/CGPA
From To Part Time/Full Time
□

Professional Qualification
Current
Dates (DD/MM/YYYY) Percentage of
Name of course Institute status
From To Part Time/Full Time
□ marks/CGPA
(Valid/Inv

If CA please tick as applicable

CA Qualifies CA Qualifies CA Qualifies CA Qualifies

Inter Qualified Year
1st attempt 2nd attempt 3rd attempt 4th attempt

Break in studies (If any) From dd/mm/yyyy To dd/mm/yyyy

Reason

Break between completion of study and employement (If any)

Years Months

Reason

Name Signature

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Employment history (In chronological order beginning with the current organisation. Information provided should be supported by relieving/ release letter at the time of joining)

Tenure in the organisation

Organisation name Designation *Annual cost to company
(DD/MM/YY)
(First Party/Third Party/Deputation/Etc.) -
as per documents Reporting to Department and role
From To
On joining At the end On joining At the end
(DD/MM/YYYY) (DD/MM/YYYY)

Benefits from last employer (Tick your response)

1. Office car (describe entitlement) : Yes No

Break During Employment (If any) From dd/mm/yyyy To dd/mm/yyyy

Reason

Name Signature

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Other information

Job Related capabilities:

Yes No
Would you be willing to relocate?

Have you applied to us before?

Yes No

If yes, please share details.

What is your desired salary?

What is your preferred joining date?

References

(Please provide details of professional references (supervisors or seniors you have worked with)

Reference details Reference 1 Reference 2

Name

Address

Contact number

Position/Title

Organisation

Period of acquaintance (years)

Nature of acquaintance

Can PwC SDC contact this referee prior to

an offer acceptance being made? (Yes/

Note to interviewer: Joining date 2 Monday in month

Do you have relative(s) working in PwC SDC or PwC network? Yes No

If Yes, please specify the following

Location & Employee Relationship with the

Full Name
ID employee

Please note, PwC SDC personal relationship at work policy requires full disclosure for all relationship prior and during employment with PwC SDC. Relationship include but not limited to
spouse, parents, siblings, cousins, uncles, aunties, niece, nephew, in-laws, personal intimate relationships etc.

Name Signature

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 GOVERNMENT HIRE STATUS Yes No
(Please answer this question as "Yes" or "No" post
reviewing the explanation/definitions provided below)

Do you have an immediate family member in a position as or a business relationship with any state (government)-working personnel?
Definitions:

• Immediate Family: Means the applicant’s

o Spouse* / Spouse equivalent*
o Children
o Parents
o Any other relative providing financial support to the applicant
• Business Relationship: Means any relationship to or ownership of a proprietorship, partnership, firm, corporation, trust or other entity
through which business is conducted and a state(government)-working personnel is an owner, director, officer, partner, beneficiary of the
entity. Owner must be more than five percent of the business.

*Spouse: A husband or wife, either by marriage or under common law, is considered a spouse
*Spouse Equivalent: A cohabitant occupying a relationship generally equivalent to that of a spouse would be considered a spouse
equivalent

Name: Relation:

Workplace: Designation:

Currently Working Yes No Sector:

Name: Relation:

Workplace: Designation:

Currently Working Sector:

Yes No

Relation:
Name:

Workplace: Designation:

Currently Working Yes No Sector:

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Identification details

PAN number
*Mandatory document to be submitted within 2 months of joining
Do you have appropriate
entitlement to work in India Yes No

(e.g. Visa, India passport)

Do you have a passport Yes No Country of citizenship

Passport no.

Date of issue

Date of expiry

Place of issue

Visa details-to work

in other countries

VISA date of issue

VISA date of expiry

Please provide full details in case you select "Yes" as an answer to the following questions Yes No
(Tick yes or no in the respective box)

Have you ever been arrested by police for any reason?

Did any one make /lodge any FIR against you:

Declaration

I certify that the information furnished above is factually correct and subject to verification by PwC SDC(including
Reference Check and Background Verification) I accept that an appointment given to me on this basis can be revoked
and/or terminated without any notice at any time in future if any information provided by me has been falsified,
misleading or deliberately omitted/suppressed. I provide my consent to PwC SDC to share my relevant personal
information with internal departments/vendors/regulators or any other parties who are involved in facilitating my on-
boarding formalities, entitled benefits administration or any other subsequent matters related to my employment. I
also certify that I am at present in a sound mental and physical condition to undertake employment with PwC SDC.

I agree Yes No

Date (DD/MM/YYYY)

Place Signature

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