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ACPL Background Verification Form PDF

This document is a background verification form requesting personal and employment details of an applicant such as name, date of birth, contact information, employment history including organization names, addresses, designations, dates of employment, salaries, reasons for leaving. It also requests reference details and authorization from the applicant to verify the provided information.

Uploaded by

VINOD VAUSHIK
Copyright
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We take content rights seriously. If you suspect this is your content, claim it here.
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180 views

ACPL Background Verification Form PDF

This document is a background verification form requesting personal and employment details of an applicant such as name, date of birth, contact information, employment history including organization names, addresses, designations, dates of employment, salaries, reasons for leaving. It also requests reference details and authorization from the applicant to verify the provided information.

Uploaded by

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

Employee Code Employee Department


Personal Details :- Please Use CAPITAL Letters
First
Name of Middle
Applicant
Surname

Father Name

Date of Birth Sex Male Female

Mobile No. Home Phone

Religion Nationality

EMPLOYMENT – 1 If you are still employed in this organization, please fill in the date before which you would not
like the verification to be initiated in the “to” column. If you are not sure or would like to intimate this date later,
please write 'Still Employed'

Organization Name

Complete Address

City State Postal Code Phone No.


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

Designation Department

Last CTC Per Annum Reason of Leaving

Supervisor Name Designation & Department Phone Number


/ Reporting Manager Name

HR Manager Name

Phone Number
EMPLOYMENT – 2

Organization Name

Complete Address

City State Postal Code Phone No.


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

Designation Department

Last CTC Per Annum Reason of Leaving

Supervisor Name Designation & Department Phone Number


/ Reporting Manager Name

HR Manager Name

Phone Number

EMPLOYMENT – 3
Organization Name

Complete Address

City State Postal Code Phone No.


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

Designation Department

Last CTC Per Annum Reason of Leaving

Supervisor Name Designation & Department Phone Number


/ Reporting Manager Name

HR Manager Name

Phone Number
REFERENCE VERIFICATION
Note – The reference provided should be currently employed or engaged in a professional activity.
Please ensure that the contact numbers of the reference are active numbers and are reachable for
verification. Also please ensure not to provide details of any relatives as reference.
Professional Reference - 1
Full name of the Reference

 Phone No.
 Email ID
 Organization
 Designation &
Department
 Relationship with
the candidate
Professional Reference - 2
Full name of the Reference

 Phone No.
 Email ID
 Organization
 Designation &
Department
 Relationship with
the candidate

To Whom It May Concern


Please Print

______________________________________________________________________________________________________________________________
First name Middle name Last name

I hereby authorize ACPL or their representatives to verify information presented on my employment


application/resume and to procure an investigative report or consumer report for that purpose.
I hereby grant authority for the bearer of this letter to access or be provided with full details
previous employment record held by any company or business for whom I previously worked. This
information should include the dates of employment; the nature of the position held, details of salary upon
departure and an appraisal of my performance, capabilities and character. In addition, please provide any
other pertinent information requested by the individual presenting this authority. I hereby release from
liability all persons or entities requesting or supplying such information.
of my qualification/degree (copy of my certificates attached)
Information in respect to my character from the records maintained by local authorities

Signature Date:- DD/MM/YY

For Employment Verification:


• Clear Photocopy of the relieving/experience certificates
• Clear Photocopy of Salary Slips
• Employee Code of the organization

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